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ATI RN Nursing Care of Children EXAM
Teaching the parents of a school-aged child who has a new diagnosis of osteomyelitis of the tibia. The nurse should identify that which of the following statements by the parents indicates an understanding of the teaching? my child will have a cast until healing is complete. My child will receive antibiotics for several weeks. My child can return to playing sports once he is discharged. My child needs to be in contact isolation. Answer: b The nurse should instruct the parent that the child will receive antibiotic therapy for at least 4 weeks. Surgery might be indicated if the antibiotics are not successful. A - incorrect Weight bearing must be avoided with osteomyelitis. Therefore, the child is placed in a comfortable position with the limb supported. There is no indication for a cast. C- incorrect Weight bearing should be avoided to prevent complications and minimize pain. Therefore, it will be several weeks to months before the child can play contact sports. D- incorrect Contact isolation is NOT necessary, because osteomyelitis is not a communicable illness. A nurse is auscultating the lungs of an adolescent who has asthma. The nurse should identify the sound as which of the following? Click the audio button to listen. A- Biots respiration B- Chaney Stokes respiration C- tackypnea D - Bradypnea Answer- c The nurse should identify the sound heard during auscultation as tachypnea, which is a rapid, regular breathing pattern. This breathing pattern often occurs with anxiety, fever, metabolic acidosis, or severe anemia. A- Biot's respirations are periods of apnea alternating with two or three shallow breaths. B- Cheyne-Stokes respirations are periods of apnea alternating with periods of hyperventilation. D- Bradypnea is a slow, regular breathing pattern. A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the priority action by the nurse? A- Elevate the head of the child's bed B- insert a large-bore IV catheter for the child C- determine the allergen that caused the child's reaction D- administer IM epinephrine to the child
Answer- d
C- A urine specific gravity of 1.035 is above the expected reference range and indicates concentrated urine. D- A BUN level of 25 mg/dL is above the expected reference range and indicates the kidneys are not excreting BUN as they should be. The nurse is providing teaching about Social Development to the parents of a preschooler. Which of the following play activities should the nurse recommend for the child? A- Play pat-a-cake B- using a push pull toy C- creating a scrapbook D- playing dress-up Answer - d The nurse should instruct the parents that at the preschool age, play should focus on social, mental, and physical development. Therefore, playing dress-up is a recommended play activity for this child. A- Playing pat-a-cake is a recommended play activity for an infant. B- Using a push pull toy is a recommended play activity for a toddler. C- Creating a scrapbook is a recommended play activity for a school-age child. A nurse is teaching the parents of a newborn about ways to prevent sudden infant death syndrome SIDS. Which of the following instructions should the nurse include? A- Place the infant in a prone position to sleep. B- Allow the infant to sleep on a large pillow. C- User soft mattress in the infant's crib. D- Give the infant a pacifier at bedtime. Answer- d The nurse should inform the parent that protective factors against SIDS include breastfeeding and the use of a pacifier when the infant is sleeping. A- The nurse should instruct the parent to place the infant in a supine position to sleep. Prone and side-lying positions are risk factors for SIDS. B- Placing the infant on a large pillow to sleep can increase the risk of suffocation, asphyxiation, and SIDS. C- The nurse should instruct the parent to use a firm mattress and avoid the use of waterbeds, beanbags, or soft mattresses when placing the infant to bed. The use of a soft mattress in the infant's crib is a risk factor for SIDS and can lead to asphyxiation.
A nurse is assessing an infant who has pneumonia. Which of the following findings is the priority for the nurse to report to the provider? A- Nasal flaring B- WBC 11, C- diarrhea D- abdominal distension Answer- a When using the airway, breathing, circulation approach to client care, the nurse should place the priority on nasal flaring. Nasal flaring indicates that the infant is experiencing acute respiratory distress. B- The nurse should report a WBC of 11,300/mm 3 because it is above the expected reference range and indicates infection. However, another finding is the priority for the nurse to report. C- The nurse should report diarrhea because it is a manifestation of pneumonia in infants and indicates the current treatment is not effective. However, another finding is the priority for the nurse to report. D- The nurse should report abdominal distension because it is a manifestation of pneumonia in infants and indicates the current treatment is not effective. However, another finding is the priority for the nurse to report. A school nurse is assessing a school-age child blood pressure while he is seated in a chair. The child starts to experience a tonic-clonic seizure. Which of the following actions should the nurse take first? A- Clear the immediate area around the child of hazardous objects B- loosen the child restrictive clothing C- assist the child to a side-lying position on the floor D- apply an oxygen mask to the child Answer- c The greatest risk to this child is aspiration, occlusion of the airway, and bodily injury from falling out of the chair. The nurse should ease the child down to floor in a side-lying position immediately. This position enables the child's secretions to drain from the mouth, preventing aspiration, and maintaining a patent airway. A- The nurse should clear the area around the child of hazardous objects. However, this is not the first action the nurse should take. B- The nurse should loosen the child's restrictive clothing. However, this is not the first action the nurse should take. D- The nurse should apply an oxygen mask to the child to prevent hypoxia. However, this is not the first action the nurse should take. A nurse is preparing to administer ibuprofen 5 mg per kg every 6 hours PRN for temperatures above 38.0 degrees Celsius or 100.5 degrees Fahrenheit to an infant who weighs 17.6 lb. The infant has a temperature of 38.4 degrees Celsius or 100 + 1.2 degrees Fahrenheit. Available is
B is incorrect. The nurse should not identify the left lower quadrant as the location of McBurney's point. C is incorrect. The nurse should not identify the right upper quadrant as the location of McBurney's point. A nurse is providing teaching to the family of a school-age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include in the teaching? A- Limit the movement of the child large joints. B- Encourage the child to perform independent self care. C- Provide the child with a soft mattress for sleeping. D- Schedule a 2 - hour daily nap for the child in the afternoon. Answer- b The nurse should teach the family the importance of encouraging the child to perform independent self-care. This will minimize the child's pain while maximizing mobility. Encouraging and praising the child's efforts for independence will also increase his self-esteem. A- Large joints should be exercised regularly to maintain mobility and strengthen muscles. C- Children who have juvenile idiopathic arthritis should sleep on a firm mattress to enhance comfort and rest. A soft mattress can increase pressure to the affected joints and increase the child's pain. D- Daytime naps are discouraged because stiffness can occur quickly and easily with inactivity, and naps can interfere with nighttime sleeping. A nurse is assessing a client who has a new diagnosis of celiac disease. Which of the following clinical manifestations should the nurse expect? A- Steatorrhea B- projectile vomiting C- sunken abdomen D- weight gain Answer- a The nurse should realize that clients who have celiac disease are unable to digest gluten. This will cause damage to the cells in the bowel, leading to malabsorption, steatorrhea, and diarrhea. B- Clients who have pyloric stenosis will exhibit projectile vomiting rather than celiac disease. C- A distended abdomen, rather than a sunken abdomen, is a manifestation of celiac disease. D- Weight loss, rather than weight gain, is a manifestation of celiac disease. A nurse is providing teaching to an adolescent about how to manage tinea pedis. Which of the following statements by the Adolescent indicates an understanding of the teaching? A- I should buy some plastic shoes to wear at the swimming pool B- I should wear sandals as much as possible C- I should place the permethrin cream between my toes twice-daily
D- I should I seal my non washable shoes in plastic bags for a couple of weeks Answer- a The use of plastic shoes increases the occurrence of tinea pedis. The nurse should instruct the adolescent to avoid wearing plastic shoes. B- Sandals allow air to circulate around the feet, decreasing perspiration and eliminating the medium for bacteria and fungus to grow. The nurse should inform the adolescent that wearing sandals, open-toed, or well-ventilated shoes will promote healing of his fungal infection. C- Permethrin 5% cream is a scabicide used to place on the lesions created by scabies. This treatment is not recommended for tinea pedis. D- Sealing non-washable items in plastic bags for 14 days is a recommended practice for clients who have pediculosis. This practice is not recommended for tinea pedis. A nurse at an urgent care clinic is assessing an adolescent client who has an upper respiratory tract infection. Which of the following findings should the nurse recognize as a manifestation of pertussis? A- Inflamed throat with exudate B- purulent eye drainage C- dry, hacking cough D- koplik spots on buccal mucosa Answer- c The nurse should recognize that a dry, hacking cough is a manifestation of pertussis. This disease usually begins with indications of an upper respiratory tract infection, which includes a dry, hacking cough that is sometimes more severe at night. A- An inflamed throat with exudate is a manifestation of acute streptococcal pharyngitis. B- Purulent eye drainage is a manifestation of bacterial conjunctivitis. D- Koplik spots on buccal mucosa are a manifestation of rubeola (measles). A nurse is providing teaching about car seat use to the mother of a six-month-old infant. Which of the following statements by the mother indicates an understanding of the teaching? A- I should secure the car seat using lower anchors and tethers instead of the seat belt B- I should position the car seat harness one inch above my baby's shoulders C- I will make sure that the car seat is placed at a 90 degree angle D- I will pad my baby's car seat with a blanket for traveling long distances Answer- a Lower anchors and tethers, or the LATCH child safety seat system, should be used to secure an infant's car seat in the vehicle. This system provides anchors between the front cushion and the back-rest for the car seat. Therefore, if this system is available, the seatbelt does not have to be used. B- The car seat harness in rear-facing car seats should be positioned at or just below the infant's shoulders.
Page 10 of 27 B- A nurse should apply mesh gauze to the child's wound following hydrotherapy to prevent infection. D- Prophylactic antibiotic therapy is not recommended for children who have burns. A nurse is caring for a 10 year old child following a head injury. Which of the following findings should the nurse identify as an indication that the child is developing diabetes insipidus? A- Urine specific gravity of 1. B- sodium 155 C- blood glucose 45 D- urine output 35 ml per hour Answer- b A child who has a head injury can develop diabetes insipidus as a result of pituitary hypofunction leading to a deficiency of antidiuretic hormone. Underexcretion of antidiuretic hormone leads to polyuria and polydipsia and possibly dehydration. With the excessive loss of free water, sodium levels rise above the expected reference range. A- Urine specific gravity of 1.045 is above the expected reference range. A child who has diabetes insipidus is more likely to have diluted urine and urine specific gravity below the expected reference range. C- Blood glucose of 45 mg/dL is below the expected reference range. A child who has diabetes insipidus should have a blood glucose level within the expected reference range. D- Urine output of 35 mL/hr is within the expected reference range. A child who has diabetes insipidus is more likely to have polyuria. A nurse is creating a plan of care for a toddler who has minimal change nephrotic syndrome mcns and 3 + pitting edema. Which of the following interventions should the nurse include in the plan? A- Encourage an increased fluid intake for the toddler B- place the child in an Airborne infection isolation room C- increase the toddler's dietary sodium intake D- administer corticosteroids to the toddler Answer- d The nurse should recognize that corticosteroids are the treatment of choice for providers caring for children who have MCNS. Therefore, the nurse should include administration of prescribed corticosteroids in the plan of care for this toddler. A- Children who have MCNS are on dietary fluid restriction during the edema phase. Therefore, the nurse should not encourage fluid intake for the toddler who has 3+ pitting edema. B- Children who have MCNS do not require isolation precautions. Airborne infection isolation room is used for clients who have airborne infections, such as tuberculosis.
ATI RN Nursing Care of Children Online Practice 2016 A C- Children who have MCNS are on a low-sodium diet during the edema phase. Therefore, the nurse should not increase dietary sodium intake for the toddler who has 3+ pitting edema. A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent asthma. Which of the following instructions should the nurse include? A- You should give your child his salmeterol inhaler every 4 hours when he is having an acute episode of wheezing. B- You should monitor your child's weight weekly while he is receiving inhaled corticosteroid therapy C- pulmonary function test will be performed every 12 to 24 months to evaluate how your child is responding to therapy D- when using the peak expiratory flow meter, record your child average of three readings Answer- c The nurse should inform the parent that her child will need pulmonary function tests every 12 to 24 months to evaluate the presence of lung disease and how the child is responding to the current treatment regimen. As children grow, sometimes their symptoms can improve or decline and treatment needs to change accordingly. A- salmeterol - The nurse should inform the parent that long-acting beta 2 agonists are to be used in conjunction with a low or medium dosage inhaled corticosteroid, and never used alone. Using this medication alone on an as-needed basis during an acute asthma attack is dangerous and can lead to worsening of the child's condition. B- The nurse should instruct the parent that the use of inhaled corticosteroids has not been shown to have any negative effects on growth. The provider might monitor the child's growth for systemic absorption; however, it is not necessary for the parent to weigh the child weekly. D- The nurse should instruct the parent to measure the child's airflow using a peak expiratory flow meter. This should be done twice daily with the skill repeated in a sequence of three, waiting 30 seconds between each measurement. The parent should record the highest of the three readings, rather than the average. A nurse is assessing a three-year-old toddler at a well-child visit. Which of the following manifestations should the nurse report to the provider? A- Blood pressure 90/ 50 B- respiratory rate 45/min C- weight 14.5 kg or 32 lb D- heart rate 110/min Answer- b A respiratory rate of 45/min is above the expected reference range for a 3 - year-old toddler and can indicate respiratory dysfunction and acute respiratory distress. Therefore, the nurse should report this finding to the provider immediately. A- A blood pressure of 90/50 mm Hg is within the expected reference range for a 3 - year-old toddler. C- A weight of 14.5 kg (32 lb) is within the expected reference range for a 3 - year-old toddler.
ATI RN Nursing Care of Children Online Practice 2016 A D- I will give my child polyethylene glycol daily for 7 days Answer- c The nurse should teach the parent to closely monitor the child's number of wet diapers. Monitoring the number of wet diapers per day is the best way for the parent to monitor adequate output and hydration status. A- Children recovering from dehydration should not b e encouraged to drink frequent, small amounts of fruit juice because it is high in carbohydrates, low in electrolytes, and has a high osmolality value. B- The nurse should teach the parent to encourage solid foods even when the child has diarrhea. D- Polyethylene glycol is an osmotic agent that will pull fluid into the bowel, increasing the frequency of stools, which will increase the level of dehydration. A nurse is preparing to collect a sample from a toddler for a sickle turbidity test. Which of the following actions should the nurse plan to take? A- Obtain a sputum specimen B- perform an allen test C- perform a finger stick D- obtain a stool specimen Answer- c The nurse should perform a finger stick on a toddler as a component of the sickle-turbidity test. If the test is positive, hemoglobin electrophoresis is required to distinguish between children who have the genetic trait and children who have the disease. A- Sputum specimens are collected to identify the infectious organism in a child who has as acute respiratory tract infection. Therefore, this is not a component of the sickle-turbidity test. B- An Allen test determines adequate circulation by observing capillary refill before an arterial puncture. Therefore, this is not a component of the sickle-turbidity test. D- Stool specimens are collected to identify organisms or parasites that cause diarrhea or to check for the presence of occult blood. Therefore, this is not a component of the sickle-turbidity test. A nurse is caring for a school-age child who has peripheral edema. Which of the following assessments should the nurse perform to confirm peripheral edema? A- Palpate the dorsum of the child's feet B- play the child daily using the same scale C- assess the child's skin turgor D- observe the child for periorbital swelling Answer- a The nurse should palpate the dorsum of the feet by pressing her fingertip against a bony prominence for 5 seconds to assess for peripheral edema.
ATI RN Nursing Care of Children Online Practice 2016 A B- Weighing the child daily might indicate that the child has retained fluid; however, this is not an acceptable method for assessing for peripheral edema. C- Assessing the child's skin turgor measures the elasticity and mobility of the skin; however, this is not an acceptable method for assessing for peripheral edema. D- Observing the child for periorbital swelling is an appropriate method for assessing central edema; however, this is not an acceptable method for assessing for peripheral edema. A nurse in the emergency department is caring for a toddler who has partial thickness burns on his right arm. Which of the following actions should the nurse take? A- Insert a nasogastric tube B- initiate prophylactic antibiotics therapy C- cleanse the affected area with mild soap and water D- apply a topical corticosteroid to the affected area Answer- c The nurse should wash the affected area with mild soap and water to remove any loose tissue that could cause infection. A- Inserting a nasogastric tube to empty the contents of the stomach and maintain decompression is an intervention for major burn management. B- Prophylactic antibiotics are not recommended for burns of any type. D- The nurse should apply an antibiotic ointment to the affected area to prevent infection. A nurse is performing hearing screenings for children at a community health fair. Which of the following children should the nurse refer to a provider for a more extensive hearing evaluation? A- A toddler who is 18 months old and has unintelligible speech B- an infant who is 3 months old and has an exaggerated startle response C- a preschooler who is 4 years old and prefers playing with others rather than alone D- an infant who is 8 months old and is not yet making babbling sounds Answer- d The nurse should refer an infant who is not making babbling sounds by the age of 7 months to a provider for more extensive evaluation of hearing. A- The nurse should refer a toddler who does not possess intelligible speech by the age of 24 months to a provider for more extensive evaluation of hearing. B- The nurse should refer infants who are under the age of 4 months and lack a startle response to a provider for more extensive evaluation of hearing. C- The nurse should refer a preschooler who prefers playing alone and avoids interaction with others to a provider for more extensive evaluation of hearing.
ATI RN Nursing Care of Children Online Practice 2016 A A- Use a kitchen teaspoon to measure the medication B- brush the child teeth after giving the medication C- double the next dose If the child misses a dose D- repeat the dose If the child vomits Answer- b The nurse should instruct the parents to brush the child's teeth after administering digoxin to prevent tooth decay caused by the medication, which comes as a sweetened liquid to enhance the taste. A- The nurse should instruct the parents to use the calibrated device that comes with the medication when measuring the medication to avoid accidental overdose. C- The parent should administer digoxin at regular intervals, usually twice daily, or every 12 hr. The nurse should instruct the parents not to double the medication amount if they miss a dose because this can result in digoxin toxicity. D- Nausea, vomiting, and decreased appetite are common manifestations of digoxin toxicity in children. The nurse should instruct the parents not to administer a second dose if the child vomits and to notify the provider. A nurse is providing teaching to the parent of a school-age child who has oral candidiasis and is to begin taking oral Nystatin. Which of the following instructions should the nurse include? A- Check the medication prior to Administration B- provide the medication through a straw C- rinse the child mouth with water immediately after giving the medication D- next the medication with applesauce If the child dislikes the taste Answer- a The nurse should instruct the parent to shake the medication prior to administration in order to disperse the medication evenly within the suspension. B- The nurse should instruct the parent to put the medication directly in the child's mouth and make sure the child swishes it around before swallowing. C- The nurse should instruct the parent to have the child keep the medication in his mouth for as long as possible before swallowing it. Rinsing his mouth can wash some of the medication away and decrease effectiveness. D- The parent should not mix the medication with food because this will interfere with the absorption. The nurse is providing anticipatory guidance to the mother of a toddler. Which of the following expected Behavior characteristics of toddlers should the nurse include in the teaching? A- Controls impulsive feelings B- understand right from wrong C- usually separated from parents for a long periods of time D- expresses likes and dislikes
ATI RN Nursing Care of Children Online Practice 2016 A Answer- d The nurse should teach the mother that her toddler will begin to express her likes and dislikes. This is the time in life when a toddler is developing autonomy and self-concept. She will try to assert herself and frequently refuse to comply. The parent should allow the child to have some control but also set limits in order for her to learn from her behavior and learn to control her actions. A- The mother should expect a school-age child to be able to control impulsive feelings. A toddler is more likely to have difficulty controlling strong and impulsive feelings as she tries to assert her independence and gain control of situations. B- The mother should expect a preschooler to begin to understand right from wrong and to modify her behavior in response to others' expectations. A toddler has a great deal of curiosity and asks many questions but is not able to fully understand what behaviors are right or wrong. C- The mother should expect that her toddler might be able to separate from her for a short period of time, but the toddler is more likely to experience acute separation anxiety when separated from her mother for an extended time. The toddler might offer resistance if she is left with a new babysitter or at a new day care center. The nurse is reviewing the laboratory report of a school-age child who is experiencing fatigue. Which of the following findings should the nurse recognize as an indication of anemia? A- Hematocrit 28% B- hemoglobin 13.5 g C- WBC 8000 D- platelet 250, Answer- a The nurse should recognize that this hematocrit level is below the expected reference range for a school-age child. The child can exhibit fatigue, lightheadedness, tachycardia, dyspnea, and pallor due to the decreased oxygen-carrying capacity. B- This hemoglobin level is within the expected reference range for a school-age child. C- This WBC is within the expected reference range for a school-age child. D- This platelet is within with expected reference range for a school-age child. A nurse is creating a plan of care for an infant who has an epidural hematoma with a skull fracture. Which of the following actions should the nurse include in the plan? A- Position the infant side lying with her head at a 0 - 5 degree angle B- monitor the infant for tachycardia to prevent brain stem herniation C- suction the infant snares every two hours while awake to maintain patency D- implements seizure precautions for the infants Answer- d The nurse should implement seizure precautions for an infant who has an epidural hematoma as a safety measure.
ATI RN Nursing Care of Children Online Practice 2016 A C- The parents should avoid placing objects, such as tongue depressors, in the infant's mouth to prevent injury to the suture line. A nurse is caring for a hospitalized preschooler. The child's mother is going home for a few hours while another relative stay with the child. Which of the following statements should the nurse make to explain to the child when her mother will return? A- Your mommy will be back at 7 p.m. B- your mommy will be back after she takes care of your brother C- your mommy will be back in the morning D- your mommy will be back after you eat Answer- d Preschoolers make sense of time best when they can associate it with an expected daily routine, such as meals and bedtime. Therefore, the child comprehends time best when it is explained to them in relation to an event they are familiar with, such as eating. A- A preschooler does not have an accurate understanding of time. They use language, but most of the time they do not actually know or conceive the meaning of the words. B- A preschooler does not have an accurate understanding of time. They use language, but most of the time they do not actually know or conceive the meaning of the words. Also, this response by the nurse does not relate to the child directly. C- A preschooler does not have an accurate understanding of time. They use language, but most of the time they do not actually know or conceive the meaning of the words. A nurse is planning developmental activities for a newly admitted 10 year old child who has neutropenia. Which of the following actions should the nurse plan to take? A- Provide the child with a book about Adventure B- arrange frequent visits from family members and peers C- give the child a large piece puzzle D- use puppet to entertain the child Answer- a The nurse should provide a school-age child with a book about adventure as a developmental activity because children are expanding their knowledge and imagination during this age. Through reading, school-age children can feel powerful and skillful as they imagine themselves in the stories they read. B- The nurse should limit visitors for a child who has neutropenia because this places the child at an increased risk of infection. C- The nurse should provide a large-piece puzzle to a preschooler. School-age children desire to be mentally challenged with complex board and video games. D- The nurse should use puppets to entertain toddlers. A school-age child would not be entertained for very long or mentally challenged with puppets. They prefer complex board and video games.
ATI RN Nursing Care of Children Online Practice 2016 A A nurse in the emergency department is caring for a school-age child who has epiglottitis. Which of the following actions should the nurse take? A- Obtain a throat culture from the child B- monitor the child's oxygen saturation C- put a warm mist humidifier in the child's room D- Place the child in a Supine position Answer- b The nurse should monitor the child's oxygen saturation level because the child is experiencing acute respiratory distress and it is necessary to determine if the child is responding to treatment. A- Obtaining a throat culture places the child at risk for complete airway obstruction. The nurse should wait until an airway is established for the child before performing any diagnostic testing. C- The nurse should administer humidified oxygen by face mask or blow-by, rather than place a warm mist humidifier in the child's room. D- Placing the child in the supine position increases the child's risk for a complete airway obstruction. The nurse should place the child in an upright position, and sometimes it is helpful for the child to lean over the bedside table to help with breathing. A nurse in an Emergency Department is assessing a three-month-old infant who has rotavirus and is experiencing acute vomiting and diarrhea. Which of the following manifestations should the nurse identify as an indication that the infant has moderate to severe dehydration? A- Heart rate 124/ minute B- increase tear production C- sunken anterior fontanel D- capillary refill 2 seconds Answer- c The nurse should recognize that a sunken anterior fontanel is an indication of moderate to severe dehydration due to the acute loss of fluid. A- A heart rate of 124/min is within the expected reference range of 106 to186/min for a 3 - to 5 - month-old infant. The nurse should expect the infant who has moderate to severe dehydration to have tachycardia. B- An infant who has moderate to severe dehydration is more likely to have absence of tears, rather than increased tear production. D- Capillary refill of 2 seconds is within the expected reference range for a 3-month-old infant. An infant who has moderate to severe dehydration is more likely to have delayed capillary refill of greater than 2 seconds.
