Peds Proctored Exam ATI Respiratory

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Sample questions from Peds Proctored Exam ATI Respiratory

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a pediatric unit, a 6-year-old with asthma has an SpO2 of 89% on room air, speaks in two-word phrases, and has intercostal retractions. Which action should the nurse take first?

   • A.Ask the child to demonstrate use of the peak-flow meter
   • B.Notify the child's parent to bring the home inhaler
   • C.Apply oxygen and position the child upright
   • D.Review the child's asthma action plan

   Rationale: Hypoxemia, retractions, and limited speech indicate significant respiratory distress, so supporting oxygenation is the immediate priority. Peak-flow testing and reviewing the action plan can wait until breathing is stabilized. The parent may bring the inhaler later, but the nurse should not delay oxygen while waiting.

2. 2.Refer to the client's chart. Which action should the nurse take next for this 2-month-old in the emergency department?

   • A.Prepare for immediate airway support and notify the rapid response team
   • B.Place the infant flat and obtain a chest radiograph first
   • C.Continue routine observation because the temperature is normal
   • D.Offer an oral feeding to assess sucking ability

   Rationale: The infant's falling SpO2, apnea, and decreased responsiveness at 1030 indicate impending respiratory failure and require immediate airway support. A normal temperature does not make the deterioration safe to observe. Feeding and lying flat can worsen respiratory compromise, and imaging must not delay stabilization.

3. 3.During a home visit, the parent of a 4-year-old with asthma reports using a metered-dose inhaler with a spacer. Which instructions should the nurse reinforce? Select all that apply.

   • A.Have the child breathe in slowly through the spacer after one puff
   • B.Fire several puffs into the spacer at once before the child inhales
   • C.Wait about 1 minute before a second puff of the same medication, if prescribed
   • D.Shake the inhaler before each actuation
   • E.Rinse the child's mouth after an inhaled corticosteroid

   Rationale: Shaking suspensions, giving one puff at a time, using a slow inhalation, and rinsing after inhaled corticosteroids support medication delivery and reduce adverse effects. Several puffs released together can reduce the amount of medication inhaled. The caregiver should follow the prescribed dose and device instructions.

4. 4.In a pediatric clinic, a 9-year-old with cystic fibrosis has a new prescription for pancreatic enzymes. Which instruction should the nurse give the parent?

   • A.Crush the capsules and mix them into hot cereal
   • B.Give the enzymes with every meal and snack
   • C.Give the enzymes at bedtime on an empty stomach
   • D.Give the enzymes only when the child reports abdominal pain

   Answer and rationale are in the full material.

5. 5.A 12-year-old hospitalized with pneumonia has a temperature of 39.2 C, RR 34/min, and SpO2 91% on room air. Which prescription should the nurse implement first?

   • A.Collect a sputum specimen before any other intervention
   • B.Administer the first oral antibiotic dose with food
   • C.Encourage ambulation in the hallway
   • D.Apply oxygen to maintain the prescribed saturation goal

   Answer and rationale are in the full material.