Free ATI RN Nursing Care of Children practice for RN Nursing Care of Children Online Practice 2019 A (ATI RN). Answer 59 nursing exam-style questions with ratio
Superficial palpation of the abdomen is often perceived by the child as tickling. Which measure by the nurse is most likely to minimize this sensation and promote relaxation?
Select the best answer.
Explanation:
Allowing the child to place their hand over the nurse's hand helps reduce the tickling sensation and increases the child's comfort during the examination.
The nurse is preparing to admit a child to the hospital with a diagnosis of minimal change nephrotic syndrome. The nurse understands that the peak age at onset for this disease is what?
Select the best answer.
Explanation:
The peak age for the onset of minimal change nephrotic syndrome (MCNS) is typically between 4 and 5 years old. MCNS is the most common cause of nephrotic syndrome in children, particularly within this age range.
A nurse is carrying on a conversation with a 7-year-old child during an office visit. Which is an example of the level of language development the nurse should expect in this child?
Select the best answer.
Explanation:
The correct answer is B. Understanding time concepts like 'half past' can be challenging for a 7-year-old, indicating the level of language development. Choice A is incorrect as fascination with bathroom language is common in this age group but not necessarily indicative of language development. Choice C is incorrect as a 7-year-old typically cannot carry on an adult conversation due to cognitive and experiential limitations. Choice D is incorrect as by the age of 7, children should be able to speak in full sentences.
What is an advantage of the ventrogluteal muscle as an injection site in young children?
Select the best answer.
Explanation:
The ventrogluteal site is free of significant nerves and vascular structures, making it a safer choice for intramuscular injections in young children compared to other sites that may be more prone to complications.
The mother of a 6-month-old infant has returned to work and is expressing breast milk to be frozen. She asks for directions on how to safely thaw the breast milk in the microwave. What should the nurse recommend?
Select the best answer.
Explanation:
Thawing or heating breast milk in a microwave is not recommended because it can create hot spots that may burn the infant and destroy essential nutrients.
After teaching a group of nursing students about developmental milestones for children between the ages of 1 and 4 years, the instructor determines that the teaching was successful when the students identify which of the following as a gross motor developmental milestone that occurs between 2 to 3 years of age?
Select the best answer.
Explanation:
Climbing is a gross motor milestone typically achieved between 2 to 3 years of age. It involves coordination and strength. Jumping in place is usually mastered around 2 years of age. Standing on one foot with help is a skill that emerges around 3 years. Riding a tricycle typically occurs closer to 3 years and involves coordination and balance, which are more refined skills compared to climbing at an earlier age.
An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is which?
Select the best answer.
Explanation:
Providing a simple explanation satisfies the child's curiosity and helps reduce any anxiety about the procedure.
In the newborn, into what muscle is intramuscular vitamin K administered?
Select the best answer.
Explanation:
In newborns, intramuscular vitamin K is traditionally administered into the vastus lateralis muscle. This site is preferred due to its large muscle mass and accessibility. The dorsogluteal site is not recommended for newborns due to the risk of injury to the sciatic nerve. The deltoid site is also not recommended for newborns. The rectus femoris muscle is not commonly used for intramuscular injections in newborns.
The nurse is aware that skin turgor best estimates what?
Select the best answer.
Explanation:
Skin turgor is a quick and simple way to assess hydration status. Poor skin turgor can indicate dehydration.
Which one of the following strategies might be recommended for an infant with failure to thrive (FTT) to increase caloric intake?
Select the best answer.
Explanation:
Being persistent through 10 to 15 minutes of food refusal is recommended to help increase caloric intake in infants with FTT. Establishing a routine and using developmental stimulation can also be helpful, but the priority is ensuring adequate caloric intake.
What diagnostic test allows visualization of renal parenchyma and renal pelvis without exposure to external-beam radiation or radioactive isotopes?
Select the best answer.
Explanation:
Renal ultrasonography provides imaging of the renal parenchyma and pelvis without the risks associated with radiation or radioactive isotopes, making it a safer option, especially for children.
During a routine health assessment, the nurse notes that an 8-month-old infant has a significant head lag. Which is the most appropriate action?
Select the best answer.
Explanation:
Significant head lag at 8 months is concerning and warrants further evaluation, as it may indicate developmental delays or neurological issues.
A breastfed infant is being seen in the clinic for a 6-month checkup. The mother tells the nurse that the infant recently began to suck her thumb. Which is the best nursing intervention?
Select the best answer.
Explanation:
Thumb sucking is a normal self-soothing behavior in infants and usually does not indicate a problem. Reassuring the mother that this is normal is the appropriate response.
As children grow and develop, their style of play changes. Which play style is descriptive of the school-age child?
Select the best answer.
Explanation:
The correct answer is B. School-age children are typically able to play structured games with other children and follow the rules of the game. This ability reflects their growing cognitive and social development. Choice A is incorrect as school-age children often engage in group play. Choice C is incorrect as school-age children usually have more autonomy in their play choices. Choice D is incorrect as school-age children tend to form more organized play settings rather than loose groups.
What type of dehydration occurs when the electrolyte deficit exceeds the water deficit?
Select the best answer.
Explanation:
Hypotonic dehydration occurs when the loss of electrolytes exceeds the loss of water, leading to a decrease in plasma osmolarity. This often occurs when sodium loss is greater than water loss, as in diarrhea or vomiting.
What condition is the most common cause of acute renal failure in children?
Select the best answer.
Explanation:
Severe dehydration is the most common cause of acute renal failure in children, as it leads to prerenal azotemia, which can progress to renal failure if not corrected. Other causes like pyelonephritis and tubular destruction are less common and usually secondary to other conditions.
The nurse is caring for a child with a urinary tract infection who is on intravenous gentamicin (Garamycin). What interventions should the nurse plan for this child with regard to this medication? (Select all that apply.)
Select the best answer.
Explanation:
Gentamicin is an aminoglycoside antibiotic that requires monitoring of serum peak and trough levels to avoid toxicity, particularly nephrotoxicity and ototoxicity. Encouraging fluids and monitoring urinary output are also crucial to minimize the risk of kidney damage.
The nurse is teaching the mother of a 9-month-old infant about administering liquid iron preparation. Which information should be included in the teaching?
Select the best answer.
Explanation:
The correct answer is A. Iron supplements can cause stools to turn black, which is a normal and harmless side effect. Iron is best absorbed on an empty stomach, although it can be given with food if gastrointestinal upset occurs. Vitamin C, not D, enhances iron absorption. Choice B is incorrect because Vitamin C enhances iron absorption, not Vitamin D. Choice C is incorrect as there is no need to mix liquid iron with saliva before swallowing. Choice D is incorrect because iron is best absorbed on an empty stomach.
At what age is it safe to give infants whole milk instead of commercial infant formula?
Select the best answer.
Explanation:
Whole milk should not be introduced before 12 months because it lacks the necessary nutrients, such as iron, that infants need for proper growth and development.
Parents of a child who will need hemodialysis ask the nurse, What are the advantages of a fistula over a graft or external access device for hemodialysis? (Select all that apply.)
Select the best answer.
Explanation:
A fistula typically has fewer complications, allows for greater freedom of movement, and involves natural vessel changes that improve dialysis efficiency. However, it is not ready for immediate use, which is why it may take weeks to mature before it can be used.
A child is admitted with renal failure. Which of these findings should the nurse expect?
Select the best answer.
Explanation:
Azotemia (elevated BUN and creatinine) and oliguria (reduced urine output) are classic signs of renal failure, indicating impaired kidney function. In renal failure, the kidneys are unable to effectively filter waste products, leading to an increase in BUN and creatinine levels in the blood. Additionally, oliguria occurs due to decreased kidney function. Increased GFR (Choice C) is not expected in renal failure as it signifies improved kidney function, which is not the case in renal failure. Polyuria and elevated creatinine clearance (Choice D) are not typical findings in renal failure. Polyuria is more commonly associated with conditions like diabetes insipidus, while elevated creatinine clearance would indicate increased kidney function, which is contrary to the impaired function seen in renal failure.
What term is appropriate terminology to use for an infant whose intrauterine growth rate was slowed and whose birth weight falls below the 10th percentile on intrauterine growth charts?
Select the best answer.
Explanation:
The correct answer is D, 'Small for gestational age.' A small for gestational age, or small-for-date, infant is any child whose intrauterine growth rate was slowed and whose birth weight falls below the 10th percentile on intrauterine growth curves. Choices A and B, 'Postterm' and 'Postmature,' refer to infants born after 42 weeks of gestational age regardless of birth weight, and do not specifically address growth rate. Choice C, 'Low birth weight,' refers to infants with a birth weight less than 2500 g (5.5 pounds) regardless of gestational age, which is a different classification compared to being small for gestational age.
The child is admitted with acute abdominal pain and possible appendicitis. What intervention is appropriate to relieve the abdominal discomfort during the evaluation?
Select the best answer.
Explanation:
Allowing the child to assume a position of comfort is appropriate as it helps alleviate discomfort without the risk of complications. Placing the child in the Trendelenburg position could increase intra-abdominal pressure and worsen the condition. Applying moist heat may lead to vasodilation and potential perforation in case of appendicitis. Administering a saline enema can be harmful if the appendix is inflamed or perforated.
Which type of family should the nurse recognize when the paternal grandmother, the parents, and two minor children live together?
Select the best answer.
Explanation:
An extended family includes relatives such as grandparents, aunts, uncles, and other extended family members living together, beyond just the nuclear family unit.
A school-age child with celiac disease asks for guidance about snacks that will not exacerbate the disease. What snack should the nurse suggest?
Select the best answer.
Explanation:
Popcorn is a safe snack for a child with celiac disease as it is naturally gluten-free. Other options like pizza, pretzels, and oatmeal cookies typically contain gluten unless specifically made with gluten-free ingredients, which can exacerbate celiac symptoms. Therefore, popcorn is the best option to suggest to the child to avoid any adverse effects on their condition.
An adolescent with irritable bowel syndrome comes to see the school nurse. What information should the nurse share with the adolescent?
Select the best answer.
Explanation:
The correct answer is B: Stress management may be helpful. Stress is known to exacerbate symptoms of irritable bowel syndrome (IBS), making stress management an essential part of managing the condition. While dietary modifications can also be beneficial, a low-fiber diet is not universally recommended for IBS, as fiber can be important for some individuals. Milk products may or may not be contributing factors, as food triggers can vary among individuals. Pantoprazole, a proton pump inhibitor, is not typically the first-line treatment for IBS, as it is more commonly used for conditions like gastroesophageal reflux disease.
When should the nurse instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux?
Select the best answer.
Explanation:
Proton pump inhibitors (PPIs) like omeprazole or lansoprazole are most effective when given 30 minutes before breakfast. This timing allows the medication to inhibit the proton pumps in the stomach that produce acid, providing better symptom control throughout the day. Administering the PPI at bedtime (choice A) may not be as effective as giving it before breakfast due to the timing of peak acid production during the day. Giving it with a meal (choice B) might affect the absorption and effectiveness of the medication. Midmorning administration (choice C) is not the recommended time for optimal PPI efficacy.
A six-year-old child is admitted to the hospital with a diagnosis of urinary tract infection. Which of these factors contribute to urinary tract infections in young children?
Select the best answer.
Explanation:
Infrequent voiding can lead to urinary stasis, which increases the risk of urinary tract infections by allowing bacteria to multiply in the bladder. Encouraging regular voiding and proper hydration can help prevent UTIs. Choices A, B, and C are incorrect. Excessive intake of carbonated beverages may irritate the bladder but is not a direct cause of UTIs. Insufficient water intake can concentrate urine but does not necessarily lead to infections. A voiding pattern of 5-6 times a day is within the normal range and is not associated with increased UTI risk.
The nurse is preparing to administer an intramuscular injection to a toddler-age client. Which is the most appropriate statement by the nurse prior to this procedure?
Select the best answer.
Explanation:
The correct answer is C because it acknowledges the child's feelings, provides clear instructions, and offers comfort and rewards to help the child cope with the procedure. Choice A is not appropriate as it may create anxiety about the injection. Choice B uses the term 'magic,' which may confuse the child and lead to fear. Choice D introduces a fantasy element that may not be beneficial in preparing the child for the injection.
The nurse is conducting discharge teaching with the parent of a 7-year-old child with minimal change nephrotic syndrome (MCNS). What statement by the parent indicates a correct understanding of the teaching?
Select the best answer.
Explanation:
Avoiding additional salt is crucial to help manage edema in children with MCNS. While monitoring urine output is important, the other statements either misinterpret the need for prolonged school absence or misunderstand the risk associated with contact sports during steroid therapy.
In terms of gross motor development, what should the nurse expect an infant age 5 months to do?
Select the best answer.
Explanation:
At 5 months, infants typically can turn from their abdomen to their back. Rolling from back to abdomen and sitting erect without support occur later.
The nurse is caring for a child with suspected ingestion of some type of poison. What action should the nurse take next after initiating cardiopulmonary resuscitation (CPR)?
Select the best answer.
Explanation:
After ensuring the child's immediate survival needs are met with CPR, contacting poison control is critical to receive specific guidance on how to proceed with treatment. Other actions may be necessary depending on the situation but should follow contacting poison control.
A mother reports to the nurse that her 6-year-old child is highly active, irritable, irregular in habits, and adapts slowly to new routines, people, or situations. Which pattern of temperament would best describe the child?
Select the best answer.
Explanation:
The 'difficult' child is the best way to describe the child in this scenario. This temperament is characterized by high activity levels, irritability, irregular habits, and difficulty adapting to changes. Choice A, the 'easy' child, is known for being generally positive and adaptable. Choice C, the 'slow-to-warm-up' child, typically needs time to adapt to new situations but is not necessarily highly active or irritable. Choice D, the 'fast-to-warm-up' child, adapts quickly to new situations, which contrasts with the child's slow adaptation mentioned in the scenario.
Which family theory explains how families react to stressful events and suggests factors that promote adaptation to these events?
Select the best answer.
Explanation:
Family stress theory explains how families respond to stress and identifies factors that help families adapt to and manage stressful events effectively.
The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which?
Select the best answer.
Explanation:
A child with a BMI greater than the 95th percentile is classified as obese, according to standard growth charts used in pediatric practice.
Children are taught the values of their culture through observation and feedback relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which factor may be culturally determined?
Select the best answer.
Explanation:
Status, or the social standing within a culture, is often culturally determined and plays a significant role in shaping behaviors and expectations.
A nurse is evaluating the effectiveness of teaching regarding care of a child with minimal change nephrotic syndrome (MCNS) that is in remission after administration of prednisone. The nurse realizes further teaching is required if the parents state what?
Select the best answer.
Explanation:
Children with MCNS in remission can usually return to school. Home schooling may be necessary only if there are complications. The other options show an understanding of proper care during remission.
Which describe the feelings and behaviors of adolescents related to divorce? (Select all that apply.)
Select the best answer.
Explanation:
Adolescents may withdraw from social interactions, worry about the impact of the divorce, and express strong emotions such as anger or sadness.
What illnesses does respiratory hygiene and cough etiquette by the Centers for Disease Control and Prevention (CDC) prevent?
Select the best answer.
Explanation:
The correct answer is C: RSV, influenza, and adenovirus. The CDC recommends respiratory hygiene and etiquette to prevent the transmission of respiratory syncytial virus (RSV), influenza, adenovirus, and other droplet-transmitted unknown viruses. Choices A, B, and D are incorrect because HBV, Hib, pertussis, HSV, and varicella are not typically transmitted via droplets but through other modes of transmission.
What does the Hib conjugate vaccine protect against?
Select the best answer.
Explanation:
The Hib conjugate vaccine is crucial for protecting children from several severe infections caused by Haemophilus influenzae type b, including bacterial meningitis, epiglottitis, bacterial pneumonia, septic arthritis, and sepsis. Therefore, all the provided options are correct. Bacterial meningitis, epiglottitis, and bacterial pneumonia are serious conditions that the Hib vaccine effectively prevents, making choice D the correct answer. Choices A, B, and C are incorrect when considered individually as the Hib vaccine does not protect against only one specific infection; rather, it provides immunity against multiple diseases caused by Haemophilus influenzae type b.
What factor predisposes an infant to fluid imbalances?
Select the best answer.
Explanation:
Infants have immature kidneys that are less efficient at concentrating urine, making them more susceptible to fluid imbalances. Their higher surface area to volume ratio also contributes to greater insensible fluid losses.
After a 7-year-old with acute diarrhea has been rehydrated with oral rehydration solutions, what type of diet should the nurse recommend following rehydration?
Select the best answer.
Explanation:
After rehydration, a regular diet is generally recommended to ensure proper nutrition and recovery. A regular diet includes a balanced intake of all food groups and nutrients. Fruit juices may be too high in simple sugars and lack necessary nutrients, which can exacerbate diarrhea. While a high carbohydrate diet may be beneficial in some cases, a regular diet is more comprehensive. The BRAT diet, consisting of bananas, rice, apples, and toast or tea, was previously recommended for diarrhea, but it lacks adequate protein and fat, so a regular diet is now preferred for overall better nutrition and recovery.
The nurse is planning to counsel family members as a group to assess the family's group dynamics. Which theoretical family model is the nurse using as a framework?
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Explanation:
Family systems theory views the family as an interconnected system where changes in one member affect the entire family, making it ideal for assessing group dynamics.
Which immunization is recommended for all newborns?
Select the best answer.
Explanation:
The correct answer is B, the Hepatitis B vaccine. This vaccine is recommended for all newborns to prevent Hepatitis B infection, which can lead to chronic liver disease and liver cancer. The Hepatitis B vaccine is a crucial part of the routine immunization schedule for infants. Choices A, C, and D are incorrect because the recommended vaccine for newborns is specifically Hepatitis B, not Hepatitis A, Hepatitis C, or a combination of Hepatitis A, B, and C vaccines.
Play activities of the preschool-age child include:
Select the best answer.
Explanation:
The correct answer is A, 'Having imaginary playmates.' Preschool-age children often engage in imaginative play, which includes creating imaginary friends or playmates. This type of play helps them develop creativity, social skills, and emotional expression. Choice B, 'Selective collection of objects,' may be more common in older children and is not a typical play activity for preschoolers. Choice C, 'Complex board games,' are usually beyond the developmental level of preschoolers as they require more advanced cognitive skills. Choice D, 'Associative play,' is a term used to describe a type of play where children play alongside each other but not necessarily together, which is different from the imaginative play involving imaginary playmates that preschoolers often engage in.
The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of clinical reasoning?
Select the best answer.
Explanation:
Clinical reasoning is purposeful and goal-directed, involving the use of critical thinking and decision-making skills to provide effective patient care.
As children grow and develop, their style of play changes. Which play style is seen in the preschooler?
Select the best answer.
Explanation:
The correct answer is B: Associative. Associative play is common in preschoolers, where children engage in separate activities but interact by sharing toys and talking with each other. This stage is characterized by more social interaction than solitary play (option A), where children play alone without interacting with others. Cooperative play (option C) involves children working together towards a common goal, which is typically seen in older children. Parallel play (option D) is when children play alongside each other but do not actively engage with one another, which is more common in toddlers.
The nurse is teaching a client to prevent future urinary tract infections (UTIs). What factor is most important to emphasize as the potential cause?
Select the best answer.
Explanation:
Urinary stasis is the most important factor in the development of UTIs because it provides an environment for bacterial growth. While poor hygiene and congenital anomalies are contributing factors, preventing urinary stasis is key in UTI prevention.
Which clinical manifestations should the nurse expect in a child diagnosed with nephroblastoma?
Select the best answer.
Explanation:
The correct answer is D: Hypertension. Nephroblastoma, also known as Wilms' tumor, often causes hypertension due to its impact on the kidney, which plays a role in regulating blood pressure. Atrial fibrillation (choice A) and endocarditis (choice B) are not typically associated with nephroblastoma. Hyperlipidemia (choice C) is also not a common clinical manifestation of nephroblastoma.
The nurse is caring for a child with hypernatremia. The nurse evaluates the child for which signs and symptoms of hypernatremia? (Select all that apply.)
Select the best answer.
Explanation:
Hypernatremia typically presents with lethargy, oliguria, and intense thirst due to the body's attempt to conserve water. Apathy can also occur, but lethargy and thirst are more consistent indicators.
The nurse is interviewing the mother of an infant. The mother reports, "I had a difficult delivery, and my baby was born prematurely." This information should be recorded under which heading?
Select the best answer.
Explanation:
The history section of the health record includes details about pregnancy, labor, and delivery, as these factors can have significant implications for the child's health.
What term describes the invagination of one segment of bowel within another?
Select the best answer.
Explanation:
Intussusception is the correct answer. It refers to the condition where one segment of the bowel folds into another, leading to an obstruction. Atresia (Choice A) is the absence or abnormal closure of a normal opening or tubular structure. Stenosis (Choice B) is the narrowing of a passage in the body. Herniation (Choice C) is the abnormal protrusion of an organ or tissue through a defect in its surrounding walls. Intussusception is a medical emergency commonly observed in infants and young children and necessitates prompt intervention to prevent severe complications.
What is the most frequent cause of hypovolemic shock in children?
Select the best answer.
Explanation:
Hypovolemic shock in children is most frequently caused by blood loss, which can result from trauma, surgery, or gastrointestinal bleeding. Sepsis and anaphylaxis can lead to different types of shock (septic and anaphylactic), and heart failure is related to cardiogenic shock.
What is the best age to introduce solid food into an infant's diet?
Select the best answer.
Explanation:
The introduction of solid foods is recommended at 4 to 6 months when the infant's digestive system is more developed and ready for solids.
According to Erikson's developmental theory, toddlers need to be encouraged to become independent to successfully complete which developmental challenge?
Select the best answer.
Explanation:
The correct answer is C: Autonomy vs. shame and doubt. Erikson's developmental stage for toddlers focuses on the conflict between developing a sense of independence (autonomy) and feelings of inadequacy (shame and doubt). Encouraging toddlers to explore their environment and make choices helps them build self-confidence and independence. Choices A, B, and D are incorrect because trust vs. mistrust relates to infancy, industry vs. inferiority is associated with school-age children, and initiative vs. guilt is linked to preschoolers.
In planning care for children, the nurse considers children's anxiety about hospitalization. Which measure should be included in the child's plan of care to help reduce anxiety?
Select the best answer.
Explanation:
Therapeutic play should be included in the child's plan of care to help reduce anxiety during hospitalization. It is an effective strategy that allows children to express their feelings, understand procedures, and reduce anxiety levels. Time-out (choice B) is not suitable for addressing anxiety related to hospitalization. Counseling (choice C) may be beneficial but is not as specifically tailored to reduce anxiety in the hospital setting as therapeutic play. Movies (choice D) may provide a temporary distraction but do not actively involve the child in addressing their emotions and fears associated with hospitalization.
What is the best age to introduce solid food into an infant's diet?
Select the best answer.
Explanation:
The introduction of solid foods is recommended at 4 to 6 months when the infant's digestive system is more developed and ready for solids.
According to Erikson's developmental theory, toddlers need to be encouraged to become independent to successfully complete which developmental challenge?
Select the best answer.
Explanation:
The correct answer is C: Autonomy vs. shame and doubt. Erikson's developmental stage for toddlers focuses on the conflict between developing a sense of independence (autonomy) and feelings of inadequacy (shame and doubt). Encouraging toddlers to explore their environment and make choices helps them build self-confidence and independence. Choices A, B, and D are incorrect because trust vs. mistrust relates to infancy, industry vs. inferiority is associated with school-age children, and initiative vs. guilt is linked to preschoolers.
In planning care for children, the nurse considers children's anxiety about hospitalization. Which measure should be included in the child's plan of care to help reduce anxiety?
Select the best answer.
Explanation:
Therapeutic play should be included in the child's plan of care to help reduce anxiety during hospitalization. It is an effective strategy that allows children to express their feelings, understand procedures, and reduce anxiety levels. Time-out (choice B) is not suitable for addressing anxiety related to hospitalization. Counseling (choice C) may be beneficial but is not as specifically tailored to reduce anxiety in the hospital setting as therapeutic play. Movies (choice D) may provide a temporary distraction but do not actively involve the child in addressing their emotions and fears associated with hospitalization.
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