Free ATI RN Nursing Care of Children practice for ATI RN Nursing Care of Children Assessment (ATI RN). Answer 47 nursing exam-style questions with rationales, e
What interventions would the nurse implement to maintain the skin integrity of a preterm infant born at 30 weeks?
Select the best answer.
Explanation:
To maintain the skin integrity of a preterm infant born at 30 weeks, the nurse should bathe the infant with sterile water no more than two or three times per week. The eyes, oral and diaper areas, and pressure points should be cleansed daily. It is essential to avoid using alkaline-based soaps as they might destroy the 'acid mantle' of the skin. Additionally, cleansing with mild solutions and rinsing thoroughly with plain water is recommended to prevent skin irritation and maintain skin integrity. Therefore, options A, C, and D are incorrect as they do not align with the best practices for preterm infant skin care.
The nurse is teaching parents guidelines for feeding their 8-month-old infant with failure to thrive (FTT). Which statement by the parents indicates a need for further teaching?
Select the best answer.
Explanation:
Providing 8 oz of juice daily is excessive for an 8-month-old infant and can displace other nutrient-rich foods or formulas that are necessary for growth, especially in an infant with FTT.
By which age should the nurse expect that an infant will be able to pull to a standing position?
Select the best answer.
Explanation:
Pulling to a standing position typically occurs between 11 to 12 months, marking the progression towards walking.
What diet is most appropriate for the child with chronic renal failure (CRF)?
Select the best answer.
Explanation:
A low-phosphorus diet is important in managing chronic renal failure to prevent hyperphosphatemia and its associated complications, such as bone disease. Protein intake should be controlled but not necessarily low, and vitamin D supplementation is often required, not reduced.
Which dietary information should the nurse include in the teaching plan for a school-age child with chronic renal failure?
Select the best answer.
Explanation:
A low-phosphorus diet is recommended for children with chronic renal failure to prevent hyperphosphatemia, which can lead to bone disease and other complications. Phosphorus is found in many processed foods and should be limited. Choices A, B, and D are incorrect because high sodium intake can lead to fluid retention and hypertension, while Vitamin D supplementation and vitamins C, E, K are not specifically indicated for dietary recommendations in chronic renal failure.
A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent?
Select the best answer.
Explanation:
The correct recommendation for decreasing the number and total volume of emesis in an infant with gastroesophageal reflux is to thicken feedings and enlarge the nipple hole. Thicker feedings can reduce the frequency and volume of emesis by making the food less likely to be regurgitated. Enlarging the nipple hole helps ensure the thickened feedings can pass through. Surgical therapy (Choice A) is not the initial recommendation for managing gastroesophageal reflux in infants. Placing the infant in a prone position for sleep after feeding (Choice B) is not recommended due to the increased risk of sudden infant death syndrome (SIDS). Reducing the frequency of feeding by encouraging larger volumes of formula (Choice D) can exacerbate the reflux symptoms.
What is an appropriate screening test for hearing that the nurse can administer to a 5-year-old child?
Select the best answer.
Explanation:
Pure tone audiometry is an appropriate and effective screening test for hearing in a 5-year-old child, helping to assess the ability to hear various frequencies and volumes.
The nurse is caring for a child receiving chemotherapy with the following orders: Zantac 70 mg IV in normal saline 30 mL to infuse over 30 minutes. The nurse should set the infusion pump to deliver how many mL/hour?
Select the best answer.
Explanation:
The correct answer is A: 60 mL/hour. The total volume to be infused is 30 mL over 30 minutes. To calculate the infusion rate in mL/hour, divide the total volume by the total time in hours. In this case, 30 mL / 0.5 hours = 60 mL/hour. Choice B, 45 mL/hour, is incorrect as it does not correspond to the calculated infusion rate. Choices C and D, 30 mL/hour and 15 mL/hour respectively, are also incorrect based on the calculation.
A parent brings their 2-year-old son in for a well visit. The nurse assesses his growth since the last appointment. Which finding should concern the nurse?
Select the best answer.
Explanation:
The correct answer is D. A total weight gain of 15 lb in one year for a 2-year-old is excessive and may indicate an underlying issue such as a metabolic disorder or overfeeding. This rapid weight gain can put the child at risk for health problems. Choices A, B, and C are not typically concerning findings in a 2-year-old. A prominent abdomen can be normal at this age due to a toddler's slightly protruding belly, a forward curve of the spine at the sacral area is a typical finding in young children, and an increase in height of 5 inches in a year is within the expected range of growth for a 2-year-old.
The nurse is reviewing the importance of role learning for children. The nurse understands that children's roles are primarily shaped by which members?
Select the best answer.
Explanation:
Parents play the primary role in shaping their children's roles and behaviors, especially in early childhood, through modeling, guidance, and expectations.
The nurse is using a bulb syringe to suction a neonate after delivery. What is an important consideration?
Select the best answer.
Explanation:
The correct consideration when using a bulb syringe to suction a neonate after delivery is to clear the mouth and pharynx before the nasal passages to prevent aspiration of amniotic fluid. Compressing the bulb syringe before insertion is important to create suction. Using two bulb syringes is unnecessary, as one is sufficient for both the mouth/pharynx and nasal passages. It is not recommended to continue using a bulb syringe until all secretions are removed; instead, mechanical suction can be employed if more forceful removal of secretions is required.
The nurse is teaching parents about the effects of media on childhood obesity. The nurse realizes the parents understand the teaching if they make which statements? (Select all that apply.)
Select the best answer.
Explanation:
Increased screen time is associated with unhealthy habits, such as poor sleep and snacking, which contribute to obesity, but it does not necessarily improve nutrition knowledge.
A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this child?
Select the best answer.
Explanation:
Prednisone, an immunosuppressant, increases the child's susceptibility to infections, making infection prevention a critical nursing goal. Detecting edema and stimulating appetite are important but secondary to preventing potentially life-threatening infections.
What is the therapeutic intervention that provides the best chance of survival for a child with cirrhosis?
Select the best answer.
Explanation:
Liver transplantation offers the best chance of survival for children with cirrhosis, especially in advanced stages where the liver can no longer function effectively. Cirrhosis is a late stage of scarring of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. While nutritional support, blood component therapy, and corticosteroids may be part of the treatment plan to manage symptoms and complications, they do not address the underlying cause of cirrhosis or provide a cure like liver transplantation does.
A 6-year-old child has patient-controlled analgesia (PCA) for pain management after orthopedic surgery. The parents are worried that their child will be in pain. What should your explanation to the parents include?
Select the best answer.
Explanation:
PCA pumps are designed to deliver both a continuous baseline dose and patient-activated bolus doses, which can help manage pain effectively while minimizing the risk of overdose.
Physiologically, the child compensates for fluid volume losses by which mechanism?
Select the best answer.
Explanation:
In response to dehydration, the body compensates by shifting fluids from the interstitial spaces to the intravascular space to maintain blood pressure and perfusion to vital organs. Hemoconcentration and vasoconstriction are other compensatory mechanisms but are less immediate.
Clinical manifestations of sodium excess (hypernatremia) include which signs or symptoms?
Select the best answer.
Explanation:
Hypernatremia often presents with dry, sticky mucous membranes due to dehydration. Hyperreflexia and abdominal cramps may also occur, but dry mucous membranes are more consistently observed in cases of sodium excess.
A preschool-age child is admitted to the pediatric unit for surgery. The parents request to stay with their child. How should the nurse respond?
Select the best answer.
Explanation:
The correct response is to let the parents know they are allowed to stay with the child. Allowing parents to stay with the child can help reduce the child's anxiety and provide comfort. Choice A is incorrect as the parents should be encouraged to stay with their child. Choice B is not the immediate response the nurse should provide. Choice D is inappropriate as it does not address the benefits and importance of parental presence for the child's well-being during hospitalization.
What organism is a parasite that causes acute diarrhea?
Select the best answer.
Explanation:
Giardia lamblia is a protozoan parasite known to cause acute diarrhea, often through contaminated water or food. Shigella, Salmonella, and E. coli are bacterial pathogens that also cause diarrhea but are not parasites.
The nurse is caring for a very low-birth-weight (VLBW) infant with a peripheral intravenous infusion. What nursing considerations regarding infiltration should be included in planning IV care?
Select the best answer.
Explanation:
Hypertonic solutions can damage tissues if they leak from the vein due to infiltration. It is crucial to monitor for this complication to prevent severe tissue damage. Infiltration is not solely related to the activity level of VLBW infants; it can occur due to various reasons such as vein condition, catheter placement, and fluid type. Continuous infusion pumps may not always detect infiltration, as they typically alarm for pressure changes but not all infiltration instances. Checking the infusion site regularly, preferably hourly, is essential to prevent complications like tissue damage from extravasations, fluid overload, and dehydration.
The nurse is teaching a child experiencing severe edema associated with minimal change nephrotic syndrome about his diet. The nurse should discuss what dietary need?
Select the best answer.
Explanation:
Fluid restriction is often necessary to manage severe edema associated with MCNS. Increasing protein is not typically recommended due to the risk of exacerbating proteinuria, and calorie reduction is not generally needed.
The nurse is admitting a 9-year-old child with hemolytic uremic syndrome. What clinical manifestations should the nurse expect to observe? (Select all that apply.)
Select the best answer.
Explanation:
Hemolytic uremic syndrome (HUS) typically presents with hematuria, anorexia, hypertension, and purpura due to the hemolytic anemia, thrombocytopenia, and renal failure that characterize this condition.
What is the primary goal in the treatment of a child with nephrotic syndrome?
Select the best answer.
Explanation:
The primary goal in treating nephrotic syndrome in children is to reduce proteinuria. Nephrotic syndrome is characterized by proteinuria, leading to hypoalbuminemia and edema. By reducing proteinuria, kidney damage can be minimized, and symptoms can be managed effectively. Decreasing urine output (Choice A) is not the primary goal, as it does not address the underlying issue of protein loss. Increasing serum albumin (Choice B) is a consequence of reducing proteinuria rather than the primary goal. Increasing blood pressure (Choice D) is not a goal in treating nephrotic syndrome and may even be contraindicated to prevent further kidney damage.
Which type of breath sound is normally heard over the entire surface of the lungs except for the upper intrascapular area and the area beneath the manubrium?
Select the best answer.
Explanation:
Vesicular breath sounds are normally heard over most of the lung fields, except near the trachea and main bronchi, where bronchial or bronchovesicular sounds may be heard.
The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful?
Select the best answer.
Explanation:
Drawing allows the child to express feelings and thoughts non-verbally, which can be particularly effective for children who have difficulty articulating their emotions.
The nurse is preparing to admit a 5-year-old child with hepatitis A. What clinical features of hepatitis A should the nurse recognize?
Select the best answer.
Explanation:
The correct answer is C. Hepatitis A typically presents with a rapid onset, early fever, and nausea/vomiting. These are common clinical features seen in patients with hepatitis A. A pruritic rash is not commonly associated with hepatitis A, so choice C is incorrect. Choice A and B alone are not sufficient to cover all the clinical features of hepatitis A.
The nurse is seeing an adolescent and the parents in the clinic for the first time. Which should the nurse do first?
Select the best answer.
Explanation:
Introducing oneself is the first step in establishing a rapport and setting a professional tone for the interaction.
What is the most critical physiologic change required of newborns at birth?
Select the best answer.
Explanation:
The correct answer is A: Transition from fetal to neonatal breathing. The onset of breathing is the most immediate and critical physiologic change required for the transition to extrauterine life. Factors that interfere with this normal transition increase fetal asphyxia, which is a condition of hypoxemia, hypercapnia, and acidosis. While body temperature maintenance, stabilization of fluid and electrolytes, and closure of fetal shunts in the heart are crucial changes in the transition to extrauterine life, breathing and the exchange of oxygen for carbon dioxide must take precedence as they are essential for newborn survival.
What is a high-fiber food that the nurse should recommend for a child with chronic constipation?
Select the best answer.
Explanation:
Popcorn is a high-fiber food that can help manage chronic constipation in children. Other options like white rice and ripe bananas are low in fiber and less effective for treating constipation.
The nurse is preparing a child for possible alopecia from chemotherapy. What information should the nurse give regarding alopecia?
Select the best answer.
Explanation:
The correct answer is B. Hair loss from chemotherapy is usually temporary, and when it regrows, it may have a different color or texture. Sun exposure should be minimized, as the scalp may be more sensitive. Wearing hats and scarves can provide comfort and protection, but there is no preference over wearing a wig. Choice A is incorrect because hair regrowth after chemotherapy varies from person to person and usually occurs sooner than two years. Choice C is incorrect as sun exposure should be minimized to protect the sensitive scalp. Choice D is incorrect as the preference between wearing hats, scarves, or a wig is subjective and depends on the individual's comfort and preferences.
The nurse is caring for an adolescent hospitalized for asthma. The adolescent belongs to a large family. The nurse recognizes that the adolescent is likely to relate to which group?
Select the best answer.
Explanation:
Adolescents typically identify and relate more closely to their peer group, especially during the teenage years when peer relationships become a central focus.
The nurse is teaching parents about potential causes of colic in infancy. Which should the nurse include in the teaching session?
Select the best answer.
Explanation:
Overeating, swallowing excessive air (leading to frequent burping), and parental smoking are known to contribute to colic in infants. Understimulation is not typically associated with colic.
Which are included in the evaluation step of the nursing process? (Select all that apply.)
Select the best answer.
Explanation:
The evaluation step involves determining if outcomes are met, modifying the plan if needed, and selecting alternative interventions if goals are not achieved.
What statement is an advantage of peritoneal dialysis compared with hemodialysis?
Select the best answer.
Explanation:
Peritoneal dialysis is generally easier to learn and can be safely performed at home. Although dietary limitations still apply, this method offers greater flexibility in treatment scheduling compared to hemodialysis, which often requires multiple weekly visits to a dialysis center.
The nurse is explaining different parenting styles to a group of parents. The nurse explains that an authoritative parenting style can lead to which child behavior?
Select the best answer.
Explanation:
An authoritative parenting style, which balances warmth with firmness, is associated with fostering self-reliance and independence in children.
What is a physical characteristic of infants whose mothers smoked during pregnancy?
Select the best answer.
Explanation:
The correct answer is D: Growth restriction in weight, length, and chest and head circumference. Infants born to mothers who smoke during pregnancy exhibit growth failure in weight, length, chest, and head circumference. This growth failure is directly related to the number of cigarettes smoked by the mother. Choices A, B, and C are incorrect because infants exposed to maternal smoking do not tend to be large for gestational age, experience growth restriction in weight only, or be preterm but size appropriate for gestational age.
What is the leading cause of morbidity and mortality in children with cystic fibrosis?
Select the best answer.
Explanation:
Respiratory infections are the leading cause of morbidity and mortality in children with cystic fibrosis. Cystic fibrosis primarily affects the respiratory system, leading to thick mucus buildup in the lungs, which predisposes these children to recurrent respiratory infections. Malnutrition and diabetes are common comorbidities in cystic fibrosis but are not the leading causes of morbidity and mortality in affected children. Liver disease can occur in cystic fibrosis but is less common than respiratory complications.
Which intervention is the most appropriate recommendation for relief of teething pain?
Select the best answer.
Explanation:
A frozen teething ring is effective for relieving teething pain as the cold helps numb the gums and reduce inflammation, making it a safe and effective method for managing discomfort
What procedure is most appropriate for the assessment of an abdominal circumference related to a bowel obstruction?
Select the best answer.
Explanation:
Marking the point of measurement ensures consistent and accurate assessments of abdominal circumference, especially important in conditions like bowel obstruction where changes need to be monitored closely.
Frequent urine tests for specific gravity are required on a 6-month-old infant. What method is the most appropriate way to collect small amounts of urine for these tests?
Select the best answer.
Explanation:
Aspirating urine from cotton balls inside the diaper is a minimally invasive method and effective for collecting small amounts of urine. Using a collection bag can be more cumbersome, and other methods are not as effective for this age.
An infant is suspected of having esophageal atresia/tracheoesophageal fistula. While waiting for the pediatrician to see the infant, which action should the nurse take?
Select the best answer.
Explanation:
Positioning the infant with the head of the bed elevated helps to prevent aspiration and manage secretions until further treatment can be provided. Choice B is incorrect as the priority is ensuring the infant's safety and health, not immediate bonding. Choice C is incorrect as breastfeeding may worsen the condition. Choice D is incorrect as it does not address the potential risk of aspiration associated with esophageal atresia/tracheoesophageal fistula.
An infant, age 6 months, has six teeth. The nurse should recognize that this is what?
Select the best answer.
Explanation:
Having six teeth at 6 months is earlier than the typical tooth eruption schedule, but it is not unusual or dangerous. It is within the range of normal variations in infant development.
What problem is most often associated with myelomeningocele?
Select the best answer.
Explanation:
Hydrocephalus is the most commonly associated problem with myelomeningocele, present in 80% to 90% of affected children. Biliary atresia and tracheoesophageal fistula are not typically associated with myelomeningocele. Craniostenosis refers to the premature closing of cranial sutures and is not a common issue seen with myelomeningocele.
The parents of an 8-month-old infant voice concern to the nurse that their infant is not developing motor skills as the infant should. What question would be appropriate for the nurse to ask in determining if their fears are warranted?
Select the best answer.
Explanation:
The correct answer is A. By 8 months, an infant should be able to transfer objects between hands, which is an important motor skill milestone. This action shows coordination and developing fine motor skills. Choices B, C, and D involve more advanced motor skills that are typically not expected at 8 months of age. Drinking from a cup, holding a pencil to scribble, and engaging in purposeful play with toys are skills that develop later in infancy.
The physician tells the parents of a 2-year-old that the child probably has RSV. The parents ask how the diagnosis will be confirmed. How should the nurse respond?
Select the best answer.
Explanation:
The correct answer is A. RSV is typically diagnosed by swabbing the nose and testing the secretions. This method helps confirm the presence of the respiratory syncytial virus. Choice B is incorrect because while symptoms are important in diagnosis, specific tests like swabbing for RSV do exist. Choice C is incorrect as sending a viral culture to an outside lab is not the primary method for diagnosing RSV. Choice D is a duplicate of choice B and is incorrect for the same reasons.
The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the presenting signs?
Select the best answer.
Explanation:
The symptoms of gagging and drooling suggest that the foreign object is likely lodged in the esophagus. This can cause significant discomfort and potential complications, requiring immediate medical evaluation.
What is the most important intervention in the management of a child with sickle cell crisis?
Select the best answer.
Explanation:
The most important intervention in managing a child with sickle cell crisis is the administration of pain relief. During a sickle cell crisis, severe pain is a prominent symptom due to vaso-occlusive episodes. Effective pain management, along with adequate hydration and oxygen therapy, is crucial in treating a sickle cell crisis and preventing further complications. Choice A, the administration of iron supplements, is not the priority during a sickle cell crisis. Iron supplements are typically used to manage anemia in individuals with sickle cell disease but are not the primary intervention during a crisis. Choice B, the initiation of a high-calorie diet, is not the most critical intervention during a sickle cell crisis. While proper nutrition is important in managing sickle cell disease, it is not the immediate priority during a crisis. Choice D, limiting fluid intake, is not recommended during a sickle cell crisis. Hydration is essential in managing sickle cell crisis to prevent complications like dehydration and further vaso-occlusive episodes.
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