PEDIATRICS FINAL ATI 2022 EXAM SCRIPT
2026 UPDATED QUESTIONS WITH
DETAILED ANSWERS GRADED A+
⩥ *ICP*
*INFANTS* sign and symptoms. Answer: • Irritability/ poor feeding
• *High pitched cry/ difficult to soothe*
• Fontanels: Tense & Bulging
• Cranial Sutures Separated
• Eyes: Sun Setting Eyes signs
• Scalp Veins Distended
⩥ *ICP*
*CHILDREN* signs and symptoms. Answer: • Headache
• Vomiting (usually projectile)
• Seizures
• Diplopia (Dbl vision), blurred vision
⩥ *ICP*
,Pain Management in Comatose Child Answer: • Opioids
• Fentanyl, Midazolam, Vecuronium
• Acetaminophen Codeine
• Quiet, Dim lit environment
*PAIN INCREASES ICP*
⩥ *ICP*
Personality and Behavioral Signs of Increasing Pressure Answer: •
Irritability, restlessness
• Drowsiness, indifference, decrease in physical activity and motor skills
• Diminished physical activity
• Inability to follow commands, memory loss
• Lethargy and drowsiness
⩥ *ICP*
Late Signs of Increasing Pressure Answer: Decreased LOC
Decreased motor response to command
Decreased sensory response to painful stimuli
Alterations in pupil size and reactivity
Papilledema-(optic disc pressure)
Decerebrate or decorticate posturing
,Cheyne-Stokes respirations
⩥ *ICP*
Management Answer: Airway management is primary concern
Cerebral hypoxia *LASTING >4 MINUTES MAY CAUSE
IRREVERSIBLE BRAIN DAMAGE- RECOGNIZE EARLY!!*
CO2 causes vasodilation, increased cerebral blood flow, and increased
ICP
May have minimal gag and cough reflexes
Risk of aspiration of secretions
⩥ *ICP*
Medications Answer: • Osmotic Diuretics
• Sedatives / Antiepileptic's
• Paralytic agents
• Anti-Pyretics
• Barbiturates (last resort)
⩥ *ICP* management
Coma Assessment
Pediatric Glasgow Coma Scale Answer: THREE PART ASSESSMENT
Includes:
• Eyes
, • Verbal response
• Motor response
*Score of 15*: unaltered LOC
*Score of 8*: Generally accepted as definition of a coma
*Score of 3*: extremely decreased LOC (worst possible score on the
scale)
⩥ *ICP*
Nursing Care in Child Answer: • Frequent repositioning
• Avoid Activities that Increase ICP
• Eliminate / limit environmental noise
• Suctioning -*Contraindicated causes Hypoxia + Cough = ↑ICP*
⩥ *ICP*
Nutrition Answer: • IV admin of fluids- parenteral nutrition
• Caution w/over hydration
• Later: gastric feedings w/NG Tube or GI Tube
• Pt may have risk of Aspiration
⩥ *VP SHUNT CARE* Answer: Postoperative interventions:
2026 UPDATED QUESTIONS WITH
DETAILED ANSWERS GRADED A+
⩥ *ICP*
*INFANTS* sign and symptoms. Answer: • Irritability/ poor feeding
• *High pitched cry/ difficult to soothe*
• Fontanels: Tense & Bulging
• Cranial Sutures Separated
• Eyes: Sun Setting Eyes signs
• Scalp Veins Distended
⩥ *ICP*
*CHILDREN* signs and symptoms. Answer: • Headache
• Vomiting (usually projectile)
• Seizures
• Diplopia (Dbl vision), blurred vision
⩥ *ICP*
,Pain Management in Comatose Child Answer: • Opioids
• Fentanyl, Midazolam, Vecuronium
• Acetaminophen Codeine
• Quiet, Dim lit environment
*PAIN INCREASES ICP*
⩥ *ICP*
Personality and Behavioral Signs of Increasing Pressure Answer: •
Irritability, restlessness
• Drowsiness, indifference, decrease in physical activity and motor skills
• Diminished physical activity
• Inability to follow commands, memory loss
• Lethargy and drowsiness
⩥ *ICP*
Late Signs of Increasing Pressure Answer: Decreased LOC
Decreased motor response to command
Decreased sensory response to painful stimuli
Alterations in pupil size and reactivity
Papilledema-(optic disc pressure)
Decerebrate or decorticate posturing
,Cheyne-Stokes respirations
⩥ *ICP*
Management Answer: Airway management is primary concern
Cerebral hypoxia *LASTING >4 MINUTES MAY CAUSE
IRREVERSIBLE BRAIN DAMAGE- RECOGNIZE EARLY!!*
CO2 causes vasodilation, increased cerebral blood flow, and increased
ICP
May have minimal gag and cough reflexes
Risk of aspiration of secretions
⩥ *ICP*
Medications Answer: • Osmotic Diuretics
• Sedatives / Antiepileptic's
• Paralytic agents
• Anti-Pyretics
• Barbiturates (last resort)
⩥ *ICP* management
Coma Assessment
Pediatric Glasgow Coma Scale Answer: THREE PART ASSESSMENT
Includes:
• Eyes
, • Verbal response
• Motor response
*Score of 15*: unaltered LOC
*Score of 8*: Generally accepted as definition of a coma
*Score of 3*: extremely decreased LOC (worst possible score on the
scale)
⩥ *ICP*
Nursing Care in Child Answer: • Frequent repositioning
• Avoid Activities that Increase ICP
• Eliminate / limit environmental noise
• Suctioning -*Contraindicated causes Hypoxia + Cough = ↑ICP*
⩥ *ICP*
Nutrition Answer: • IV admin of fluids- parenteral nutrition
• Caution w/over hydration
• Later: gastric feedings w/NG Tube or GI Tube
• Pt may have risk of Aspiration
⩥ *VP SHUNT CARE* Answer: Postoperative interventions:
