ATI PEDIATRICS PROCTORED EXAM UPDATED 2023
1. The nurse is reviewing laboratory results. Which cation will the
nurse observe is the most abundant in the blood?
a. Sodium
b. Chloride
c. Potassium
d. Magnesium
ANS: A
Sodium is the most abundant cation in the blood. Potassium is the
predominant intracellular cation. Chloride is an anion (negatively
charged) rather than a cation (positively charged). Magnesium is
found predominantly inside cells and in bone.
7. The nurse receives the patient’s most recent blood work
results. Which laboratory value is of greatest concern?
a. Sodium of 145 mEq/L
b. Calcium of 15.5 mg/dL
c. Potassium of 3.5 mEq/L
d. Chloride of 100 mEq/L
ANS: B
Normal calcium range is 8.4 to 10.5 mg/dL; therefore, a value of 15.5
mg/dL is abnormally high and of concern. The rest of the laboratory
values are within their normal ranges: sodium 136 to 145 mEq/L;
potassium
3.5 to 5.0 mEq/L; and chloride 98 to 106 mEq/L.
8. The nurse observes that the patient’s calcium is elevated. When
, checking the phosphate level, what does the nurse expect to see?
a. Increased
b. Decreased
c. Equal to calcium
d. No change in phosphate
ANS: B
Phosphate will decrease. Serum calcium and phosphate have an inverse
relationship. When one is elevated, the other decreases, except in
some patients with end-stage renal disease.
9. Four patients arrive at the emergency department at the same time.
Which patient will the nurse see first?
a. An infant with temperature of 102.2° F and diarrhea for 3 days
b. A teenager with a sprained ankle and excessive edema
A middle-aged adult with abdominal pain who is moaning and holding
c. her stomach
An older adult with nausea and vomiting for 3 days with blood
d. pressure 112/60
ANS: A
The infant should be seen first. An infant’s proportion of total body
water (70% to 80% total body weight) is greater than that of children
or adults. Infants and young children have greater water needs and
immature kidneys. They are at greater risk for extracellular volume
deficit and hypernatremia because body water loss is proportionately
greater per kilogram of weight. A teenager with excessive edema
from a sprained ankle can wait. A middle-aged adult moaning in pain
can wait as can an older adult with a blood pressure of 112/60.
10. The patient has an intravenous (IV) line and the nurse needs to
remove the gown. In which order will the nurse perform the steps,
starting with the first one?
1. Remove the sleeve of the gown from the arm without the IV.
2. Remove the sleeve of the gown from the arm with the IV.
, 3. Remove the IV solution container from its stand.
4. Pass the IV bag and tubing through the sleeve.
, 2, 3,
b. 2, 3, 4, 1
c. 3, 4, 1, 2
d. 4, 1, 2, 3
ANS: A
Change regular gowns by following these steps for maximum speed and
arm mobility: (1) To remove a gown, remove the sleeve of the gown
from the arm without the IV line, maintaining the patient’s privacy.
(2) Remove the sleeve of the gown from the arm with the IV line. (3)
Remove the IV solution container from its stand, and pass it and the
tubing through the sleeve. (If this involves removing the tubing from
an EID, use the roller clamp to slow the infusion to prevent the
accidental infusion of a large volume of solution or medication.)
11.A 2-year-old child is brought into the emergency department after
ingesting a medication that causes respiratory depression. For which acid-
base imbalance will the nurse most closely monitor this child?
a. Respiratory alkalosis
b. Respiratory acidosis
c. Metabolic acidosis
d. Metabolic alkalosis
ANS: B
Respiratory depression leads to hypoventilation. Hypoventilation results
in retention of CO2 and respiratory acidosis. Respiratory alkalosis
would result from hyperventilation, causing a decrease in CO2 levels.
Metabolic acid-base imbalance would be a result of kidney
dysfunction, vomiting, diarrhea, or other conditions that affect
metabolic acids.
1. The nurse is reviewing laboratory results. Which cation will the
nurse observe is the most abundant in the blood?
a. Sodium
b. Chloride
c. Potassium
d. Magnesium
ANS: A
Sodium is the most abundant cation in the blood. Potassium is the
predominant intracellular cation. Chloride is an anion (negatively
charged) rather than a cation (positively charged). Magnesium is
found predominantly inside cells and in bone.
7. The nurse receives the patient’s most recent blood work
results. Which laboratory value is of greatest concern?
a. Sodium of 145 mEq/L
b. Calcium of 15.5 mg/dL
c. Potassium of 3.5 mEq/L
d. Chloride of 100 mEq/L
ANS: B
Normal calcium range is 8.4 to 10.5 mg/dL; therefore, a value of 15.5
mg/dL is abnormally high and of concern. The rest of the laboratory
values are within their normal ranges: sodium 136 to 145 mEq/L;
potassium
3.5 to 5.0 mEq/L; and chloride 98 to 106 mEq/L.
8. The nurse observes that the patient’s calcium is elevated. When
, checking the phosphate level, what does the nurse expect to see?
a. Increased
b. Decreased
c. Equal to calcium
d. No change in phosphate
ANS: B
Phosphate will decrease. Serum calcium and phosphate have an inverse
relationship. When one is elevated, the other decreases, except in
some patients with end-stage renal disease.
9. Four patients arrive at the emergency department at the same time.
Which patient will the nurse see first?
a. An infant with temperature of 102.2° F and diarrhea for 3 days
b. A teenager with a sprained ankle and excessive edema
A middle-aged adult with abdominal pain who is moaning and holding
c. her stomach
An older adult with nausea and vomiting for 3 days with blood
d. pressure 112/60
ANS: A
The infant should be seen first. An infant’s proportion of total body
water (70% to 80% total body weight) is greater than that of children
or adults. Infants and young children have greater water needs and
immature kidneys. They are at greater risk for extracellular volume
deficit and hypernatremia because body water loss is proportionately
greater per kilogram of weight. A teenager with excessive edema
from a sprained ankle can wait. A middle-aged adult moaning in pain
can wait as can an older adult with a blood pressure of 112/60.
10. The patient has an intravenous (IV) line and the nurse needs to
remove the gown. In which order will the nurse perform the steps,
starting with the first one?
1. Remove the sleeve of the gown from the arm without the IV.
2. Remove the sleeve of the gown from the arm with the IV.
, 3. Remove the IV solution container from its stand.
4. Pass the IV bag and tubing through the sleeve.
, 2, 3,
b. 2, 3, 4, 1
c. 3, 4, 1, 2
d. 4, 1, 2, 3
ANS: A
Change regular gowns by following these steps for maximum speed and
arm mobility: (1) To remove a gown, remove the sleeve of the gown
from the arm without the IV line, maintaining the patient’s privacy.
(2) Remove the sleeve of the gown from the arm with the IV line. (3)
Remove the IV solution container from its stand, and pass it and the
tubing through the sleeve. (If this involves removing the tubing from
an EID, use the roller clamp to slow the infusion to prevent the
accidental infusion of a large volume of solution or medication.)
11.A 2-year-old child is brought into the emergency department after
ingesting a medication that causes respiratory depression. For which acid-
base imbalance will the nurse most closely monitor this child?
a. Respiratory alkalosis
b. Respiratory acidosis
c. Metabolic acidosis
d. Metabolic alkalosis
ANS: B
Respiratory depression leads to hypoventilation. Hypoventilation results
in retention of CO2 and respiratory acidosis. Respiratory alkalosis
would result from hyperventilation, causing a decrease in CO2 levels.
Metabolic acid-base imbalance would be a result of kidney
dysfunction, vomiting, diarrhea, or other conditions that affect
metabolic acids.
