ATI RN PEDIATRICS PROCTORED EXAM 2024 QUESTIONS WITH ANSWERS AND RATIONALES
1. A nurse is caring for a patient who expresses a desire to have an elective
... [Show More] abortion. The nurse’s religious and ethical values are strongly opposed. How should the nurse best handle the situation?
a. Attempt to educate the patient about the consequences of abortion.
Refer the patient to a family planning center or another health
b. professional.
Continue to care for the patient, and limit conversation as much as
c. possible.
Inform the patient that, because of immoral issues, another nurse will
d. have to care for her.
ANS: B
The nurse must be aware of personal beliefs and values and is not required to participate in counseling or procedures that compromise those values. However, the patient is entitled to nonjudgmental care and should be referred to someone who can create a trusting environment. The nurse should not care for a patient if the quality of care could be jeopardized. The nurse should not attempt to push personal values onto a patient. The nurse also should not create tension by informing the patient that he or she does not have the same morals; this could cause the patient to feel guilty or defensive when receiving care from any health care professional.
2. Which patient is most in need of a nurse’s referral to adoption services?
a. A woman considering abortion for an unwanted pregnancy
b. An infertile couple religiously opposed to artificial insemination
c. A woman who suffered miscarriage during her first pregnancy
d. An infertile couple who has been attempting conception for 3 months
ANS: B
Adoption is an option for someone with infertility, especially if infertility treatments are unavailable owing to religious or financial constraints. A patient who wishes to have an elective abortion may be educated about all the possibilities, but the nurse should approach the patient in a nonjudgmental manner and should accept the patient’s decision. When a patient has recently miscarried, the nurse should assess the patient’s feelings about the loss and should address any concerns the patient may have about fertility. Infertility is the inability to conceive after 1 year of unprotected intercourse; therefore, talking about adoption after one miscarriage or after only 3 months of attempting conception would be too soon.
3. The nurse is caring for a patient who recently had unprotected sex with a partner who has HIV. Which response by the nurse is best?
“You should have your blood drawn today to see if you were
a. infected.”
b. “If you have the virus, you will have flu-like symptoms in 6 months.” “Highly active antiretroviral therapy has been shown effective in
c. slowing the disease process.”
“I will set you up with a support group to help you cope with dying
d. within the next 10 years.”
ANS: C 1
Highly active retroviral therapy increases the survival time of a person with HIV or
AIDS. HIV antibodies will not show up in blood work for 6 weeks to 3 months. The infection stage of HIV lasts for about a month after the virus is contracted; during that time, the patient may experience flu-like symptoms. A support group may be beneficial for a patient who contracts HIV; however, it is unknown whether the patient has contracted HIV, and antiretroviral therapy has helped people live beyond the 10 years expected if HIV goes untreated.
4. An 18-year-old male patient informs the nurse that he isn’t sure if he is homosexual because he is attracted to both genders. Which response by the nurse will help establish a trusting relationship?
a. “Don’t worry. It’s just a phase you will grow out of.”
b. “Those are abnormal impulses. You should seek therapy.”
c. “At your age, it is normal to be curious about both genders.” “Having questions about sexuality is normal but if these sexual
d. activities make you feel bad you should stop.”
ANS: C
Adolescents have questions about sexuality. The patient will feel most comfortable discussing his sexual concerns further if the nurse establishes that it is normal to ask questions about sexuality. The nurse can then discuss in greater detail. Although it is normal for young adults to be curious about sexuality, the nurse should use caution in giving advice on taking sexual action. The nurse should promote safe sex practices. Telling the patient not to worry dismisses his concern. Telling the patient that he is abnormal might offend the patient and prevent him from establishing an open relationship.
5. A nurse is caring for a 35-year-old female patient who recently started taking antidepressants after repeated attempts at fertility treatment. The patient tells the nurse, “I feel happier, but my sex drive is gone.” Which nursing diagnosis has the highest priority?
a. Sexual dysfunction
b. Ineffective coping
c. Risk for self-directed violence
d. Deficient knowledge about contraception
ANS: A
Antidepressants have adverse effects on sexual desire and response. The nurse should be sure to educate the patient on the potential for these side effects and how to correct for them, for example, using lubricant to ease discomfort. The patient has taken steps toward effective coping by seeking therapy. The patient has not expressed a reason for the nurse to be concerned about contraceptives. The nurse should always assess for concerns about violence in a patient’s life. Although some antidepressants have been related to self-directed violence, this patient focus is on becoming pregnant (fertility treatments) but sex drive is gone.
6. A nurse is using the PLISSIT model when caring for a patient with dyspareunia from diminished vaginal secretions. The nurse suggests using water-soluble lubricants. Which component of PLISSIT is the nurse using?
a. P
b. LI
c. SS 2
d. IT
ANS: C
The nurse is using the specific suggestions (SS). The PLISSIT model is as follows:
Permission to discuss sexuality issues
Limited Information related to sexual health problems being experienced Specific Suggestions—only when the nurse is clear about the problem Intensive Therapy
—referral to professional with advanced training if necessary
7. A patient who has had several sexual partners in the past month expresses a desire to use a contraceptive. Which contraceptive method should the nurse recommend?
a. Condom
b. Diaphragm
c. Spermicide
d. Oral contraceptive
ANS: A
Condoms are both a contraceptive and a barrier against STIs and HIV; proper use will greatly reduce the risk. Spermicides, diaphragms, and oral contraceptives all protect against pregnancy; however, they are not a barrier and do not prevent bodily fluids from coming in contact with the patient during sexual intercourse.
1. A 3-week-old infant is referred to an orthopedic clinic because the pediatrician heard a click when flexing the child's right hip during a routine physical examination. The orthopedic physician suspects that the child might have developmental dysplasia of the hip (DDH). The parents ask the nurse to identify risk factors commonly associated with DDH. Which response is accurate?
A. Vertex delivery
B. Male gender
C. Breech presentation
D. Second-born child Rationale:
Developmental dysplasia of the hip (DDH) occurs more often in infants who present in the breech position, not the vertex (head-first) position. Twice as many females as males present in the breech position; thus, 80% of children
1 | P a g e
with DDH are females, not males. Of breech presentations, 60% occur with first-born children, not subsequent siblings, possibly because of the unstretched uterus and compaction of the surrounding abdominal contents, which tend to increase compression on the uterus in the nulliparous woman.
2. The nurse is teaching the parents of a 2-year-old child with a congenital heart defect about signs and symptoms of congestive heart failure. Which information about the child is most important for the parents to report to the health care provider?
A. Sits or squats frequently when playing outdoors
B. Exhibits a sudden and unexplained weight gain C. Is not completely toilet- trained and has some accidents
D. Demonstrates irritation and fatigue 1 hour before bedtime Rationale:
Sudden and unexplained weight gain can indicate fluid retention and is a sign of congestive heart failure. Option A is used by the child to reduce chronic hypoxia, especially during exercise. Option C is common; 2-year-olds are not expected to be toilet-trained. Option D is normal.
3. A newborn female whose mother is HIV-positive is scheduled for the first follow-up assessment with the nurse. If the child is HIV-positive, which initial symptom is she most likely to exhibit?
A. Shortness of breath
B. Joint pain
C. Persistent cold
D. Organomegaly Rationale:
Respiratory tract infections commonly occur in the pediatric population, but the child with AIDS has a decreased ability to defend the body against these common infections. Thus, the most typical presenting symptom of a child who contracted AIDS through vertical transmission (i.e., from the mother during delivery) is a persistent cold or respiratory infection. Options A, B, and D are symptoms of AIDS complications that may occur later as the disease progresses.
4. Following the administration of immunizations to a 6-month-old girl, the nurse provides the family with home care instructions. Which statement by the mother indicates that further teaching is needed?
A. "I will give her a baby aspirin every 4 hours as needed for fever."
B. "I will call the clinic if her cry becomes highpitched or unusual."
C. "I know I can expect her to be irritable over the next 2 days."
2 | P a g e [Show Less]