ATI RN
Nursing Care of Children ATI
1. The nurse is performing an assessment on a 12-month-old infant. Which fine or gross motor developmental skill demonstrates the proximodistal acquisition of skills?
- A. Standing
- B. Sitting without assistance
- C. Fully developed pincer grasp
- D. Taking a few steps holding onto something
Correct answer: C
Rationale: The development of a pincer grasp reflects fine motor skills, which develop in a proximodistal pattern (from the center of the body outward).
2. 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?
- A. 60 mL/hour
- B. 45 mL/hour
- C. 30 mL/hour
- D. 15 mL/hour
Correct answer: A
Rationale: 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.
3. The nurse is administering the first hepatitis A vaccine to an 18-month-old child. When should the child return to the clinic for the second dose of hepatitis A vaccination?
- A. After 2 months
- B. After 3 months
- C. After 4 months
- D. After 6 months
Correct answer: D
Rationale: The second dose of the hepatitis A vaccine is recommended 6 months after the first dose to ensure full immunity.
4. The nurse is providing anticipatory guidance to parents of a 4-month-old infant on preventing an aspiration injury. What should the nurse include in the teaching?
- A. Keep baby powder out of reach.
- B. Inspect toys for removable parts.
- C. Allow the infant to take a bottle to bed.
- D. Teething biscuits can be used for teething discomfort.
Correct answer: A
Rationale: Baby powder can be inhaled by the infant and cause respiratory distress. Toys should be inspected to prevent choking hazards. Allowing an infant to take a bottle to bed can increase the risk of aspiration, and hard foods like teething biscuits should be given with caution.
5. What approach is the most appropriate when performing a physical assessment on a toddler?
- A. Demonstrate the use of equipment
- B. Perform traumatic procedures last
- C. Use minimum physical contact initially
- D. Always proceed systematically in a head-to-toe direction
Correct answer: C
Rationale: The most appropriate approach when performing a physical assessment on a toddler is to use minimum physical contact initially. This helps gain the toddler's cooperation and reduces their distress. Performing traumatic procedures last is crucial as they are likely to upset the child and should be handled with care. Demonstrating the use of equipment may be complex for toddlers to understand, so it is not the most appropriate initial approach. Proceeding systematically in a head-to-toe direction is a good practice but using minimum physical contact initially is more important to establish trust and cooperation with the toddler.
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