ATI Pediatrics Proctored Test

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Following delivery of a newborn and placenta, you note that the mother has moderate vaginal bleeding. The mother is conscious and alert, and her vital signs are stable. Treatment for her should include:

  • A. carefully packing the vagina with sterile dressings.
  • B. massaging the uterus if signs of shock develop.
  • C. treating her for shock and providing rapid transport.
  • D. administering oxygen and massaging the uterus.
Correct Answer: D

Rationale: Administering oxygen and massaging the uterus are appropriate interventions to manage postpartum bleeding. Oxygen helps support tissue perfusion, and uterine massage can aid in uterine contraction, controlling bleeding. These actions are indicated when the mother experiences moderate vaginal bleeding post-delivery, as described in the scenario. Careful monitoring for signs of shock should continue while these interventions are implemented to ensure the mother's condition remains stable. Choices A and B are incorrect because packing the vagina with sterile dressings is not recommended for postpartum bleeding unless it is severe and immediate action is needed, while massaging the uterus is a proactive approach and should not be delayed until signs of shock develop. Choice C is also incorrect as rapid transport is not the primary intervention in this scenario where the mother is conscious, alert, and stable, and the focus should be on immediate management of the bleeding.

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Your assessment of a newborn reveals cyanosis to the chest and face and a heart rate of 90 beats/min. What should you do first?

  • A. Dry the infant briskly.
  • B. Suction the mouth.
  • C. Begin artificial ventilations.
  • D. Begin chest compressions.
Correct Answer: C

Rationale: In a newborn with cyanosis to the chest and face and a heart rate of 90 beats/min, the priority action is to begin artificial ventilations. A heart rate below 100 beats/min with cyanosis indicates a need for immediate respiratory support to improve oxygenation. Drying the infant briskly or suctioning the mouth may be necessary later but are not the initial priority. Chest compressions are not indicated as the heart rate is above 60 beats/min.

Which of the following signs would you expect to see in a child with respiratory failure?

  • A. Slow, irregular breathing
  • B. Flushed skin
  • C. Strong cry
  • D. Unconsciousness
Correct Answer: A

Rationale: In a child with respiratory failure, slow, irregular breathing is a common sign. Respiratory failure impairs the ability to exchange oxygen and carbon dioxide efficiently, leading to altered breathing patterns. Flushed skin, a strong cry, or unconsciousness may not be specific signs of respiratory failure and could be indicative of other conditions. Flushed skin may be a sign of fever or increased blood flow, a strong cry may indicate pain or distress, and unconsciousness can have various causes beyond respiratory failure.

Which of the following statements regarding sudden infant death syndrome (SIDS) is correct?

  • A. Death as a result of SIDS can occur at any time of the day or night.
  • B. Certain cases of SIDS are predictable and therefore preventable.
  • C. Most cases of SIDS occur in infants younger than 6 months.
  • D. SIDS is uncommon in infants older than 1 year of age.
Correct Answer: A

Rationale: The correct answer is A. SIDS can occur at any time of the day or night, although it most commonly occurs during sleep. SIDS is sudden and unpredictable, making it challenging to prevent in all cases. While most cases occur in infants younger than 6 months, it is not limited to this age group. SIDS is not uncommon in infants older than 1 year of age, although less common than in younger infants.

Which of the following statements regarding febrile seizures in children is correct?

  • A. They can occur even after a child has had a fever for longer than 24 hours.
  • B. They can be caused by viral or bacterial meningitis.
  • C. They do not typically occur on the first day of a fever.
  • D. They typically last less than 15 minutes and often do not have a postictal phase.
Correct Answer: D

Rationale: The correct answer is D. Febrile seizures in children typically last less than 15 minutes and often do not have a postictal phase, meaning there is usually no prolonged recovery period or confusion after the seizure. They are commonly associated with the rapid rise in body temperature at the onset of a fever, rather than the duration of the fever itself. Choices A, B, and C are incorrect because febrile seizures can occur even after a child has had a fever for longer than 24 hours, they can be caused by viral or bacterial meningitis, and they do not have a typical pattern of occurring on the first day of a fever.

When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, which of the following questions would be MOST appropriate to ask?

  • A. When did you first notice the symptoms?
  • B. Do you have a history of high blood pressure?
  • C. What medications do you take and why?
  • D. Have you previously had a heart attack?
Correct Answer: A

Rationale: The most appropriate question to ask when assessing a geriatric patient who may have experienced an acute ischemic stroke is when the symptoms were first noticed. This information is crucial for determining the time window for potential treatments like thrombolytic therapy, as prompt intervention is necessary for stroke management. Option B is not as relevant in the acute assessment of stroke, though important for overall health history. Option C is important but may not be as time-sensitive as determining symptom onset. Option D focuses on a different cardiac event, not directly related to the current concern of a possible stroke.

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