Free ATI RN Nursing Care of Children practice for ATI Complete RN Nursing Care of Children 2 (ATI RN). Answer 49 nursing exam-style questions with rationales, e
The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss?
Select the best answer.
Explanation:
The weight loss is most likely due to the reduction of edema, as glomerulonephritis often causes fluid retention that resolves with treatment, leading to significant weight loss.
Which condition is characterized by a harsh, barking cough in children?
Select the best answer.
Explanation:
Croup is the correct answer. It is characterized by a harsh, barking cough due to inflammation of the upper airways, specifically the larynx and trachea. Asthma (Choice A) often presents with wheezing and shortness of breath, not a barking cough. Bronchiolitis (Choice B) typically causes wheezing and respiratory distress in infants. Pneumonia (Choice D) manifests with symptoms such as fever, productive cough, and chest pain, but not usually a barking cough.
Which reflex, present at birth, is elicited by stroking the sole of the infant's foot, resulting in the fanning of the toes?
Select the best answer.
Explanation:
The Babinski reflex is the correct answer. This reflex is characterized by the fanning out of the toes when the sole of the foot is stroked. It is a normal reflex in infants and is typically present at birth, disappearing by around 12 months of age. The Moro reflex, which involves the infant's response to a sudden loss of support or a loud noise, is not related to the fanning of toes. Sucking and rooting reflexes are related to feeding behaviors and are not elicited by stroking the sole of the foot.
Which data should be included in a health history?
Select the best answer.
Explanation:
The review of systems is a critical part of a health history, helping to identify any symptoms or conditions that need further evaluation.
Which muscle is contraindicated for the administration of immunizations in infants and young children?
Select the best answer.
Explanation:
The dorsogluteal muscle is contraindicated for immunizations in infants and young children due to the risk of injury to the sciatic nerve. The anterolateral thigh is the preferred site.
At a well-child visit, parents ask the nurse how to know if a daycare facility is a good choice for their infant. Which observation should the nurse stress as especially important to consider when making the selection?
Select the best answer.
Explanation:
Ensuring that providers practice proper handwashing after diaper changes is crucial in preventing the spread of infections and maintaining a hygienic environment for the infants.
The nurse is planning a teaching session to adolescents about deaths by unintentional injuries. Which should the nurse include in the session with regard to deaths caused by injuries?
Select the best answer.
Explanation:
More deaths due to unintentional injuries occur in males, which may be due to higher risk-taking behaviors.
When caring for a child with an intravenous (IV) infusion, what is an appropriate nursing action?
Select the best answer.
Explanation:
Frequent monitoring of the IV site for signs of infiltration is crucial to prevent tissue damage, especially in pediatric patients. Changing the site every 24 hours is unnecessary unless complications arise, and using a macrodropper is not specific to pediatric care.
The nurse is presenting a staff development program about understanding culture in the healthcare encounter. Which components should the nurse include in the program? (Select all that apply.)
Select the best answer.
Explanation:
Cultural humility, sensitivity, and competency are key components in providing culturally competent care in healthcare encounters.
The nurse is selecting a site to begin an intravenous infusion on a 2-year-old child. The superficial veins on his hand and arm are not readily visible. What intervention should increase the visibility of these veins?
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Explanation:
Gently tapping over the site helps dilate the veins and increase visibility. Applying a cold compress or raising the extremity above the body level constricts the veins, making them harder to access. Prolonged tourniquet use can cause discomfort and venous congestion.
The nurse is preparing to care for a newborn with an omphalocele. The nurse should understand that care of the infant should include what intervention?
Select the best answer.
Explanation:
The priority intervention for an infant with an omphalocele is to cover the intact bowel with a nonadherent dressing to protect the exposed organs and prevent infection. This intervention is crucial to prevent injury and maintain the infant's safety. Initiating feedings or maintaining pain management are not the immediate priorities in the care of an infant with an omphalocele. Performing immediate surgery may be required in the future, but initially, covering the bowel is the first critical step in management.
Nursing care of children focuses on improving quality by:
Select the best answer.
Explanation:
The correct answer is D because nursing care for children should encompass a holistic approach that considers not only physical health but also emotional, social, and developmental aspects. Providing a holistic environment promotes optimal growth and development by addressing all these dimensions. Choices A, B, and C are incorrect because while sanitation, curing illnesses, and addressing communicable diseases are important aspects of child healthcare, they do not encompass the comprehensive care provided by a holistic approach.
The school nurse understands that children are impacted by divorce. Which has the most impact on the positive outcome of a divorce?
Select the best answer.
Explanation:
The level of ongoing family conflict is the most significant factor influencing the positive or negative outcomes for children during and after a divorce
What is the most appropriate action for a healthcare provider if a child presents with suspected meningitis?
Select the best answer.
Explanation:
Isolating the child is a priority to prevent the spread of infection until meningitis is confirmed or ruled out. Meningitis, particularly bacterial, is highly contagious and can lead to outbreaks if not properly managed. Isolation and prompt treatment are critical in preventing serious complications. Administering antibiotics immediately without confirmation of the diagnosis can be harmful if the cause is viral or non-infectious. Performing a lumbar puncture is a diagnostic procedure that should be done by a healthcare provider but is not the initial action when suspecting meningitis. Obtaining a complete blood count may be part of the diagnostic workup but is not the most appropriate initial action in suspected meningitis.
The nurse is teaching parents about the types of behaviors children exhibit when living with chronic violence. Which statement made by the parents indicates further teaching is needed?
Select the best answer.
Explanation:
Children exposed to chronic violence may struggle with stress and concentration but are less likely to consistently exhibit caring behaviors without intervention and support.
A child is refusing to use the potty and having accidents, even though he has achieved toilet training. This is an example of which type of behavior?
Select the best answer.
Explanation:
The correct answer is D, regression. Regression occurs when a child reverts to an earlier behavior, such as having accidents after being successfully toilet trained. This regression often happens due to stress or changes in routine. Choices A, B, and C are incorrect because positive reinforcement involves encouraging desired behavior, desensitization is a process of reducing sensitivity to a stimulus, and phobia is an intense fear or aversion to a specific object or situation, none of which directly apply to the described situation of the child having accidents after being toilet trained.
The nurse is aware that which age group is at risk for childhood injury because of the cognitive characteristic of magical and egocentric thinking?
Select the best answer.
Explanation:
Preschool children are at higher risk for injury due to magical and egocentric thinking, which can lead to misjudgments about their abilities and dangers.
The nurse is assessing a child suspected of having pinworms. Which is the most common symptom the nurse expects to assess?
Select the best answer.
Explanation:
Intense perianal itching is the most common symptom of pinworm infection, especially at night when the female worms lay their eggs
The nurse is discussing home care with a mother whose 6-year-old child has hepatitis A. What information should the nurse include?
Select the best answer.
Explanation:
Teaching infection control measures is crucial as Hepatitis A is highly contagious, especially in household settings. Proper hand hygiene and avoiding sharing personal items can prevent the spread of the virus within the family. Option A is incorrect because bed rest is not typically required for hepatitis A. Option C is incorrect as the child can return to school once feeling well and no longer contagious, not necessarily after a specific duration. Option D is incorrect because hepatitis A can be transmitted through contaminated food, water, or close personal contact.
A mother delivers an infant at 30 weeks gestation and asks if formula is better than breast milk since the baby is premature. What should the nurse respond?
Select the best answer.
Explanation:
Human milk is preferred, even for preterm infants, because it contains essential nutrients and antibodies that are particularly beneficial for their growth and development. Choice B is incorrect because human milk is rich in essential nutrients necessary for preterm infants. Choice C is incorrect as commercial infant formulas do not provide the same benefits as human milk. Choice D is incorrect as specialized formulas are available to meet the unique nutritional needs of preterm infants, but human milk remains the optimal choice.
What is the first sign of puberty in boys?
Select the best answer.
Explanation:
The first sign of puberty in boys is typically the enlargement of the testes. This is due to the increase in production of testosterone, which leads to physical changes such as growth of the testes. Choice B, decreased levels of testosterone, is incorrect as puberty is marked by an increase in testosterone levels. Choice C, voice deepening, and choice D, pubic hair growth, usually occur later in the puberty process compared to testicular enlargement, making them incorrect answers.
Which inpatient pediatric patient would not be able to go to the playroom due to their physical condition?
Select the best answer.
Explanation:
The correct answer is A. A child with chickenpox should not go to the playroom due to being contagious, as the virus can easily spread to other children. Children with fractures (choice B), new-onset diabetes mellitus (choice C), or postoperative appendectomy (choice D) do not pose a risk of spreading an infectious disease, so they can safely go to the playroom.
The nurse is planning care for a patient with a different ethnic background. Which should be an appropriate goal?
Select the best answer.
Explanation:
Adapting ethnic practices to health needs respects the patient's cultural background while ensuring that care is effective and culturally sensitive.
Which term best describes the sharing of common characteristics that differentiate one group from other groups in a society?
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Explanation:
Ethnicity refers to the shared characteristics such as nationality, culture, language, and beliefs that differentiate one group from another.
A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. What should the therapeutic plan initially include?
Select the best answer.
Explanation:
Dietary modification is often the first step in managing chronic constipation in children, focusing on increasing fiber and fluid intake. Other interventions like bowel cleansing and toilet training may follow if dietary changes are insufficient.
Parents of a preschool child ask the nurse, "Should we set rules for our child as part of a discipline plan?" Which is an accurate response by the nurse?
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Explanation:
Clear and reasonable rules provide structure and help children understand expectations, promoting consistent behavior and discipline.
What is the purpose of using cimetidine (Tagamet) for gastroesophageal reflux?
Select the best answer.
Explanation:
The correct answer is A. Cimetidine (Tagamet) is an H2 receptor antagonist that works by reducing gastric acid secretion. This action helps to decrease the acidity in the stomach, which in turn reduces the symptoms of gastroesophageal reflux. Choice B is incorrect because cimetidine does not neutralize acid but rather decreases its production. Choice C is incorrect as cimetidine does not affect the rate of gastric emptying time. Choice D is incorrect as cimetidine does not coat the lining of the stomach and esophagus but instead works to reduce gastric acid secretion.
Melena, the passage of black, tarry stools, suggests bleeding from which source?
Select the best answer.
Explanation:
Melena indicates bleeding from the upper GI tract. The black, tarry appearance of the stool results from the partial digestion of blood as it passes through the intestines, typically originating from sources like the stomach or duodenum. Lower GI bleeding usually presents as bright red blood in the stool, originating from sources like the colon or rectum. Choices A, C, and D are incorrect because melena specifically points to upper GI bleeding rather than issues in the perianal/rectal area, lower GI tract, or hemorrhoids/anal fissures.
Urinary tract anomalies are frequently associated with what irregularities in fetal development?
Select the best answer.
Explanation:
Malformed or low-set ears are often associated with congenital urinary tract anomalies, as both the ears and kidneys develop around the same time during fetal growth. Myelomeningocele, cardiovascular anomalies, and lower extremity defects are less commonly associated with UT anomalies.
What is the priority assessment for a nurse when caring for an infant suspected of having necrotizing enterocolitis (NEC)?
Select the best answer.
Explanation:
The correct answer is D: Closely monitor abdominal distention. Monitoring the abdomen for signs of distention is crucial in the early detection of necrotizing enterocolitis (NEC). In NEC, the bowel wall is edematous and breaking down, leading to abdominal distention. Holding feedings is important in the management of NEC, as feedings may need to be stopped temporarily. Checking gastric residuals before feedings helps in assessing the infant's tolerance to feedings. Taking rectal temperatures is contraindicated in NEC as it can lead to the perforation of the bowel.
An infant with short bowel syndrome is receiving total parenteral nutrition (TPN). The practitioner has added continuous enteral feedings through a gastrostomy tube. The nurse recognizes this as important for which reason?
Select the best answer.
Explanation:
Continuous enteral feedings help stimulate the small intestine's adaptation in short bowel syndrome, promoting better nutrient absorption and eventually reducing reliance on TPN. This approach is crucial for long-term management and improving the child's prognosis. Choice A is incorrect because weaning off TPN typically occurs gradually over time, not the next day. Choice C is incorrect because TPN can be adjusted to provide necessary nutrients, and enteral feedings are mainly used to stimulate intestinal function. Choice D is incorrect as the addition of enteral feedings does not necessarily indicate imminent discharge; it primarily focuses on enhancing intestinal adaptation and reducing reliance on TPN.
What statement best describes Hirschsprung disease?
Select the best answer.
Explanation:
Hirschsprung disease is characterized by the absence of ganglion cells in a segment of the colon, leading to a lack of peristalsis and obstruction. The other options do not accurately describe this condition.
Which condition is often associated with a "ground-glass" appearance on a chest x-ray in neonates?
Select the best answer.
Explanation:
The correct answer is B, Respiratory distress syndrome. Respiratory distress syndrome often presents with a "ground-glass" appearance on a chest x-ray in neonates due to surfactant deficiency. Choice A, Pneumonia, typically appears as patchy infiltrates on chest x-ray. Choice C, Bronchopulmonary dysplasia, is characterized by hyperinflation and fibrosis, not a ground-glass appearance. Choice D, Congenital diaphragmatic hernia, usually shows mediastinal shift and bowel loops in the chest cavity on x-ray, not a ground-glass appearance.
What is the appropriate site to administer an intramuscular (IM) vaccine to a newborn?
Select the best answer.
Explanation:
The correct site to administer an intramuscular (IM) vaccine to a newborn is the vastus lateralis muscle. For newborns, the vastus lateralis is preferred over the dorsogluteal site because the dorsogluteal site has been associated with low antibody seroconversion rates, indicating a reduced immune response. The vastus lateralis is also recommended for IM injections in newborns, while the deltoid muscle is preferred for older infants and children. The ventral gluteal muscle and the biceps muscle are not appropriate sites for IM injections. Therefore, choice B is the correct answer.
What is the required number of milliliters of fluid needed per day for a 14-kg child?
Select the best answer.
Explanation:
The fluid requirement for a 14-kg child is approximately 100 mL/kg/day, so for a 14-kg child, the requirement is around 1400 mL/day.
The parent of an 8.2-kg (18-lb) 9-month-old infant is borrowing a federally approved car seat from the clinic. The nurse should explain that the safest way to put in the car seat is what?
Select the best answer.
Explanation:
Infants should be placed rear-facing in the back seat until they are at least 2 years old or exceed the weight/height limit of their car seat for optimal safety.
What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome?
Select the best answer.
Explanation:
Reduced serum albumin is a hallmark of minimal change nephrotic syndrome (MCNS) due to massive proteinuria. This results in hypoalbuminemia, which contributes to the edema characteristic of this condition.
A four-year-old child has a history of repeated otitis media despite antibiotic treatment. Which treatment measure should the nurse discuss with the parents?
Select the best answer.
Explanation:
The correct answer is C: The insertion of tympanostomy (pressure equalizing) tubes. This treatment measure is appropriate for a child with recurrent otitis media as it helps drain fluid from the middle ear and prevent further infections. Adenoidectomy (choice B) involves the removal of the adenoids, which may not directly address the ear infections. Antibiotic treatment (choice A) has already been ineffective in this case, so alternative measures are necessary. Tonsillectomy (choice D) is not typically indicated for otitis media unless there are specific reasons such as enlarged tonsils contributing to the condition.
When teaching a discipline class for parents of pre-schoolers, the nurse will be guided by which principle?
Select the best answer.
Explanation:
The correct principle to guide the nurse when teaching a discipline class for parents of pre-schoolers is that discipline is meant to teach and gradually shift control from parents to the child, promoting self-discipline. This approach focuses on educating children on appropriate behavior rather than solely relying on punishment. Choice A is incorrect because using the strictest punishment is not the most effective method for discipline. Choice B is incorrect because punishment can reinforce unwanted behavior if not used appropriately. Choice D is incorrect because discipline and punishment are not synonymous; discipline involves a broader aspect of teaching and guiding behavior.
The nurse is caring for a child with Beta Thalassemia. Which child is in a group most at risk for Beta Thalassemia?
Select the best answer.
Explanation:
Corrected Rationale: Beta Thalassemia is most common in individuals of Mediterranean descent, such as those from Italy, Greece, and the Middle East. This genetic disorder affects hemoglobin production and can lead to severe anemia. Choice A is the correct answer as individuals of Mediterranean descent are at the highest risk for Beta Thalassemia. Choices B, C, and D are incorrect as they do not belong to the population group most at risk for this genetic disorder.
The nurse is conducting discharge teaching to an adolescent with a methicillin-resistant Staphylococcus aureus (MRSA) infection. What should the nurse include in the instructions?
Select the best answer.
Explanation:
Avoiding sharing of towels and washcloths, using bleach when laundering, and taking daily baths with antibacterial soap are critical to prevent the spread of MRSA. Cold water is not effective for laundering in these cases.
The nurse manager is compiling a report for a hospital committee on the quality of nursing-sensitive indicators for a nursing unit. Which does the nurse manager include in the report?
Select the best answer.
Explanation:
The education and certification of nurses are key nursing-sensitive indicators that reflect the quality of care provided on the unit.
Surgery is performed on a child to correct cryptorchidism. The parents understand the reason for the surgery if they tell the nurse this was done to do what?
Select the best answer.
Explanation:
The primary reason for correcting cryptorchidism through surgery is to prevent damage to the undescended testicle, which can lead to infertility and increase the risk of testicular cancer. Prevention of UTIs and prostate cancer are not the primary concerns in this context.
What is an appropriate play activity for a 7-month-old infant to encourage visual stimulation?
Select the best answer.
Explanation:
Playing peek-a-boo is an ideal play activity for a 7-month-old as it encourages visual tracking and social interaction, which are key developmental milestones at this age.
Which laboratory test would be most important for the nurse to assess when caring for a toddler suspected of having cystic fibrosis?
Select the best answer.
Explanation:
The sweat chloride test is the primary diagnostic test for cystic fibrosis. Cystic fibrosis is characterized by abnormal transport of chloride and sodium across epithelial cell membranes, leading to increased chloride in sweat. This test is crucial for diagnosing cystic fibrosis in suspected cases. Liver enzymes (Choice A), serum calcium (Choice B), and urine creatinine (Choice D) are not specific tests for cystic fibrosis and would not provide the necessary information for diagnosis in this case.
What is typically the first sign of puberty in females?
Select the best answer.
Explanation:
The correct answer is A: Breast development (thelarche) is usually the first sign of puberty in females, typically beginning between ages 8 and 13. This marks the start of puberty, followed by pubic hair growth, a growth spurt, and eventually menarche (the onset of menstruation). Pubic hair growth and axillary hair growth usually follow breast development in the sequence of pubertal changes. Therefore, the first noticeable change indicating the onset of puberty in females is the development of breast buds.
Where would nonpathologic cyanosis normally be present in the newborn shortly after birth?
Select the best answer.
Explanation:
Nonpathologic cyanosis in newborns shortly after birth is typically present in the feet and hands, known as acrocyanosis. This is a normal finding due to the immature peripheral circulation in newborns. Cyanosis of the bridge of the nose, circumoral area, and mucous membranes indicates generalized cyanosis, which suggests a potential underlying distress or major abnormality. Therefore, choice A is correct as it describes the expected location for nonpathologic cyanosis in newborns, while choices B, C, and D represent areas associated with abnormal cyanosis.
An infant weighed 8 lb at birth and was 18 inches in length. What weight and length should the infant be at 5 months of age?
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Explanation:
By 5 months, an infant's weight should typically double from birth, and length should increase by approximately 50%.
At which age can most infants sit steadily unsupported?
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Explanation:
Most infants can sit steadily without support by 8 months, indicating advanced gross motor skill development.
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