a 12 month old child presents to the clinic for a well visit after missing several appointments the child began her immunization schedule but has miss
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Nursing Elites

ATI RN

ATI Nursing Care of Children

1. A 12-month-old child presents to the clinic for a well visit after missing several appointments. The child began her immunization schedule but has missed several follow-up appointments and doses of immunizations. What is the most appropriate nursing intervention?

Correct answer: C

Rationale: Children who began primary immunization at the recommended age but fail to receive all the doses do not need to begin the series again but should receive only the missed doses. The child may receive missed vaccinations on a catch-up schedule per CDC guidelines.

2. The nurse is taking a health history of an adolescent. Which best describes how the chief complaint should be determined?

Correct answer: B

Rationale: Asking the adolescent directly about the reason for their visit encourages open communication and helps the nurse understand the primary concern from the patient's perspective.

3. An effective means of establishing rapport with the hospitalized pre-schooler is through:

Correct answer: C

Rationale: Play is an effective way to communicate and build rapport with young children, especially pre-schoolers. It helps them feel comfortable, express themselves, and establish a connection with the caregiver. Lengthy discussions may not be suitable for their age and attention span, while explanation with drawings and models can enhance communication but may not engage them as effectively as play. Silence, on the other hand, may create a sense of unease or lack of interaction for pre-schoolers.

4. Which finding suggests fluid volume deficit in an infant presenting with vomiting and diarrhea for 2 days?

Correct answer: B

Rationale: A sunken fontanel is a classic sign of dehydration in infants, indicating a fluid volume deficit. In dehydration, the fontanel sinks due to decreased fluid volume in the body. Increased blood pressure (Choice A) is not typically associated with dehydration in infants. Decreased pulse rate (Choice C) is not a common finding in fluid volume deficit, as the body tries to increase the heart rate to compensate for decreased volume. Low urine specific gravity (Choice D) may be seen in dehydration, but it is not as specific or as easily observable as a sunken fontanel.

5. A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include?

Correct answer: B

Rationale: Postoperative teaching should focus on assessing bowel function to ensure the colostomy is functioning properly. This includes monitoring stool output, color, consistency, and signs of infection or blockage. Choice A, dilating the stoma, is not recommended without healthcare provider guidance, as it can lead to complications. Choice C, limitation of physical activities, may not be as crucial immediately after colostomy creation. Choice D, measures to prevent prolapse of the rectum, is more relevant for conditions like rectal prolapse and not specifically for a colostomy.

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