ATI RN PEDIATRICS PROCTORED LATEST EXAM
2024 WITH QUESTIONS AND ANSWERS. DETAILED
RATIONALES. A+ GRADE
1. A nurse is caring for a patient who
... [Show More] expresses a desire to have an elective 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.
b. Refer the patient to a family planning center or another health professional.
c. Continue to care for the patient, and limit conversation as much as possible.
d. Inform the patient that, because of immoral issues, another nurse will 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?
a. “You should have your blood drawn today to see if you were infected.”
b. “If you have the virus, you will have flu-like symptoms in 6 months.”
c. “Highly active antiretroviral therapy has been shown effective in slowing the disease process.”
d. “I will set you up with a support group to help you cope with dying 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.”
d. “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
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.
8. 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
ANS: D- 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 with DDH are females, not males. Of breech presentations, 60%
occur with first-born children, not subsequent siblings, possibly because of the un stretched uterus and
compaction of the surrounding abdominal contents, which tend to increase compression on th [Show Less]