Review RN ATI Nursing Care of Children 2019

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RN ATI Nursing Care of Children 2019

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Total Questions : 50

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Question 1:

A nurse is preparing to initiate intravenous (IV) antibiotic therapy for a newly admitted 12-month-old infant. Which of the following actions should the nurse plan to take?

A. Use a 24-gauge catheter to start the IV. B. Start the IV in the infant's foot. C. Cover the insertion site with an opaque dressing. D. Change the IV site every 3 days.

Answer and Explanation

Choice A:

A 24-gauge catheter is appropriate for a small and fragile vein of a 12-month-old infant. It minimizes the risk of damaging the vein and ensures the comfort of the infant during IV therapy.

Choice B:

Starting an IV in the infant's foot is not the first choice due to the risk of movement dislodging the catheter. The hand or the antecubital fossa are preferred sites for IV insertion in infants.

Choice C:

While it is important to cover the IV insertion site, an opaque dressing is not necessary. A transparent dressing is preferred as it allows for continuous visibility of the site for signs of infection or phlebitis.

Choice D:

The IV site should not be routinely changed every 3 days. It should be changed based on clinical indications such as signs of infection, infiltration, or phlebitis, or if the IV becomes dislodged.

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Question 2:

A nurse is preparing a 4-year-old child for a tonsillectomy. Which of the following statements should the nurse make?

A. "You will have a special sleep so you won't feel anything." B. "Your mom will be there throughout the procedure." C. "You will be put to sleep for your surgery." D. "Your throat will feel better when you wake up."

Answer and Explanation

Choice A:

This statement is developmentally appropriate and helps to alleviate the child's anxiety about pain during the procedure. It uses language that a 4-year-old can understand without causing unnecessary fear.

Choice B:

While it is comforting to know a parent will be close by, this statement is not accurate as parents are typically not present in the operating room during the procedure. It could lead to confusion and distress when the parent is not there.

Choice C:

This statement is too vague and may not be fully understood by a child. It lacks the reassurance that the child will not feel pain, which is an important aspect to address.

Choice D:

Although this statement is positive and forward-looking, it does not address the child's immediate concerns about the procedure itself. It is important to reassure the child about what to expect during the surgery.

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Question 3:

A nurse is planning to administer immunizations to a 2-month-old infant. Which of the following actions should the nurse take to decrease the infant's pain?

A. Ask the parent to leave the room during the injections. B. Administer the injections while the infant is breastfeeding. C. Apply a warm pack to the injection site prior to administration. D. Administer the injections in the deltoid muscle.

Answer and Explanation

Choice A:

Asking the parent to leave the room during the injections is not recommended as the presence of a parent can provide comfort to the infant, which may help in reducing pain and anxiety.

Choice B:

Administering the injections while the infant is breastfeeding is an effective method to decrease pain. Breastfeeding provides comfort and distraction, and the natural sugars in breast milk can have a mild analgesic effect.

Choice C:

Applying a warm pack to the injection site prior to administration is not a standard practice for reducing pain from immunizations. Instead, using a cold compress after the injection can help to reduce swelling and discomfort.

Choice D:

Administering injections in the deltoid muscle is not appropriate for a 2-month-old infant due to the underdeveloped muscle mass. The anterolateral thigh is the recommended site for immunizations in infants.

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Question 4:

A nurse is caring for a child during a tonic-clonic seizure. Which of the following actions should the nurse take? (Select all that apply)

A. Loosen tight clothing around the child's neck. B. Firmly hold the child's arms to one side. C. Place a pillow under the child's head. D. Insert a tongue blade into the child's mouth. E. Clear the area of hard objects.

Answer and Explanation

Choice A:

Loosening tight clothing around the child's neck is important to ensure that the child can breathe easily and to prevent any additional discomfort or injury during the seizure.

Choice B:

It is not recommended to firmly hold the child's arms to one side as this can cause injury. Instead, the nurse should ensure the child's safety by clearing the area of any hard or sharp objects.

Choice C:

Placing a pillow under the child's head can help to protect the head from injury during the seizure. It provides a soft cushion to prevent the child from hitting their head on hard surfaces.

Choice D:

Inserting a tongue blade into the child's mouth is not advised as it can cause injury to the child's mouth or teeth, and there is a risk of the child biting down and breaking the blade.

Choice E:

Clearing the area of hard objects is crucial to prevent injury to the child during the seizure. Removing any potential hazards ensures a safer environment for the child to move without harm.

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Question 5:

A nurse is assessing a toddler during a well-child visit. Which of the following findings should the nurse identify as an indication of nephrotic syndrome?

A. Constipation B. Increased abdominal girth C. Irritability D. Increased urinary output

Answer and Explanation

Choice A:

Constipation is not typically associated with nephrotic syndrome. It may be related to dietary factors, dehydration, or other gastrointestinal issues.

Choice B:

Increased abdominal girth can be an indication of nephrotic syndrome due to the accumulation of fluid in the abdomen (ascites) as a result of low albumin levels in the blood, which is a characteristic of this condition.

Choice C:

Irritability can be a non-specific symptom and may be caused by a variety of factors. It is not a direct indication of nephrotic syndrome.

Choice D:

Increased urinary output is not characteristic of nephrotic syndrome. In fact, decreased urine output may be observed due to the loss of protein in the urine and subsequent fluid retention in the body.

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Question 6:

A nurse is creating a plan of care for an adolescent who has muscular dystrophy. Which of the following interventions should the nurse include in the plan?

A. Recommend the adolescent use a wheelchair to prevent stress on the lower extremities. B. Avoid influenza and pneumococcal vaccines for 24 months. C. Initiate a referral for chest physiotherapy every 4 hours. D. Encourage the adolescent to perform incentive spirometry to maintain lung capacity.

Answer and Explanation

Choice A:

Recommending the use of a wheelchair can help prevent stress on the lower extremities, which is important for an adolescent with muscular dystrophy. This condition can lead to muscle weakness and using a wheelchair can aid in mobility and independence.

Choice B:

Avoiding influenza and pneumococcal vaccines is not recommended. Vaccinations are important for preventing infections, especially in individuals with compromised health conditions like muscular dystrophy.

Choice C:

Initiating a referral for chest physiotherapy every 4 hours can be beneficial for an adolescent with muscular dystrophy. This therapy can help clear mucus from the lungs and improve respiratory function, which is often compromised in this condition.

Choice D:

Encouraging the adolescent to perform incentive spirometry is important to maintain lung capacity. Muscular dystrophy can affect the muscles used for breathing, and incentive spirometry can help strengthen these muscles and improve respiratory health.

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Question 7:

A nurse is caring for a 6-month-old infant who has gastroenteritis. Which of the following findings should the nurse identify as a manifestation of severe dehydration?

A. Produces tears when crying B. Sunken anterior fontanel C. Weight loss of 5% D. Capillary refill time 3 seconds

Answer and Explanation

Choice A:

Producing tears when crying is not typically a sign of severe dehydration. In fact, the ability to produce tears may suggest that the infant is not severely dehydrated.

Choice B:

A sunken anterior fontanel is a classic sign of severe dehydration in infants. The fontanel, which is the soft spot on the top of a baby's head, can appear sunken when there is significant fluid loss.

Choice C:

While weight loss can be a sign of dehydration, a 5% weight loss alone does not necessarily indicate severe dehydration. Other clinical signs should also be considered.

Choice D:

A capillary refill time of 3 seconds is at the upper limit of normal. Prolonged capillary refill time can be a sign of dehydration, but it is not as specific as a sunken anterior fontanel for severe dehydration.

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Question 8:

A nurse is providing discharge teaching to the parents of a school-age child following the placement of a ventriculoperitoneal shunt. The nurse should determine that the teaching was effective when the parents identify which of the following as an indicator that the shunt has been displaced?

A. Decreased urine output B. Increased sleeping C. Hyperactive bowel sounds D. Elevated temperature

Answer and Explanation

Choice A:

Decreased urine output is not directly related to ventriculoperitoneal shunt displacement. It may indicate other issues such as dehydration or kidney problems.

Choice B:

Increased sleeping is not a specific indicator of shunt displacement. While it may be a concern if there are significant changes in the child's sleep patterns, it is not a definitive sign of this complication.

Choice C:

Hyperactive bowel sounds are not associated with shunt displacement. They may indicate gastrointestinal issues but are not relevant to the function of a ventriculoperitoneal shunt.

Choice D:

An elevated temperature can be an indicator of shunt displacement, as it may suggest an infection or other complications related to the shunt. Parents should be aware of this sign and seek medical attention if it occurs.

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Question 9:

A nurse in a community center is providing an in-service for parents about nutritional guidelines. Which of the following instructions should the nurse include in the teaching?

A. Introduce popcorn as a healthy snack at 12 months of age. B. Provide 36 oz of milk per day to a toddler. C. Offer 8 to 10 oz of juice per day to a preschooler. D. Encourage a 15-year-old to increase calcium intake.

Answer and Explanation

Choice A:

Introducing popcorn as a healthy snack at 12 months of age is not recommended due to the risk of choking. Popcorn is a choking hazard for young children and should be avoided until they are older.

Choice B:

Providing 36 oz of milk per day to a toddler may be excessive and can lead to iron deficiency anemia due to the displacement of other iron-rich foods. The American Academy of Pediatrics recommends 16-24 oz of milk per day for toddlers.

Choice C:

Offering 8 to 10 oz of juice per day to a preschooler exceeds the American Academy of Pediatrics' recommendation of limiting juice to 4-6 oz per day for children 1-6 years old to prevent dental caries and ensure they consume more whole fruits.

Choice D:

Encouraging a 15-year-old to increase calcium intake is appropriate as adolescence is a critical period for bone development. Adequate calcium intake supports optimal bone growth and density, helping to prevent osteoporosis later in life.

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Question 10:

A nurse is providing teaching about home care to the parent of a child who has scabies. Which of the following instructions should the nurse include in the teaching?

A. Treat everyone who came into close contact with the child. B. Soak combs and brushes in boiling water for 10 minutes. C. Wash the child's hair with shampoo containing ketoconazole. D. Apply petroleum jelly to the affected areas.

Answer and Explanation

Choice A:

Treating everyone who came into close contact with the child is essential because scabies is highly contagious. The mites that cause scabies can easily spread to others through direct skin contact or by sharing personal items.

Choice B:

Soaking combs and brushes in boiling water for 10 minutes is a good practice to kill any mites that may be present. However, it is not the primary method of treating scabies, which requires medication.

Choice C:

Washing the child's hair with shampoo containing ketoconazole is not a standard treatment for scabies. Ketoconazole is an antifungal medication, and scabies is caused by mites, not fungi.

Choice D:

Applying petroleum jelly to the affected areas is not an effective treatment for scabies. Scabies requires prescription medications, such as topical permethrin or oral ivermectin, to eliminate the mites.

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Total Questions : 50

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RN ATI Nursing Care of Children 2019

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