Proctored Exam
ATI PN Pediatric Proctored Exam 3 (2026) |
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The INITIAL treatment for a school-age female with well-demarcated erythema and mucoid discharge in the
vulva area includes:
discontinuation of bubble baths.
P 1
, • ATI PN Pediatric 09/09/2026
Proctored Exam
instruction on front to back cleansing.
oral penicillin.
topical Premarin. - Correct Answer :instruction on front to back cleansing.
Vulvovaginitis is the most common genital complaint among prepubertal girls due to the thin hypo estrogenized
mucosal tissue with an alkaline pH, small labia minora, and location proximal to the anus. Vulvovaginitis, caused
by streptococcal bacterial infections, is identified by well-demarcated areas of erythema with a mucoid
discharge. A 10-day regimen of oral penicillin or amoxicillin is the treatment for a streptococcal infection which is
the most common organism. Vulvovaginitis can be caused by poor hygiene in girls who may be wiping
inadequately or inappropriately (e.g. from back to front), leading to local irritation. Prepubertal females should
be instructed in proper hygiene and wiping of perianal area. Soaps, shampoos, and bubble baths are the most
common cause of dysuria due to chemical urethritis. Topical Premarin is used in the initial treatment of labial
adhesions.
Emphasis on promoting healthy behavioral changes for the overweight child should include which of the
following?
establishing family goals
maintaining family holiday meal rituals
weighing child daily
using weight loss as a sign of success - Correct Answer :establishing family goals
Effective weight loss planning and implementation need to involve the entire family. Emphasis should be placed
on family change and family goals as children will copy their parents' behaviors. In addition, parents have control
over some aspects of the change process that can occur in relation to goals and meals in the home. Daily
weights are not recommended, and weight loss should not be used as the measure of success. Changing
behaviors is a success by itself and should be celebrated. New family and holiday rituals should be established for
a focus on non-food related events.
P 2
, • ATI PN Pediatric 09/09/2026
Proctored Exam
A 7 year old fell, injuring the right wrist. Radiographs of the wrist were negative, and the child was treated for a
moderate sprain and sent home with a sling. Ten days later the child is still complaining of wrist pain with point
tenderness. Which should be the NEXT step in management?
discontinue use of the sling
order a bone scan
repeat wrist radiographs
refer to orthopedic surgeon - Correct Answer :repeat wrist radiographs
Early fractures and Salter I fractures can be missed initially; repeat films 10 to 14 days after an injury may be
necessary to confirm the diagnosis of a fracture. Because this child is still symptomatic with complaints of pain
and point tenderness after the fall, follow up radiographic studies are indicated. Bone scanning is useful in
diagnosing stress fractures, but not appropriate in this situation with a history of a known injury. It is likely that
this is a simple fracture that will heal quickly with immobilization, with no disruption to bone growth. If the
follow-up radiograph showed evidence of trauma to growth plates, a referral to an orthopedic surgeon would
then be appropriate.
The MOST common sign/symptom of hepatitis A in a 14 month old is:
ascites
dark urine
fever
jaundice - Correct Answer :fever
P 3
, • ATI PN Pediatric 09/09/2026
Proctored Exam
Hepatitis A is a viral infection acquired through contaminated food and water, the fecal oral route, and person to
person contact. Hepatitis A is a significant public health concern. Young children with hepatitis A tend to be
asymptomatic or have only mild flu-like symptoms including fever, nausea, and anorexia. Few children younger
than 6 years have jaundice. Older children usually are symptomatic, with symptoms typically lasting less than 2
months. A symptom of jaundice is dark urine. The elderly have more disease complications with hepatitis A
including ascites, prolonged cholestasis, pancreatitis, and death from liver failure.
The factor with the STRONGEST link to malignant melanoma is
Special Note: It has been determined as of November 2016 that there are two (2) correct answers to this
question, supported by separate references. Credit will be given for choosing EITHER of the correct options.
family history of malignant melanoma.
fair skin coloring.
living near the equator.
sun exposure early in life. - Correct Answer :family history of malignant melanoma.
sun exposure early in life.
Skin cancers are the most frequent cancers seen in this country, accounting for nearly 50% of all new cancers.
The most serious of the skin cancers is malignant melanoma and its incidence is increasing at a rate of about 4%
per year. There are several risk factors for developing skin cancers including family history, fair skin color, and
living at high altitudes or near the equator. At the time this module was published, the supporting reference
cited the most significant factor in developing malignant melanoma as sun exposure early in life. Good pediatric
anticipatory guidance should include avoiding sun exposure in any child less than 6 months of age, limiting sun
exposure to children over 6 months of age, and using a sun screen with an SPF of 15 or greater when sun
exposure does occur. An additional, newer reference indicates that family history is the more important factor.
P 4