ATI Nursing Proctored Pediatric Test Banks

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The primary critical observation for Apgar scoring is the:

  • A. Heart rate
  • B. Respiratory rate
  • C. Presence of meconium
  • D. Evaluation of the Moro reflex
Correct Answer: A

Rationale: The primary critical observation for Apgar scoring is the heart rate. This is because the heart rate is vital for life and immediate assessment of the infant's heart rate provides crucial information about the baby's overall well-being and response to the birthing process. The Apgar score assesses five components: heart rate, respiratory effort, muscle tone, reflex irritability, and skin color. Among these components, the heart rate is considered the most critical because it directly reflects the infant's cardiovascular status and their ability to maintain adequate perfusion of vital organs. Therefore, for quick assessment and immediate intervention, the heart rate is prioritized as the primary observation in Apgar scoring.

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A 46 y.o. woman is admitted to the rehabilitation unit with left-sided hemiparesis resulting from a subarachnoid hemorrhage. She is not oriented to her surroundings or situation, but she does recognize her family. On admission, she tells her nurse that she can walk to the bathroom without assistance. Which of the ff. responses by the nurse is best?

  • A. Allow her to ambulate unassisted, to encourage positive self-esteem.
  • B. Ask her to demonstrate her ability to ambulate.
  • C. Explain that someone will assist her as long as she is in the rehabilitation facility.
  • D. Ask another staff member to help ambulate the patient the first time.
Correct Answer: C

Rationale: The best response by the nurse is to explain that someone will assist the patient as long as she is in the rehabilitation facility. This is important for ensuring the safety of the patient, especially considering her condition with left-sided hemiparesis resulting from a subarachnoid hemorrhage. While encouraging independence is important in rehabilitation, it should not compromise the patient's safety. The nurse should prioritize the patient's well-being and provide necessary assistance to prevent any potential falls or injuries during ambulation.aising the risk of falling or getting injured.

A 15-month-old toddler was able to do all the following EXCEPT

  • A. walks alone
  • B. makes tower of 3 cubes
  • C. inserts raisin in a bottle
  • D. responds to his/her name
Correct Answer: D

Rationale: Responding to name usually occurs earlier, around 6-9 months.

The clue to need a help for a child who does not respond correctly to 'Give me' or 'Sit down' or 'Come here' when spoken without gestural cues is by age of

  • A. 15 months
  • B. 18 months
  • C. 21 months
  • D. 24 months
Correct Answer: D

Rationale: By 24 months, a child should be able to follow simple commands without gestures.

Children with ALL who carry poor outcome include all the following EXCEPT

  • A. age younger than 1 year and older than 10 year
  • B. T-cell immunophenotype
  • C. hyperdiploidy chromosomal abnormality
  • D. initial leukocyte count of > 50,000
Correct Answer: C

Rationale: Hyperdiploidy is generally associated with a favorable prognosis in ALL, unlike other listed factors.

A 10 years old girl presented with fever and bruises for last 2 weeks. On examination she is pale; however there is no evidence of lymphadenopathy or hepatosplenomegaly. Her Hb is 6g/dl, TLC is 2700 and platelets are 90000. The most appropriate investigation to clinch the diagnosis is:

  • A. Bone marrow aspiration
  • B. Retics count
  • C. Bleeding time
  • D. PT and APTT
Correct Answer: A

Rationale: Bone marrow aspiration is essential to rule out conditions like aplastic anemia or leukemia, which could explain the symptoms and lab findings.

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