ATI RN
RN Nursing Care of Children Online Practice 2019 A
1. Two children are working on a puzzle together in the hospital playroom. Which type of play describes this activity?
- A. Solitary play
- B. Associative play
- C. Parallel play
- D. Cooperative play
Correct answer: D
Rationale: The correct answer is D, cooperative play. In cooperative play, children work together toward a common goal, such as completing a puzzle. Solitary play (A) is when a child plays alone, associative play (B) involves children playing together but without a common goal, and parallel play (C) is when children play alongside each other without direct interaction.
2. During the nurse’s initial assessment of a school-age child, the child reports a pain level of 6 out of 10. The child is lying quietly in bed watching television. What action should the nurse take?
- A. Reassess the child in 15 minutes to see if the pain rating has changed
- B. Administer the prescribed analgesic
- C. Do nothing since the child appears to be resting
- D. Ask the child’s parents if they think the child is hurting
Correct answer: B
Rationale: Pain management should be based on the child’s report of pain, regardless of their activity level. Administering the prescribed analgesic is the appropriate action. Reassessing the child in 15 minutes without providing immediate pain relief may not be in the child's best interest. Doing nothing since the child appears to be resting may lead to inadequate pain management. Asking the child’s parents if they think the child is hurting does not replace the need for direct assessment and intervention by the nurse.
3. Ongoing fluid losses can overwhelm the child’s ability to compensate, resulting in shock. What early clinical sign precedes shock?
- A. Tachycardia
- B. Slow respirations
- C. Warm, flushed skin
- D. Decreased blood pressure
Correct answer: A
Rationale: Tachycardia is an early sign of shock as the body tries to maintain cardiac output in the face of declining circulatory volume. Blood pressure often remains normal until late in the progression, at which point decompensated shock is occurring.
4. What is the first sign of puberty in girls?
- A. Acne
- B. Hair growth in the pubic area and underarms
- C. Thelarche
- D. Menarche
Correct answer: C
Rationale: The correct answer is C, Thelarche. Thelarche refers to the onset of breast development, which is typically the first sign of puberty in girls. This occurs before menarche (the first menstrual period). Choices A and B, acne and hair growth in the pubic area and underarms, are not the first signs of puberty in girls. While acne can be a common occurrence during puberty, it usually appears after other physical changes. Hair growth in the pubic area and underarms also occurs later in the puberty process.
5. The nurse is preparing to give acetaminophen (Tylenol) to a child who has a fever. What nursing action is appropriate?
- A. Retake the temperature in 15 minutes after giving the Tylenol.
- B. Place a warm blanket on the child so chilling does not occur.
- C. Check to be sure the Tylenol dose does not exceed 15 mg/kg.
- D. Use cold compresses instead of Tylenol to control the fever.
Correct answer: C
Rationale: Ensuring the dose does not exceed 15 mg/kg is critical to avoid overdose and potential liver damage. Retaking the temperature immediately or using cold compresses is not necessary, and placing a warm blanket could exacerbate the fever.
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