1|Page
ATI PN PEDIATRICS PROCTORED NEWEST 2024
ACTUAL EXAM 4 NEWEST VERSIONS EACH WITH 70
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+
ATI PN PEDIATRICS VERSION A
The nurse is caring for a newborn of a substance abusing mother who is
withdrawing from alcohol. Which of the following would the nurse likely
see in this newborn? - ANSWER- Newborn is hyperactive and irritable
Rationale: The newborn that is withdrawing from alcohol typically is
hyperactive, irritable, has trouble sleeping, and may have tremors or
seizures. Characteristics of FAS include low birth weight, and small
height and head circumference. This newborn is prone to respiratory
difficulties, hypoglycemia, hypocalcemia, and hyperbilirubinemia.
A nursing student is caring for a newborn with a defect in the neural
arch where the posterior laminae of the vertebrae have failed to close.
The nurse knows that this infant is suffering from which of the following
disorders? - ANSWER- Spina bifida
rationale: Spina bifida is a failure of the posterior laminae of the
vertebrae to close, leaving an opening through which the spinal
meninges and spinal cord may protrude. Hydrocephalus is a condition
characterized by excess cerebrospinal fluid (CSF) within the
,2|Page
ventricular and subarachnoid spaces of the cranial cavity. Cleft palate
is a result of failure of the primary and secondary palates to fuse.
Esophageal atresia is the absence of a normal opening or abnormal
closure of the esophagus.
You care for a child born with a tracheoesophageal fistula. Which
finding during pregnancy would have caused you to suspect this might
be present? - ANSWER- Hydramnios
Rationale: Because a fetus swallows amniotic fluid, when there is an
obstruction of the esophagus, amniotic fluid accumulates, leading to
hydramnios.
Four weeks before the birth of her already large child, the physician has
told the pregnant woman that if the baby gets bigger and his lungs are
ready, the physician would like to perform a cesarean to deliver the
baby. The woman asks the nurse what the downside is to having a
cesarean rather than a vaginal delivery. What is an appropriate
response by the nurse? - ANSWER- "As the baby passes through the
birth canal some of the excess fluid is expelled from the lungs, if that
doesn't happen there's a higher risk of respiratory distress."
Rationale: Transient tachypnea of the newborn (TTN) involves the
development of mild respiratory distress in a newborn. TTN results
from a delay in absorption of fetal lung fluid after birth. As the fetus
passes through the birth canal during delivery, some of the fluid is
expelled as the thoracic area is compressed. TTN is commonly seen in
newborns born by cesarean delivery. It typically occurs after birth with
,3|Page
the greatest degree of distress occurring approximately 36 hours after
birth. TTN commonly disappears spontaneously around the third day
A nurse in the newborn nursery has noticed that an infant is frothing and
appears to have excessive drooling. Further assessment reveals that the
baby has episodes of respiratory distress with choking and cyanosis.
What disorder should the nurse suspect based on these findings? -
ANSWER- esophageal atresia
Rationale: Any swallowed mucus or fluid enters the blind pouch of the
esophagus when a newborn suffers from esophageal atresia. The
newborn with this disorder will have frothing, excessive drooling, and
periods of respiratory distress with choking and cyanosis. If this
happens no feedings should be given until the newborn has been
examined.
An infant with hydrocephalus is scheduled to have a
ventriculoperitoneal shunt inserted. Immediately following the
procedure, which nursing action would best prevent decompression from
excessive CSF flow? - ANSWER- Keeping the head of the infant level
with the body
Rationale: Keeping the infant's head fairly even with the rest of the
body prevents gravity from moving more fluid into the shunt than
necessary
The nurse who is caring for newborn Andrew notices that although he
has seemed healthy at 18 hours of age, Andrew's abdomen is now
, 4|Page
distended. By 24 hours he has passed no stool. The nurse will -
ANSWER- Inform the physician of the findings
Rationale: In some newborns, a shallow opening may occur in the
anus with the rectum ending in a blind pouch some distance higher.
Thus, being able to pass a thermometer into the rectum does not
guarantee that the rectoanal canal is normal. More reliable
presumptive evidence is obtained by watching carefully for the first
meconium stool. Abdominal distention also occurs. If the newborn
does not pass a stool within the first 24 hours, the physician should be
notified. Definitive diagnosis is made by radiographic studies. In some
newborns, a colostomy is performed and extensive abdominoperineal
resection is delayed until 3-5 months of age or later.
A pre-term newborn is noted to have hypotonia, apnea, bradycardia, a
bulging fontanelle, cyanosis, and increased head circumference. These
signs indicate the newborn most likely has which of the following
complications? - ANSWER- intraventricular hemorrhage (IVH)
Rationale: Signs that may accompany IVH include hypotonia, apnea,
bradycardia, a full (or bulging) fontanelle, cyanosis, and increased
head circumference.
A newborn is diagnosed with congenital hypothyroidism prior to
discharge from the hospital. What medication does the nurse anticipate
administering to the newborn? - ANSWER- Levothyroxine
ATI PN PEDIATRICS PROCTORED NEWEST 2024
ACTUAL EXAM 4 NEWEST VERSIONS EACH WITH 70
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+
ATI PN PEDIATRICS VERSION A
The nurse is caring for a newborn of a substance abusing mother who is
withdrawing from alcohol. Which of the following would the nurse likely
see in this newborn? - ANSWER- Newborn is hyperactive and irritable
Rationale: The newborn that is withdrawing from alcohol typically is
hyperactive, irritable, has trouble sleeping, and may have tremors or
seizures. Characteristics of FAS include low birth weight, and small
height and head circumference. This newborn is prone to respiratory
difficulties, hypoglycemia, hypocalcemia, and hyperbilirubinemia.
A nursing student is caring for a newborn with a defect in the neural
arch where the posterior laminae of the vertebrae have failed to close.
The nurse knows that this infant is suffering from which of the following
disorders? - ANSWER- Spina bifida
rationale: Spina bifida is a failure of the posterior laminae of the
vertebrae to close, leaving an opening through which the spinal
meninges and spinal cord may protrude. Hydrocephalus is a condition
characterized by excess cerebrospinal fluid (CSF) within the
,2|Page
ventricular and subarachnoid spaces of the cranial cavity. Cleft palate
is a result of failure of the primary and secondary palates to fuse.
Esophageal atresia is the absence of a normal opening or abnormal
closure of the esophagus.
You care for a child born with a tracheoesophageal fistula. Which
finding during pregnancy would have caused you to suspect this might
be present? - ANSWER- Hydramnios
Rationale: Because a fetus swallows amniotic fluid, when there is an
obstruction of the esophagus, amniotic fluid accumulates, leading to
hydramnios.
Four weeks before the birth of her already large child, the physician has
told the pregnant woman that if the baby gets bigger and his lungs are
ready, the physician would like to perform a cesarean to deliver the
baby. The woman asks the nurse what the downside is to having a
cesarean rather than a vaginal delivery. What is an appropriate
response by the nurse? - ANSWER- "As the baby passes through the
birth canal some of the excess fluid is expelled from the lungs, if that
doesn't happen there's a higher risk of respiratory distress."
Rationale: Transient tachypnea of the newborn (TTN) involves the
development of mild respiratory distress in a newborn. TTN results
from a delay in absorption of fetal lung fluid after birth. As the fetus
passes through the birth canal during delivery, some of the fluid is
expelled as the thoracic area is compressed. TTN is commonly seen in
newborns born by cesarean delivery. It typically occurs after birth with
,3|Page
the greatest degree of distress occurring approximately 36 hours after
birth. TTN commonly disappears spontaneously around the third day
A nurse in the newborn nursery has noticed that an infant is frothing and
appears to have excessive drooling. Further assessment reveals that the
baby has episodes of respiratory distress with choking and cyanosis.
What disorder should the nurse suspect based on these findings? -
ANSWER- esophageal atresia
Rationale: Any swallowed mucus or fluid enters the blind pouch of the
esophagus when a newborn suffers from esophageal atresia. The
newborn with this disorder will have frothing, excessive drooling, and
periods of respiratory distress with choking and cyanosis. If this
happens no feedings should be given until the newborn has been
examined.
An infant with hydrocephalus is scheduled to have a
ventriculoperitoneal shunt inserted. Immediately following the
procedure, which nursing action would best prevent decompression from
excessive CSF flow? - ANSWER- Keeping the head of the infant level
with the body
Rationale: Keeping the infant's head fairly even with the rest of the
body prevents gravity from moving more fluid into the shunt than
necessary
The nurse who is caring for newborn Andrew notices that although he
has seemed healthy at 18 hours of age, Andrew's abdomen is now
, 4|Page
distended. By 24 hours he has passed no stool. The nurse will -
ANSWER- Inform the physician of the findings
Rationale: In some newborns, a shallow opening may occur in the
anus with the rectum ending in a blind pouch some distance higher.
Thus, being able to pass a thermometer into the rectum does not
guarantee that the rectoanal canal is normal. More reliable
presumptive evidence is obtained by watching carefully for the first
meconium stool. Abdominal distention also occurs. If the newborn
does not pass a stool within the first 24 hours, the physician should be
notified. Definitive diagnosis is made by radiographic studies. In some
newborns, a colostomy is performed and extensive abdominoperineal
resection is delayed until 3-5 months of age or later.
A pre-term newborn is noted to have hypotonia, apnea, bradycardia, a
bulging fontanelle, cyanosis, and increased head circumference. These
signs indicate the newborn most likely has which of the following
complications? - ANSWER- intraventricular hemorrhage (IVH)
Rationale: Signs that may accompany IVH include hypotonia, apnea,
bradycardia, a full (or bulging) fontanelle, cyanosis, and increased
head circumference.
A newborn is diagnosed with congenital hypothyroidism prior to
discharge from the hospital. What medication does the nurse anticipate
administering to the newborn? - ANSWER- Levothyroxine
