Free ATI RN Nursing Care of Children practice for Nursing Care of Children ATI (ATI RN). Answer 63 nursing exam-style questions with rationales, exam mode, and
A 5-year-old is hospitalized with a fractured femur. Which pain assessment tool is appropriate for this child?
Select the best answer.
Explanation:
The Faces Pain Rating Scale is appropriate for assessing pain in children who can express their feelings visually. For a 5-year-old child who can communicate effectively, using a tool like the Faces Pain Rating Scale, which uses facial expressions to indicate pain levels, is more suitable than the CRIES Scale (used for neonates), the SUN Scale (used for infants), or the NIPS Scale (used for preterm and term newborns).
The nurse is testing an infant's visual acuity. By which age should the infant be able to fix on and follow a target?
Select the best answer.
Explanation:
By 3 to 4 months of age, an infant should be able to fix on and follow a target, indicating proper visual development.
The school nurse suspects a testicular torsion in a young adolescent student. What action should the nurse take?
Select the best answer.
Explanation:
Testicular torsion is a surgical emergency requiring immediate medical evaluation. Applying heat or elevating the legs will not alleviate the torsion, and delaying care can lead to testicular necrosis.
A preschooler pretending to do the dishes like her mother is an example of:
Select the best answer.
Explanation:
Domestic mimicry is the correct answer. It refers to children imitating household activities they observe, aiding in their cognitive and social development. By engaging in such play, children understand and interact with the world around them. Choice B, 'Artificialism,' is incorrect as it pertains to the belief that environmental characteristics are created by human beings. Choice C, 'Magical thinking,' involves children believing in unrealistic events or powers. Choice D, 'Centering,' refers to a child focusing on only one aspect of a situation and not considering other viewpoints.
What is the appropriate placement of a tongue blade for assessment of the mouth and throat?
Select the best answer.
Explanation:
The side of the tongue is the appropriate place for a tongue blade to avoid triggering the gag reflex during assessment of the mouth and throat.
At what age is the first dose of the hepatitis A vaccine recommended to be started?
Select the best answer.
Explanation:
The correct answer is A: 1 year. The hepatitis A vaccine is now recommended for all children starting at age 1 year (i.e., 12 to 23 months). This is due to the recognition of hepatitis A as a significant child health problem, especially in areas with high infection rates. The virus is primarily spread through fecal-oral transmission, person-to-person contact, ingestion of contaminated food or water, and rarely through blood transfusion. Administering the first dose at 1 year helps protect children from this infection. Choices B and C are incorrect as the vaccine is not recommended at 1 month or 12 years. Choice D is also incorrect as the hepatitis A vaccine is recommended at a specific age to prevent the infection.
Which medication should the nurse expect to administer to a child with an acute sickle cell pain crisis?
Select the best answer.
Explanation:
In the management of acute sickle cell pain crisis in children, morphine is the preferred medication due to its effectiveness in providing pain relief. Meperidine (Demerol) is less commonly used in this scenario because of its potential for neurotoxicity with repeated doses. Acetaminophen (Tylenol) and Ibuprofen (Motrin) are not typically sufficient for managing the severe pain associated with sickle cell crises and are not the first-line treatment options.
A 4-month-old infant is discharged home after surgery for the repair of a cleft lip. What should instructions to the parents include?
Select the best answer.
Explanation:
Pain management is essential postoperatively to reduce crying, which could place strain on the surgical site. Feeding and holding the infant are allowed, but care should be taken to avoid placing pressure on the suture line.
What is the appropriate method for measuring the temperature of a 2-day-old neonate?
Select the best answer.
Explanation:
For a 2-day-old neonate, the most suitable method to measure temperature is the axillary method. This approach is considered safe and appropriate for neonates, minimizing the risk of injury. Tympanic temperature measurement may not be as accurate in neonates due to their small ear canals. Oral temperature measurement is not recommended for neonates as they may not be able to hold a thermometer properly in their mouths. Rectal temperature measurement is invasive and carries a higher risk of injury and should be avoided unless absolutely necessary.
Which type of family should the nurse recognize when a mother, her children, and a stepfather live together?
Select the best answer.
Explanation:
A blended family consists of a couple and their children from this and all previous relationships, including stepfamilies.
What is an important priority in dealing with the child suspected of having Wilms tumor?
Select the best answer.
Explanation:
The correct priority in dealing with a child suspected of having Wilms tumor is ensuring the abdomen is protected from palpation. Palpating the abdomen could lead to tumor dissemination, which is crucial to prevent the spread of cancerous cells. Intervening to minimize bleeding, monitoring temperature for infection, and teaching parents how to manage parenteral nutrition are not the immediate priorities in suspected cases of Wilms tumor.
What findings on physical assessment of a neonate would indicate the need for further evaluation?
Select the best answer.
Explanation:
Low-set ears in a neonate suggest major abnormalities and should prompt further evaluation. The correct alignment of the top of the pinnae of the ear with the outer canthus of the eye is crucial. Nystagmus, an involuntary eye movement, is common in newborns and often resolves on its own. Epstein pearls, small cysts on the hard palate, are insignificant and disappear over time. A positive Babinski reflex is normal in infants up to 1 year of age. Therefore, the presence of low-set ears is the most concerning finding that requires immediate attention.
When auscultating an infant's lungs, the nurse detects diminished breath sounds. What should the nurse interpret this as?
Select the best answer.
Explanation:
Diminished breath sounds in an infant are an abnormal finding and warrant further investigation to rule out conditions like atelectasis or pneumonia.
A foster parent is talking to the nurse about the health care needs for the child who has been placed in the parent's care. Which statement best describes the health care needs of foster children?
Select the best answer.
Explanation:
Foster children often have higher rates of acute and chronic health problems due to a variety of factors, including previous neglect, trauma, and inconsistent healthcare access.
After the family, which has the greatest influence on providing continuity between generations?
Select the best answer.
Explanation:
Schools play a significant role in providing continuity between generations by imparting cultural values, social norms, and knowledge to children.
The nurse is taking vital signs on a group of assigned preschool-aged children. Which assessment finding would indicate the need for further action?
Select the best answer.
Explanation:
A heart rate of 120 beats per minute is high for a preschool-aged child and may indicate an underlying issue that requires further assessment. A respiratory rate of 20 breaths per minute (choice A) is within the normal range for preschool children. Similarly, a heart rate of 89 beats per minute (choice B) falls within the expected range. A respiratory rate of 24 breaths per minute (choice D) is slightly elevated but may not be as concerning as a heart rate of 120 beats per minute.
Baby M is 5 months old. You notice that she now has the ability to grasp objects between her fingers and opposing thumb. This is known as:
Select the best answer.
Explanation:
The correct answer is C: Pincer grasp. The pincer grasp is the ability to hold objects between the thumb and another finger, typically developed around 9-12 months. At 5 months, it is early for a pincer grasp to fully develop, but the beginning of this skill can be seen as early as 5 months. Choices A and B are incorrect as the parachute reflex is a protective response to falling and the grasp reflex is an automatic response to touch. Choice D, prehension, is a general term for the act of grasping or holding objects, but it does not specifically refer to holding objects between the thumb and fingers like the pincer grasp does.
A child with acute glomerulonephritis is in the playroom and experiences blurred vision and a headache. What action should the nurse take?
Select the best answer.
Explanation:
Blurred vision and headache in a child with acute glomerulonephritis may indicate severe hypertension, which requires immediate assessment and intervention. Blood pressure should be checked, and the healthcare provider notified.
The educator is teaching about the process of physical growth and development. Which of these describes the directional pattern from head to tail?
Select the best answer.
Explanation:
Cephalocaudal development is the correct term that describes the directional pattern of growth from head to tail. This means that the head and upper body parts develop before the lower parts. Choice A, 'Cephalodistal,' refers to growth from the center of the body outward, not head to tail. Choice C, 'Proximodistal,' describes growth from the center of the body towards the extremities, not specifically from head to tail. Choice D, 'Proximocaudal,' is not a recognized term in the context of physical growth and development.
Which is the leading cause of death in infants younger than 1 year in the United States?
Select the best answer.
Explanation:
Congenital anomalies are the leading cause of death in infants younger than 1 year in the United States.
The nurse is caring for a child after a cleft palate repair who is on a clear liquid diet. Which feeding device should the nurse use to deliver the clear liquid diet?
Select the best answer.
Explanation:
An open cup is recommended for feeding after cleft palate repair to prevent injury to the surgical site and avoid creating negative pressure, which could disrupt the repair.
Which of the following conditions is characterized by a 'machine-like' murmur in children?
Select the best answer.
Explanation:
The correct answer is A, Patent ductus arteriosus. This condition is characterized by a continuous 'machine-like' murmur due to abnormal blood flow between the aorta and pulmonary artery. Ventricular septal defect (choice B) is characterized by a harsh holosystolic murmur, atrial septal defect (choice C) typically presents with a fixed split S2 and a pulmonary flow murmur, and coarctation of the aorta (choice D) is associated with a systolic murmur in the back and bilateral lower extremities.
A nurse must do a venipuncture on a 6-year-old child. What consideration is important in providing atraumatic care?
Select the best answer.
Explanation:
Showing the child the equipment before the procedure helps build trust and reduces fear. Using an 18-gauge needle is too large for a child, and multiple attempts can increase trauma. Restraining completely can increase fear and anxiety.
A child has been diagnosed with a Wilms tumor. What should preoperative nursing care include?
Select the best answer.
Explanation:
The correct answer is A: Careful bathing and handling. Preoperative care for a child with a Wilms tumor should focus on preventing any trauma to the abdomen, which could lead to tumor rupture. Monitoring behavioral status and maintaining strict isolation are not as critical in this situation. Behavioral status is important but not a priority in preoperative care for a Wilms tumor. Strict isolation is not necessary unless there are specific infectious concerns, which is not typically the case for a Wilms tumor. Administration of packed red blood cells is not a standard preoperative intervention for Wilms tumor.
What is the priority nursing intervention for a child with epiglottitis?
Select the best answer.
Explanation:
The correct answer is B: Maintain airway patency. When dealing with a child with epiglottitis, the priority nursing intervention is to ensure airway patency to prevent airway obstruction, which can lead to respiratory distress or failure. Administering antibiotics (choice A) is important to treat the infection, but airway management takes precedence. Providing hydration (choice C) and monitoring vital signs (choice D) are essential aspects of care but are secondary to securing the airway in a child with epiglottitis.
A major reason for the development of respiratory distress syndrome in the preterm infant is:
Select the best answer.
Explanation:
The correct answer is B: Lack of surfactant. Respiratory distress syndrome (RDS) in preterm infants is primarily due to a lack of surfactant, which is crucial for keeping the lungs inflated. Without adequate surfactant, the alveoli collapse, leading to breathing difficulties. Choice A, Excessive surfactant, is incorrect as RDS is caused by an insufficient amount of surfactant. Choice C, Immature immune system, and Choice D, Lack of body fat, are not directly related to the development of respiratory distress syndrome in preterm infants.
An awake, alert 4-year-old child has just arrived at the emergency department after an ingestion of aspirin at home. The practitioner has ordered activated charcoal. The nurse administers charcoal in which manner?
Select the best answer.
Explanation:
Mixing activated charcoal with a flavorful beverage in an opaque container can help mask the taste and encourage the child to ingest it. Using an opaque container can prevent the child from seeing the unappealing appearance of the charcoal mixture, increasing compliance.
The apnea monitor alarm sounds on a neonate for the third time during this shift. What is the priority action by the nurse?
Select the best answer.
Explanation:
The priority action for the nurse when the apnea monitor alarm sounds on a neonate is to assess the infant for color and the presence of respirations. This initial assessment helps determine the infant's respiratory status and the need for immediate intervention. Providing tactile stimulation or administering oxygen should only be done after assessing the infant's respiratory status. Investigating possible causes of a false alarm comes after ensuring the infant's well-being through the initial assessment.
The nurse is preparing to feed a 10-month-old child diagnosed with failure to thrive (FTT). Which actions should the nurse plan to implement?
Select the best answer.
Explanation:
Persistence in feeding, introducing new foods slowly, and maintaining a calm temperament are key strategies in managing FTT. A stimulating atmosphere may overwhelm the child and should be minimized during feeding times.
For minimal change nephrotic syndrome (MCNS), prednisone is effective when what occurs?
Select the best answer.
Explanation:
The effectiveness of prednisone in treating MCNS is indicated by diuresis and a decrease in urinary protein excretion. Subsidence of generalized edema is also a positive sign, but the key indicator is the reduction in proteinuria, which is achieved through diuresis.
The nurse is evaluating research studies according to the GRADE criteria and has determined the quality of evidence on the subject is moderate. Which type of evidence does this determination indicate?
Select the best answer.
Explanation:
Moderate evidence typically indicates that results from randomized clinical trials were inconsistent, highlighting the need for further research to confirm findings.
A school-age child is admitted to the pediatric unit with a vaso-occlusive crisis. Which of these should be included in the nursing plan of care?
Select the best answer.
Explanation:
The correct answer is D. Vaso-occlusive crises in sickle cell anemia require a comprehensive approach that includes adequate hydration to reduce blood viscosity, oxygenation to prevent further sickling of red blood cells, and aggressive pain management. This approach helps improve tissue perfusion and manage pain effectively. Choices A, B, and C are incorrect. Correction of alkalosis is not a priority in vaso-occlusive crisis management. Administration of heparin is not indicated as it can increase the risk of bleeding in sickle cell patients. Factor VIII replacement is not relevant to sickle cell anemia as it is a treatment for hemophilia, not sickle cell disease.
What is most important in the management of cellulitis?
Select the best answer.
Explanation:
Oral or parenteral antibiotics are essential in treating cellulitis to eliminate the infection. Topical antibiotics are not sufficient, and incision and drainage are only for abscesses.
While making rounds, the nurse observes the following client behaviors. Which child should the nurse further evaluate for postoperative pain?
Select the best answer.
Explanation:
The correct answer is D because screaming and thrashing his arms and legs are indicative behaviors of discomfort or pain in young children. The child's actions suggest a higher likelihood of experiencing postoperative pain and necessitate further evaluation. Choices A, B, and C do not exhibit overt signs of distress or discomfort associated with pain, making them less likely candidates for postoperative pain assessment.
You are developing a plan of care for a hospitalized child. Which age group is most likely to view illness as a punishment for misdeeds?
Select the best answer.
Explanation:
Preschool-aged children often engage in magical thinking, where they may believe that illness is a punishment for misdeeds. This belief is related to their cognitive development stage, where they may attribute cause and effect in a magical or unrealistic way. Adolescents are more likely to view illness as a disruption to their sense of independence or control. Infants lack the cognitive development to associate illness with punishment for misdeeds. School-aged children typically have a more concrete understanding of illness and its causes, moving away from magical thinking.
The nurse needs to start an intravenous (IV) line on an 8-year-old child to begin administering intravenous antibiotics. The child starts to cry and tells the nurse, "Do it later, okay?" What action should the nurse take?
Select the best answer.
Explanation:
Starting the IV as planned while allowing the child to express feelings afterward helps build trust and ensures the timely administration of necessary antibiotics. Delaying the procedure or changing the route could compromise the child's treatment.
Which assessment findings should the nurse expect in a child with sickle cell anemia experiencing an acute vaso-occlusive crisis?
Select the best answer.
Explanation:
The correct answer is D. Vaso-occlusive crises in sickle cell anemia are characterized by painful swelling of the joints in the hands and feet (hand-foot syndrome) and tissue engorgement due to the obstruction of blood flow by sickled cells. Choices A, B, and C are incorrect because circulatory collapse, hypovolemia, cardiomegaly, systolic murmur, hepatomegaly, and intrahepatic cholestasis are not typically associated with an acute vaso-occlusive crisis in sickle cell anemia.
The nurse is discussing toddler development with a parent. Which intervention will foster the achievement of autonomy?
Select the best answer.
Explanation:
Encouraging the toddler to do things for themselves when capable is the correct intervention to foster autonomy. This approach helps the toddler develop independence, self-confidence, and a sense of achievement. Choice A is incorrect as it focuses on assisting rather than encouraging independence. Choice C is incorrect as playing with other children primarily fosters social skills, not necessarily autonomy. Choice D is incorrect as learning the difference between right and wrong is related to moral development, not autonomy.
A 12-year-old child is injured in a bicycle accident. When considering the possibility of renal trauma, the nurse should consider what factor?
Select the best answer.
Explanation:
The amount of hematuria is not a reliable indicator of the severity of renal trauma, as even minor injuries can cause significant bleeding, while severe injuries may result in little or no visible blood. Renal trauma should be evaluated through imaging and clinical assessment.
At which age do most infants begin to fear strangers?
Select the best answer.
Explanation:
Fear of strangers typically begins around 6 months as infants start recognizing familiar and unfamiliar faces, which is part of their social development.
A parent brings their 4-year-old child for a check-up. Which finding would concern the nurse?
Select the best answer.
Explanation:
A resting pulse rate of 120 is elevated for a 4-year-old and may indicate an underlying issue that needs further investigation. An ectomorphic body type is a body shape and not typically a cause for concern. Weight gain within normal limits and no significant change in appetite are generally positive findings in a growing child.
The presence of which pair of factors is a good predictor of a fluid deficit of at least 5% in an infant?
Select the best answer.
Explanation:
Dry mucous membranes and an ill appearance are good indicators of dehydration in infants, often correlating with a fluid deficit of at least 5%. Sunken fontanels and poor skin turgor are also indicative but were not options here.
The charge nurse in the pediatric unit is teaching nursing students about pyloric stenosis. A student asks what causes pyloric stenosis. How should the nurse respond?
Select the best answer.
Explanation:
Pyloric stenosis is caused by the hypertrophy (thickening) of the circular muscle of the pylorus, leading to obstruction. Choice A is incorrect as it describes intussusception, not pyloric stenosis. Choice C is incorrect as a relaxed cardiac sphincter is related to gastroesophageal reflux. Choice D is incorrect as it describes Hirschsprung's disease, not pyloric stenosis.
Examination of the abdomen is performed correctly by the nurse in which order?
Select the best answer.
Explanation:
The correct order for abdominal examination is inspection, auscult
Latex allergy is suspected in a child with spina bifida. What are appropriate nursing interventions to include in care of this patient?
Select the best answer.
Explanation:
The correct answer is A: 'Avoid using any latex product.' In the case of a suspected latex allergy, it is crucial to prevent exposure to latex products to avoid allergic reactions. Choice B is incorrect because there are no truly non-allergenic latex products. Choice C is irrelevant to the situation described in the question, as the child does not have asthma. Choice D is also incorrect because desensitization is not an immediate option for managing a suspected latex allergy.
The school nurse is explaining to older school children that obesity increases the risk for which disorders? (Select all that apply.)
Select the best answer.
Explanation:
Obesity increases the risk for conditions like asthma, hypertension, dyslipidemia, and altered glucose metabolism, but not typically irritable bowel disease.
What time frame has the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists recommended that pregnant adolescents and women who are not protected against pertussis receive the tetanus, diphtheria, and pertussis (Tdap) vaccine?
Select the best answer.
Explanation:
The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists recommend that pregnant adolescents and women without protection against pertussis should receive the Tdap vaccine ideally between 27 and 36 weeks of gestation or postpartum before discharge from the hospital. This timeframe allows for the development of antibodies in the mother to protect her and provide passive immunity to the infant. Administering the vaccine during the first trimester (Choice D) is not recommended as the optimal time is between 27 and 36 weeks. Choice B, during the first prenatal visit, is too early for optimal protection, and Choice C, 24 hours prior to delivery, does not provide enough time for the vaccine to be effective before birth.
The nurse is planning an educational session with a group of school-age children. Which primary task from Erikson's theory of psychosocial development should be addressed?
Select the best answer.
Explanation:
In Erikson's theory of psychosocial development, school-age children typically focus on developing a sense of industry. This stage, occurring during middle childhood, involves the desire to feel competent and productive in their skills and abilities. Choices A, B, and D are incorrect because establishing trust in others (A) is related to the first stage of Erikson's theory (trust vs. mistrust) which occurs in infancy, developing a sense of autonomy (B) is linked to the second stage (autonomy vs. shame and doubt) which occurs in early childhood, and establishing a sense of identity (D) is associated with the fifth stage (identity vs. role confusion) which occurs in adolescence.
What is the recommended position for a child with epiglottitis to ease breathing?
Select the best answer.
Explanation:
The correct answer is C, 'Tripod.' In children with epiglottitis, the tripod position is recommended to help open the airway and ease breathing. This position involves the child sitting upright, leaning forward, and supporting themselves with their hands on their knees or another surface. This posture helps improve air entry into the lungs by maximizing the space for breathing. Choices A (Supine), B (Prone), and D (Semi-Fowler's) are incorrect. Placing a child with epiglottitis in the supine position may further obstruct the airway, while the prone position and semi-Fowler's position do not facilitate optimal air exchange in these cases.
An adolescent states, "I want to be a doctor or a lawyer when I grow up because I like taking care of people." Which Eriksonian challenge is the adolescent attempting?
Select the best answer.
Explanation:
The correct answer is A: Identity vs. role diffusion. During adolescence, individuals face the challenge of forming a cohesive sense of self and identity. In this scenario, the adolescent's desire to become a doctor or lawyer reflects the exploration of potential roles and career paths, indicating an attempt to establish a clear identity. Choices B, C, and D are incorrect. Trust vs. mistrust is a challenge experienced in infancy, industry vs. inferiority is relevant to the school-age period, and autonomy vs. shame and doubt is associated with the toddler stage, not adolescence.
As the primary caregiver for a 5-month-old baby, according to Maslow's hierarchy of basic needs, which intervention takes the highest priority?
Select the best answer.
Explanation:
The correct answer is A: Feeding every four hours. According to Maslow's hierarchy of needs, physiological needs, such as food, water, and warmth, take the highest priority. Ensuring that the baby is fed regularly is crucial for survival and overall health. Choice B, protection from harm, relates more to safety needs which come after physiological needs. Choice C, providing stimulation, is associated with higher-level needs like belongingness and esteem. Choice D, providing love, corresponds to esteem and self-actualization needs, which are higher in the hierarchy than physiological needs.
A school-age child with cancer is being prepared for a procedure. The child says, "I have had one of these before. They hurt." The nurse bases her response on what knowledge related to pain in this patient?
Select the best answer.
Explanation:
The correct answer is D. Pain is frequently reported by children with cancer, with around 84% experiencing it. Most children report moderate to severe pain, with about half finding it highly distressing. There is no evidence to suggest that children often misrepresent their pain experiences. Pain tolerance is not solely based on age but is a complex phenomenon. Children do not become accustomed to painful procedures, as each experience of pain is unique.
The nurse is educating a new nurse on the identification of pain in children. What does the nurse teach about physiologic measurements in children's pain assessment?
Select the best answer.
Explanation:
Physiologic manifestations of pain may vary considerably, so they do not provide a consistent measure of pain. Heart rate may increase or decrease. The same signs that may suggest fear, anxiety, or anger also indicate pain. In chronic pain, the body adapts, and these signs decrease or stabilize. Physiologic measurements are of limited value and must be viewed in the context of a pain rating scale, behavioral assessment, and parental report. When the child reports pain on an appropriate pain scale, the appropriate interventions should be used. Therefore, physiologic measurements are not considered a reliable standalone indicator for pain in children, making choice A the correct answer. Choice B is incorrect because physiologic measurements alone do not serve as the best indicator of pain. Choice C is incorrect as physiologic measurements are still limited even when children report pain. Choice D is incorrect as physiologic measurements are not primarily used to determine the truthfulness of a child's pain report.
The nurse is caring postoperatively for an 8-year-old child with multiple fractures and other traumatic injuries from a motor vehicle crash. The child is experiencing severe pain. What is an important consideration in managing the child's pain?
Select the best answer.
Explanation:
For severe postoperative pain, a preventive around-the-clock schedule is necessary to prevent decreased plasma levels of medications. Providing only an opioid analgesic at this time may not be sufficient for effective pain management. Increasing the dosage without an order is unsafe and may lead to oversedation. Planning a preventive schedule of pain medication around the clock ensures consistent pain relief and better management. Giving the child a clock and explaining when they can have pain medications may increase the child's focus on waiting for relief rather than addressing the pain promptly, making it a less effective strategy.
The parents of a 12-month-old child ask the nurse if the child can eat hot dogs as do their other children. The nurse's reply should be based on what?
Select the best answer.
Explanation:
Cutting hot dogs into small, irregular pieces reduces the risk of aspiration, which is a significant choking hazard for young children.
The nurse is planning an educational session with a group of school-age children. Which primary task from Erikson's theory of psychosocial development should be addressed?
Select the best answer.
Explanation:
In Erikson's theory of psychosocial development, school-age children typically focus on developing a sense of industry. This stage, occurring during middle childhood, involves the desire to feel competent and productive in their skills and abilities. Choices A, B, and D are incorrect because establishing trust in others (A) is related to the first stage of Erikson's theory (trust vs. mistrust) which occurs in infancy, developing a sense of autonomy (B) is linked to the second stage (autonomy vs. shame and doubt) which occurs in early childhood, and establishing a sense of identity (D) is associated with the fifth stage (identity vs. role confusion) which occurs in adolescence.
What is the recommended position for a child with epiglottitis to ease breathing?
Select the best answer.
Explanation:
The correct answer is C, 'Tripod.' In children with epiglottitis, the tripod position is recommended to help open the airway and ease breathing. This position involves the child sitting upright, leaning forward, and supporting themselves with their hands on their knees or another surface. This posture helps improve air entry into the lungs by maximizing the space for breathing. Choices A (Supine), B (Prone), and D (Semi-Fowler's) are incorrect. Placing a child with epiglottitis in the supine position may further obstruct the airway, while the prone position and semi-Fowler's position do not facilitate optimal air exchange in these cases.
An adolescent states, "I want to be a doctor or a lawyer when I grow up because I like taking care of people." Which Eriksonian challenge is the adolescent attempting?
Select the best answer.
Explanation:
The correct answer is A: Identity vs. role diffusion. During adolescence, individuals face the challenge of forming a cohesive sense of self and identity. In this scenario, the adolescent's desire to become a doctor or lawyer reflects the exploration of potential roles and career paths, indicating an attempt to establish a clear identity. Choices B, C, and D are incorrect. Trust vs. mistrust is a challenge experienced in infancy, industry vs. inferiority is relevant to the school-age period, and autonomy vs. shame and doubt is associated with the toddler stage, not adolescence.
As the primary caregiver for a 5-month-old baby, according to Maslow's hierarchy of basic needs, which intervention takes the highest priority?
Select the best answer.
Explanation:
The correct answer is A: Feeding every four hours. According to Maslow's hierarchy of needs, physiological needs, such as food, water, and warmth, take the highest priority. Ensuring that the baby is fed regularly is crucial for survival and overall health. Choice B, protection from harm, relates more to safety needs which come after physiological needs. Choice C, providing stimulation, is associated with higher-level needs like belongingness and esteem. Choice D, providing love, corresponds to esteem and self-actualization needs, which are higher in the hierarchy than physiological needs.
A school-age child with cancer is being prepared for a procedure. The child says, "I have had one of these before. They hurt." The nurse bases her response on what knowledge related to pain in this patient?
Select the best answer.
Explanation:
The correct answer is D. Pain is frequently reported by children with cancer, with around 84% experiencing it. Most children report moderate to severe pain, with about half finding it highly distressing. There is no evidence to suggest that children often misrepresent their pain experiences. Pain tolerance is not solely based on age but is a complex phenomenon. Children do not become accustomed to painful procedures, as each experience of pain is unique.
The nurse is educating a new nurse on the identification of pain in children. What does the nurse teach about physiologic measurements in children's pain assessment?
Select the best answer.
Explanation:
Physiologic manifestations of pain may vary considerably, so they do not provide a consistent measure of pain. Heart rate may increase or decrease. The same signs that may suggest fear, anxiety, or anger also indicate pain. In chronic pain, the body adapts, and these signs decrease or stabilize. Physiologic measurements are of limited value and must be viewed in the context of a pain rating scale, behavioral assessment, and parental report. When the child reports pain on an appropriate pain scale, the appropriate interventions should be used. Therefore, physiologic measurements are not considered a reliable standalone indicator for pain in children, making choice A the correct answer. Choice B is incorrect because physiologic measurements alone do not serve as the best indicator of pain. Choice C is incorrect as physiologic measurements are still limited even when children report pain. Choice D is incorrect as physiologic measurements are not primarily used to determine the truthfulness of a child's pain report.
The nurse is caring postoperatively for an 8-year-old child with multiple fractures and other traumatic injuries from a motor vehicle crash. The child is experiencing severe pain. What is an important consideration in managing the child's pain?
Select the best answer.
Explanation:
For severe postoperative pain, a preventive around-the-clock schedule is necessary to prevent decreased plasma levels of medications. Providing only an opioid analgesic at this time may not be sufficient for effective pain management. Increasing the dosage without an order is unsafe and may lead to oversedation. Planning a preventive schedule of pain medication around the clock ensures consistent pain relief and better management. Giving the child a clock and explaining when they can have pain medications may increase the child's focus on waiting for relief rather than addressing the pain promptly, making it a less effective strategy.
The parents of a 12-month-old child ask the nurse if the child can eat hot dogs as do their other children. The nurse's reply should be based on what?
Select the best answer.
Explanation:
Cutting hot dogs into small, irregular pieces reduces the risk of aspiration, which is a significant choking hazard for young children.
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