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TEST BANK for ATI Pediatric Proctored Exam
With NGN Questions and Verified Rationalized Answers
With 400+ Questions and Answers
1. A nurse is teaching the parent of a preschooler about ways to prevent acute
asthma attacks. Which of the following statements by the parents indicates and
understanding of the teaching?
a. "I will use a humidifier in my child's room at night"
b. "I will give my child a cough suppressant every 6 hours if he has a cough."
c. "I should avoid using a wet mop on my floors when I am cleaning."
d. "I should keep my child indoors when I mow the yard."
Ans>> "I should keep my child indoors when I mow the yard."
The nurse should instruct the parent to keep the preschooler indoors during lawn
maintenance or when the pollen count is increased. Guarding against exposure to
known allergens found outdoors, such as grass, tree, and weed pollen, will decrease the
frequency of the preschooler's asthma attacks.
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2. A nurse is assessing a 6-year-old child immediately following surgery for a
perforated appendix.Which of the following findings should the nurse expect?
a. Purulent drainage from the NG tube
b. Hypoactive bowel sounds
c. Passage of dark-red stool with mucus
d. Urine output of 20 mL/hr
Ans>> Hypoactive bowel sounds
The nurse should expect hypoactive bowel sounds following appendiceal rupture or if
the child has developed peritonitis. Additionally, hypoactive bowel sounds are an
expected finding immediately following abdominal surgery, until full peristalsis
resumes.
3. The nurse is assessing a school-age child who has an acute spinal cord injury
following a sports injury 1 week ago. Identify the area the nurse should tap to
elicit the biceps reflex
Ans>> A is correct. The nurse should identify that this is the location to tap to elicit
the biceps reflex.
B is incorrect. The nurse should tap this location to elicit the triceps reflex.
C is incorrect. The nurse should tap this location to elicit the brachioradialis reflex.
4. A nurse on a pediatric unit is caring for a toddler.
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Which of the following potential provider prescriptions should the nurse
identify as anticipated or contraindicated?
Potential Provider's Prescription: (Anticipated or Contraindicated)
1. Administer factor VIII
2. Apply ice packs to the infected joints
3. Administer morphine PRN pain
4. Perform passive range-of-motion (ROM) exercises during the first 12 hr
following injury
5. Elevate the affected joints: Administer factor VIII is anticipated. The child is
experiencing an acute episode of hemophilia due to a recent fall. During this acute
episode, there is potential for internal bleeding into the joint spaces. Therefore,
administering factor VIII is anticipated to control bleeding.
Apply ice packs to the affected joints is anticipated. The child is experiencing an acute
episode of hemarthrosis due to a recent fall, as evidenced by the bruising and
swelling of the knee joint. Therefore, applying ice packs to the affected joints is
anticipated to manage discomfort and decrease bleeding into the joint.
Administer morphine PRN pain is anticipated.The child is experiencing severe pain.
Opioids can be administered in the inpatient setting to relieve pain. Otherwise,
acetaminophen can be given at home for pain. Aspirin and NSAIDs should be avoided
because they inhibit platelet function and might increase bleeding.
Perform passive range-of-motion (ROM) exercises during the first 12 hr following
injury is contraindicated.The child is experiencing an acute episode of hemarthrosis.
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Passive ROM exercises can increase bleeding into the joint for the first 48 hr
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following injury. The toddler should be encouraged to exercise the joint as tolerated.
Elevate the affected joints is anticipated.The child is experiencing an acute episode of
hemarthrosis due to a recent fall, as evidenced by the bruising and swelling of the
knee joint. Elevation of the joint, along with the application of ice, is anticipated to
help decrease bleeding and swelling in the joint.
5. A nurse is providing discharge teaching to the parent of an 18-month-old
toddler who has dehydration due to acute diarrhea. Which of the following
statements by the parent indicates an understanding of the teaching?
a. "I will offer my child small amounts of fruit juice frequently.."
b. "I will avoid giving my child solid foods until the diarrhea has stopped,"
c. "I will monitor my child's number of wet diapers."
d. "I will give my child polyethylene glycol daily for 7 days."
Ans>> "I will monitor my child's number of wet diapers."
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The nurse should teach the parent to closely monitor the child's number of wet
diapers. Monitoring the number of wet diapers per day is an effective way for the
parent to monitor adequate output and hydration status.
6. A nurse on a pediatric unit is caring for a school-age child.
After reviewing the information in the child's medical record, which of the
following findings should the nurse address first?
The nurse should address the child's (oxygen saturation/joint swelling/fever)
followed by the child's (pain/anemia/hydration)
Ans>> Dropdown 1:
Oxygen saturation is correct. The child's pulse oximeter reading is below the expected reference range.The nurse should take action to maintain the child's oxygen
saturation above 95%. When using the urgent vs. non-urgent approach to client care,
the nurse should identify that addressing the child's hypoxia is the priority
intervention.
Joint swelling and fever are incorrect. Swelling of the joints is non-urgent because it is
an expected finding for a child who has sickle cell disease. A low-grade fever is an
expected finding for a child who is experiencing a vaso-occlusive crisis. Therefore,
there is another finding that is the nurse's priority.
Dropdown 2:
Pain is correct.The child reported their pain as 8 on a scale of 0 to 10, which indicates
severe pain. Vaso-occlusive crises can cause severe pain due to tissue ischemia from
sickled cells obstructing blood flow. When using the urgent vs. non-urgent approach
to client care, the nurse should identify that addressing the child's pain
is the priority after addressing the child's hypoxia.
Anemia and hydration are incorrect. The child's hemoglobin and hematocrit levels
are below the expected reference range. Medications are often prescribed to increase the production of red blood cells. However, this is a non-urgent finding. The
child's oral mucosa indicates dehydration, which can worsen the manifestations of a
vaso-occlusive crisis. However, this is a non-urgent finding. Therefore, there is
another finding that is the nurse's priority.
7. A nurse is caring for a school-age child following an appendectomy.
After reviewing the information in the child's medical record, which of the
following findings should the nurse identify as a potential complication?
Select the 3 findings from the child's medical record that the nurse should
identify as indications of a potential complication.
WBC count, Oxygen saturation level, Platelets, Abdomen assessment, Temperature, Abdominal dressings assessment: WBC count is correct. The child's
WBC count has increased significantly following the procedure. The nurse should
identify that this is a potential indication of a postoperative infection.
Oxygen saturation level is incorrect. The child's oxygen saturation level is within the
expected reference range. Therefore this finding does not indicate a potential
complication.
Platelets is incorrect. The child's platelet count is within the expected reference range.
Therefore this finding does not indicate a potential complication.
Abdomen assessment is correct. The child's abdomen is rigid and distended and they
are reporting increased pain. The nurse should identify that this is a potential
indication of a postoperative infection.
Temperature is correct. One day following surgery, the child's temperature has
increased and is above the expected reference range.The nurse should identify that this
is a potential indication of a postoperative infection.
Abdominal dressings assessment is incorrect.The child's abdominal dressings have
scant serous drainage present, which is an expected finding following surgery.
Therefore this finding does not indicate a potential complication.
8. A nurse is reviewing the medical record of a school-age child who is 2 days
postoperative following an open repair and casting of a fracture in the right
arm.Which of the following findings should the nurse identify as an indication of
a potential postoperative complication?
a. increased erythrocyte sedimentation rate
b. apical pulse 92/min
c. respiratory rate 24/min
d. taking an oral analgesic twice daily
Ans>> increased erythrocyte sedimentation rate
The nurse should identify that an increased erythrocyte sedimentation rate is an
indication of osteomyelitis, a potential complication following surgical repair of a
fracture.
9. A nurse is caring for a 15-year-old adolescent following a head injury.Which of
the following findings should the nurse identify as an indication that the
adolescent is developing syndrome of inappropriate antidiuretic hormone
secretion (SIADH)?
a. increased sodium level
b. decreased urine specific gravity
c. mental confusion
d. weak peripheral pulses
Ans>> mental confusion
A child who has a head injury can develop SIADH as a result of altered pitu- itary
function, leading to an oversecretion of antidiuretic hormone. Oversecretion of
antidiuretic hormone leads to a decrease in urine output, hyponatremia, and
hyperosmolality due to overhydration. As the hyponatremia becomes more severe,
mental confusion and other neurologic manifestations such as seizures can occur.
10. A nurse is discussing organ donation with the parents of a school-age
child who has sustained brain death due to a bicycle crash. Which of the
following actions should the nurse take first?
a. inform the parents that written consent is required prior to organ donation
b. provide written information to the parents about organ donation
c. ask the provider to explain misconceptions of organ donation to the parents
d. explore the parents' feelings and wishes regarding organ donation
Ans>> ex- plore the parents' feelings and wishes regarding organ donation
The first action the nurse should take when using the nursing process is assessment. The
nurse should first explore the parents' feelings and wishes regarding organ donation
to assist in determining if organ donation is the right choice for the family.
11. A nurse is caring for a preschooler who is scheduled for hydrotherapy
treatment for wound debridement following a burn injury.Which of the following actions should the nurse take prior to the procedure?
a. apply topical antimicrobial ointment to the child's wound
b. place a mesh gauze dressing over the child's wound
c. initiate prophylactic antibiotic therapy for the child
d. administer an analgesic to the child
Ans>> administer an analgesic to the child
Hydrotherapy for debridement of a wound is an extremely painful procedure that
requires analgesia and/or sedation. Controlling pain leads to reduced physiological
demands on the body caused by stress and decreases the likelihood of children
developing depression and post-traumatic stress disorder.
12. A nurse is assessing an 8-year-old child who has early indications of
shock. After establishing an airway and stabilizing the child's respirations,
which of the following actions should the nurse take next?
a. insert an indwelling urinary catheter
b. measure weight and height
c. initiate IV access
d. maintain ECG monitoring
Ans>> initiate IV access
A nurse is assessing an 8-year-old child who has early indications of shock. After
establishing an airway and stabilizing the child's respirations, which of the following
actions should the nurse take next?
13. A nurse is caring for a preschooler whose guardian is going home for a few
hours while another relative stays with the child. Which of the following
statements should the nurse make to explain to the child when their guardian
will return?
a. "Your guardian will be back at 7 p.m."
b. "Your guardian will be back after taking care of your sibling."
c. "Your guardian will be back in the morning."
d. "Your guardian will be back after you eat."
Ans>> "Your guardian will be back after you eat."
Preschoolers make sense of time best when they can associate it with an expected
daily routine, such as meals and bedtime. Therefore, the child comprehends time best
when it is explained to them in relation to an event they are familiar with, such as
eating.
14. A nurse is assessing a 4-year-old child at a well-child visit. Which of the
following developmental milestones should the nurse expect to observe?
a. identifies right from left hand
b. uses a utensil to spread butter
c. cuts an outlined shape using scissors
d. draws a stick figure with seven body parts
Ans>> cuts an outlined shape using scissors
The nurse should recognize that an expected developmental milestone of a 4year-old child is using scissors to cut out a shape.
15. A nurse in an emergency department is caring for an adolescent who has
severe abdominal pain due to appendicitis. Which of the following locations
should the nurse identify as McBurney's point
Ans>> A is correct. The nurse should identify this area of the client's abdomen as
McBurney's point. This area of the right lower quadrant located about two-thirds of
the way between the umbilicus and the client's anterosuperior iliac spine is the area
where a client who has appendicitis is most likely to report pain and tenderness.
B is incorrect. The nurse should identify this area as the left lower quadrant. Structures of this area of the client's abdomen include the sigmoid colon and part of the
descending colon. This area does not contain the appendix and is therefore not
associated with McBurney's point.
C is incorrect. The nurse should identify this area as the right upper quadrant.
Structures of this area of the client's abdomen include parts of the ascending and
transverse colon, liver, and gallbladder.This area does not contain the appendix and is
therefore not associated with McBurney's point.
16. A nurse is providing teaching about play activities for social development to
the guardians of a preschooler. Which of the following play activities should the
nurse recommend for the child?
a. playing pat-a-cake
b. using a push-pull toy
c. creating a scrapbook
d. playing dress-up
Ans>> playing dress-up
The nurse should instruct the guardians that at the preschool age, play should focus
on social, mental, and physical development.Therefore, playing dress-up is a
recommended play activity for this child.
17. A nurse is reviewing the dietary choices of an adolescent who has iron
deficiency anemia.The nurse should identify that which of the following menu
items has the highest amount of nonheme iron?
a. 1/2 cup whole milk
b. 1 cup orange juice
c. 1/2 cup raisins
➢
cup raw carrots
Ans>> 1/2 cup raisins
The nurse should encourage the adolescent to eat raisins because they contain the
highest amount of nonheme iron.
18. A nurse is reviewing the laboratory report of a school-age child who is
experiencing fatigue.Which of the following findings should the nurse identify as
an indication of anemia?
a. a low hematocrit level
b. an elevated BUN
c. an increased neutrophil count
d. a low uric acid level
Ans>> a low hematocrit level
The nurse should identify that a low hematocrit level indicates anemia. A child who
has anemia can exhibit fatigue, lightheadedness, tachycardia, dyspnea, and pallor due
to the decreased oxygen-carrying capacity of the blood cells.
19. A nurse is providing discharge teaching to the parents of a 3-month-old
infant following a cheiloplasty.Which of the following instructions should the
nurse include?
a. "Clean your baby's sutures daily with a mixture of chlorhexidine and water."
b. "Expect your baby to swallow more than usual over the next few days."
c. "Inspect your baby's tongue for white patches using a tongue depressor
every 8 hours."
d. "Apply a thin layer of antibiotic ointment on your baby's suture line daily for
the
next
3
days."
Ans>> "Apply a thin layer of antibiotic ointment on your baby's suture line daily for
the next 3 days."
The nurse should instruct the parents to apply a thin layer of antibiotic ointment on
the infant's suture line daily for 3 days and then continue to apply petroleum jelly to
the area for several weeks to promote healing.
20. A nurse is receiving change-of-shift report for four children. Which of the
following children should the nurse see first?
a. a school age child who has sickle cell anemia and reports decreased vision in
the left eye
b. a school-age child who has cystic fibrosis and a frequent nonproductive cough
c. a preschooler who has asthma and a peak flow meter reading in the green
zone
d. an adolescent who has meningitis and reports a sensitivity to lights and noise
Ans>> a school age child who has sickle cell anemia and reports decreased vision in the
left eye
When using the urgent vs. nonurgent approach to client care, the nurse should
determine the priority finding is a report of decreased vision in the left eye. This
finding indicates that the child is experiencing a vaso-occlusive crisis and should be
reported to the provider immediately.Therefore, the nurse should see this child first.
21. A nurse is providing anticipatory guidance to the guardian of a toddler.
Which of the following expected behavior characteristics of toddlers should
the nurse include?
a. controls impulsive feelings
b. understands right from wrong
c. easily separates from guardian for long periods of time
d. expresses likes and dislikes
Ans>> expresses likes and dislikes
The nurse should include that expressing likes and dislikes is an expected behavior of
toddlers. This is the time in life when a toddler is developing autonomy and
self-concept. They will try to assert themselves and frequently refuse to comply. The
guardian should allow the child to have some control, but also set limits for them so
they learn from their behavior and learn to control their actions.
22. A nurse is caring for a preschooler who has neutropenia. Which of the
following statements should the nurse make to the child's guardians?
a. "Monitor your child's temperature at least once a week."
b. "Going to the movie theater might help improve your child's mood."
c. "Avoid using your child's daycare center."
d. "Schedule your child's varicella immunization."
Ans>> "Avoid using your child's daycare center."
Children who have neutropenia are immunocompromised and susceptible to infection. Therefore, places where large groups of people gather, such as daycare
centers, should be avoided.
23. A nurse is caring for a school-age child who is in Buck's traction following a
leg fracture 24 hr ago.Which of the following actions should the nurse take?
a. change the child's position every 2 hr
b. clean the peripheral pin sites with chlorhexidine solution every 4 days
c. assess peripheral pulses once every 4 hr
d. ensure that the head of the bed is elevated to a 90 degree angle
Ans>> assess peripheral pulses once every 4 hr
Buck's traction is a type of skin traction that can be used to immobilize extremities
prior to surgery. The nurse should provide frequent neurovascular checks at least
every 4 hr after the first 24 hr of placement in Buck's traction. The nurse should
monitor and report signs of neurovascular impairment in the extremities such as
cyanosis, edema, pain, absent pulses, and tingling.
24. A charge nurse in an emergency department is preparing an in-service for a
group of a newly licensed nurses about the manifestations of child
maltreatment. Which of the following manifestations should the charge nurse
include as a potential indication of physical abuse?
a. recurrent urinary tract infections
b. symmetric burns of the lower extremities
c. failure to thrive
d. lack of subcutaneous fat
Ans>> symmetric burns of the lower extremities
The nurse should include that symmetric burns to the lower extremities can indicate
physical abuse. The patterns are usually characteristic of the method or object used,
such as cigar or cigarette burns, or burns in the shape of an iron.
25. A nurse is caring for a 10-year-old child following a head injury. Which of
the following findings should the nurse identify as an indication that the child is