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ATI NURSING CARE OF CHILDREN
PROCTORED EXAM LATEST REAL
QUESTIONS AND CORRECT ANSWERS
GRADE A
What is a dictorial or authoritarian parenting style? - CORRECT ANSWER parents try to control the child's behaviors and attitudes through unquestioned rules and expectations down syndrome - CORRECT ANSWER chromosomal abnormality small round head, flattened forehead, small nose with depressed nasal bridge, small ears with short pinna, protruding abd, hypotonia and hyper flexibility manage secretions and help prevent respiratory infections cardiac defects and strabismus rinse mouth after feeding and throughout the day cool mist humidification and use bulb syringe prn juvenile idiopathic arthritis - CORRECT ANSWER chronic autoimmune inflammatory disease affecting the joints and other tissues joint swelling, stiffness, redness and warmth worse in morning or after naps apply a splint for sleeping encourage use of a firm mattress and discourage use of pillows apply heat or warm moist packs
to the affected joints encourage warm baths NSAIDS, methotrexate, steroids Muscular dystrophy - CORRECT ANSWER group of inherited disorders with progressive degeneration of symmetric skeletal muscle groups causing progressive muscle weakness and wasting Most common Duchenne's MD - onset within 3-7years s/s: muscle weakness, unsteady gait, waddling, lordosis, and delayed motor skills development o frequent falling, learning difficulties, progressive muscle atrophy resp. and cardiac difficulties around age 20 corticosteroids complications: resp. compromise progressive weakening of the resp. muscles Impetigo - CORRECT ANSWER Caused by staph Reddish macule that becomes vascular and can erupt forming dry crusty's + itchy Direct contact Abx ointment, burow's solution Cellulitis - CORRECT ANSWER Firm swollen red area of the skin and subcutaneous tissue Fever Abx and warm moist compresses Tinea - CORRECT ANSWER fungal, Round red scaley patches, itchy in warm and moist areas Head - selenium sulfide shampoo Topical antifungal Treat infected pets as well
Seborrheic dermatitis - CORRECT ANSWER cradle cap Scaly and greasy thick flakes Not contagious Gently scrub the scalp with mild shampoo or special treatment Fine tooth comb Keep nails trimmed short for skin issue kids + gloves or socks over hands for sleeping Cotton clothing Avoid excessive heat Avoid irritants Atopic dermatitis - eczema - CORRECT ANSWER Intense itchy Damage from so much itching Antihistamines
- topical steroids Acne - CORRECT ANSWER Good diet, exercise, mild cleanser, don't pick Meds Nursing interventions for burns: - CORRECT ANSWER ABC's IV access with lg bore catheters Immunization status - tetanus in last 5 years = they are going to get one Advise family nothing greasy on burn Fluids based on urine output Kids <30 kg (66 pounds) 1- 2ml/kg/hour >30 kg 30ml/hour LR and NS sometimes Manage pain - IV opioid's Nutrition - increase protein and calories + vitamin A, C, and Zinc Restoring mobility - active and passive ROM Silver sulfadiazine - 2 nd and 3rd degree transient neutropenia Allograft - cavader Xenograft
- animals Autograft - own skin Hypoglycemia s/s: cold and clammy need some candy
<60 blood sugar - CORRECT ANSWER Hunger Shakiness Diaphoresis Irritability Pale cool skin Possible in LOC Slurred speech, HA, seizures Tachycardia and palpitations Normal to shallow respirations Hyperglycemia s/s: hot and dry, sugar is high - CORRECT ANSWER Polyuria Polydipsia Polyphagia Dehydration Tired/fatigued Weak Nausea, vomiting, abd pain Weak pulse and diminished reflexes Warm, dry, and flushed skin Rapid, deep respiration - kussmauls respirations - fruity smelling breath Diabetes mellitus diagnostic criteria - CORRECT ANSWER 8 - hour fasting blood glucose of 126 or higher o No antidiabetic meds until after the procedure A random blood glucose of 200 or more + classic s/s of diabetes Oral glucose tolerance test of 200 or more in a 2-hour sample o Balanced diet for 3 days prior o Fast for 8 hours o A fasting level is drawn at the start of the test o Then instructed to consume a specific amount of glucose - and blood levels are drawn every 30 minutes for 2 hours o Assess for hypoglycemia throughout the procedure HbA1c [glycosylated hemoglobin] o Expected range is 4-5.9% but an acceptable range for a child with diabetes can be 6- 58% with a goal of <7% Less than 7% indicates that DM is being well managed Self-monitored blood glucose - before meals and at bedtime Foot care of Diabetes Mellitus - CORRECT ANSWER
and bicarb 15] resulting in the breakdown of body fat for energy and an accumulation of ketones in the blood, urine, and lungs o Rapid onset o Fruity breath, deep breathing, kussmauls, confusion, dyspnea, n/v, dehydration, and electrolyte imbalances o Metabolic acidosis - hyperkalemia o Treatment - as we are bringing the glucose levels down, the potassium levels may switch from hyper to hypo Cardiac monitor Sodium bicarb for metabolic acidosis slow IV infusion When BG levels get around 250 - add glucose to IV fluids in order to maintain 120 - 240 BG Give IV insulin continuously Monitor levels hourly growth hormone deficiency - CORRECT ANSWER short stature, delayed bone closure, and delayed sex development growth hormone treatment - CORRECT ANSWER - somatropin subcutaneous injections until the bones have closed Immunizations - CORRECT ANSWER Common cold or minor illness - not contraindications for getting vaccinated Severe acute illness - contraindicated Immunosuppression
- contraindicated from a few Flu vaccine - hypersensitivity to eggs = c/a Varicella - corticosteroids = c/a IPV - allergy to neomycin = c/a MMR - allergy to gelatin & neomycin = c/a DTAP - occurrence of encephalopy, seizures, or inconsolable crying that lasted a long time previously = c/a VL or ventral gluteal for smaller children Older children -
deltoid muscle Charting include date, route, site, type, manufacture lot number, and expiration Low grade fever (common s/e) - don't give aspirin = Reyes syndrome Babies vaccine can give concentrated oral sucrose solution on a pacifier 2 min before and for 3 min after the injection What is an authoriatitive parenting style? - CORRECT ANSWER also known as democratic, parents direct the child's behavior by setting rules and explaining the reson for each rule setting What is passive parenting? - CORRECT ANSWER parents are uninvolved, indifferent, and emotionally removed A nurse manager on a pediatric floor is preparing an education program on working with families for a group of newly hired nurses. Which of the following should the nurse include when discussing the developmental theory? A. describes that stress is inevitable B. emphasizes that change with one member affects the entire family C. provides guidance to assist families adapting to stress D. Defines consistencies in how families change - CORRECT ANSWER D A nurse is assisting a group of parents of adolescents to develop skills that will improve communication. The nurse
CORRECT ANSWER 60 to 110/min What is the expected pulse of a child 10 years and older?
- CORRECT ANSWER 50 to 90/min What are the expected respirations fo a newborn to one year? - CORRECT ANSWER 30 to 35/min What are the expected respirations of a 1 to 2 year old? - CORRECT ANSWER 25 to 30/min What are the expected respirations of a 2 to 6 year old? - CORRECT ANSWER 21 to 25/min What are the expected respirations of a child 6 to 12 years old? - CORRECT ANSWER 19 to 21/min What are the expected respirations of a 12 year old and older? - CORRECT ANSWER 16 to 19/min What are the normal vitals of an infant? - CORRECT ANSWER HR: 80- 180 RR: 30- 35 BP: 65-80/40- 50 Fontanels - CORRECT ANSWER should be flat and soft, posterior closes between 6 and 8 weeks, anterior closes between 12 and 18 months
Teeth - CORRECT ANSWER 6 to 8 teeth by 1 year of age, 20 baby teeth and 32 permanent teeth How long is the Moro reflex present? - CORRECT ANSWER until 4 months of age How long is the Tonic neck reflex present? - CORRECT ANSWER until 3 to 4 months of age How long does the Babinski reflex last? - CORRECT ANSWER usually until a year Expected findings of the olfactory (I) nerve in infants , children, and adolescents - CORRECT ANSWER Infants: difficult to test Children and Adolescents: indentifies smell through each nostril individually Expected findings of optic nerve (II)? - CORRECT ANSWER Infants: looks at face and tracks with eyes Children and adolescents: has intact visual acuity, peripheral vision, and color vision Expected findings for trigeminal nerve? - CORRECT ANSWER infants: has rooting and sucking relfex
A nurse is assessing a 6-month-old infant. Which of the following reflexes shoudl the infant exhibit? A. Moro B. Plantar grasp C. Stepping D. Tonic necl - CORRECT ANSWER B A nurse is performing a neurological assessment on an adolescent. Which of the following is an appropriate reaction by the adolescent when the nurse checks the trigeminal cranial nerve? (select all that apply) A. clencing the teeth together tightly B. recognizing a sour tast C. identifying smells through each nostril D. detecing facial touches when eyes closed E. Looking down and in with the eyes - CORRECT ANSWER A, D What happens to a baby's birth weight? - CORRECT ANSWER it should double by 6 months and triple by 1 year How do infants grow? - CORRECT ANSWER 1 inch per month (2.5cm) for 6 months, then by 12 months, height/length should be doubled When do the first teeth arupt? - CORRECT ANSWER between 6 and 10 months
Gross and fine motor by 3 months - CORRECT ANSWER only have slight head lag Gross and fine motor by 4 months - CORRECT ANSWER should be able to roll from back to side Gross and fine motor by 5 months - CORRECT ANSWER should be able to roll from front to back Gross and fine motor by 6 months - CORRECT ANSWER should be able to roll from back to fron and hold a bottle Gross and fine motor by 7 months - CORRECT ANSWER move object from hand to hand Gross and fine motor by 8 months - CORRECT ANSWER sit unsupported Gross and fine motor by 9 months - CORRECT ANSWER crude pincer grasp Gross and fine motor by 10 months - CORRECT ANSWER prone to sitting positiion and grasp a ratty by the handle Gross and fine motor by 11 months - CORRECT ANSWER puts objects into a container and have a neater pincer grasp
B
2 months: hep B, IPV, RV, PCV, dtap, HIB 4 months: all of the 2m, hep B 6 month: all the previous Flu shots: 6m to 1 year Infant Nutrition - CORRECT ANSWER breast milk first 6 months, solids 4 to 6 months and first solid is usually iron fortified rice ceral, no juice or water is needed for first year, foods introduced one at a time over 4-7 day period to monitor for allergies What are infant safety concers? - CORRECT ANSWER choking/aspiration (grapes, coins, candy) burns (sunscnreen, handles turned away from stove, electrical outlets are covered), drowning, rear facing care seat until 2 years, crib slats are no more than 6cm, no pillows, and sleep on back A nurse is assessing a 12 months old infant during a wellchild visit. Which of the following findings should the nurse report to the provider? A. closed anterior fontanel B. eruption of 6 teeth C. Birth weight doubled D. Birth length increased by 50 % - CORRECT ANSWER C
A nurse is performing a developmental screening of a 10month old infant. Which of the following fine motor skills should the nurse expect to find? (select all that apply) A. grasp a raddle by the handle B. try building a two-block tower C. use a crude pincer grasp D. Place objects into a container E. Walkes with one hand held - CORRECT ANSWER A, C A nurse is conducting a well-baby visit with a 4 motnh old infant. Which of the following immunizations should the nurse plan to administer? (select all that apply) A. MMR B. IPV C. PCV D. varicella E. RV - CORRECT ANSWER B, C, E A nurse is providing education about introducing new foods to the parents of a 4 months old infant. The nurse should recommend that the parents introduce which of the following foods first? A. Strained yellow vegetables B. Iron fortified cereals C. Pureed foods D. Whole Milk - CORRECT ANSWER B A nurse is providing teaching about dental care and teething to the parent of a 9-month-old. Which of the
gross and fine motor skills of 2 year old toddler - CORRECT ANSWER can walk up and down stairs by placing feet on each step and build a 6-7 block tower gross and fine motor skills of 2.5 year old toddler - CORRECT ANSWER can jump with both feet and draw circles Language of a toddler - CORRECT ANSWER 1 year = 1 word senteces/hollow phrases 2 year = 2-3 word senteces Erikson's stage of Toddlers - CORRECT ANSWER autonomy vs shame and doubt, independence, begin to express selves by saying no a lot, thrive on rituals, maintian routines Toddler appropirate activities - CORRECT ANSWER blocks, push pull, thick crayons, puzzle Bathroom needs of toddlers - CORRECT ANSWER toilet training begins when they have recognized the sensation that they need to go potty Immunizations of a toddler - CORRECT ANSWER 12 - 15 month: IPV, PCV, MMR, varicells, HIB 12 - 23 months: Hep A 2 doses 6 months apart
15 - 18months: dtap and annual flu Nutrition of a toddler - CORRECT ANSWER breast milk or formula through 1 year, 1-2 year whole milk, after 2 can transition to low fat, limit juice consumption to 4-6oz per day, prevent choking, nuts, grapes, hot dogs, peanut butter, raw carrots, tough meat, popcorn What are safety hazards of toddlers? - CORRECT ANSWER burns, drowning, falls, aspiration, prevention A nurse is assessing a 2.5-year-old toddler at a well-child visit. Which of the following findings should the nurse report to the provider? A. height increased by 7.5cm or 3inches in the past year B. Head circumference exceeds chest circumference C. anterior and posterior fontanels are closed D. current weight equals four times the birth weight - CORRECT ANSWER B A nurse is performing a develomental screening on an 18 month old. Which of the following skills should the toddler be able to perform? (select all that apply) A. build a tower with 6 blocks B. Throw a ball overhead C. walk up and down stais D. draw circles E. use a spoon without rotation - CORRECT ANSWER B, E
