ATI RN
Nursing Care of Children ATI
1. A mother has just given birth to a newborn with a cleft lip. Sensing that something is wrong, she starts to cry and asks the nurse, "What is wrong with my baby?" What is the most appropriate nursing action?
- A. Encourage the mother to express her feelings
- B. Explain in simple language that the baby has a cleft lip
- C. Provide emotional support until the practitioner can talk to the mother
- D. Tell the mother a pediatrician will talk to her as soon as the baby is examined
Correct answer: A
Rationale: Encouraging the mother to express her feelings allows her to process the situation and prepares her for receiving further information in a supportive environment.
2. 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?
- A. Correction of alkalosis
- B. Pain management and administration of heparin
- C. Adequate oxygenation and replacement of factor VIII to correct the sickling
- D. Adequate hydration, oxygenation, and pain management
Correct answer: D
Rationale: 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.
3. Which of the following is a key feature of autism spectrum disorder?
- A. Delayed speech development
- B. Hyperactivity
- C. Lack of interest in toys
- D. Aggressive behavior
Correct answer: A
Rationale: Delayed speech development is a significant feature of autism spectrum disorder. Many children with autism exhibit delays in speech and language development, which can be one of the early signs of the condition. Hyperactivity, lack of interest in toys, and aggressive behavior are not key defining features of autism spectrum disorder. While some individuals with autism may exhibit these behaviors, they are not universally characteristic of the disorder.
4. What is an appropriate play activity for a 7-month-old infant to encourage visual stimulation?
- A. Playing peek-a-boo
- B. Playing pat-a-cake
- C. Imitating animal sounds
- D. Showing how to clap hands
Correct answer: A
Rationale: Playing peek-a-boo is an ideal play activity for a 7-month-old as it encourages visual tracking and social interaction, which are key developmental milestones at this age.
5. The nurse is preparing to perform a physical assessment on a 10-year-old girl. The nurse gives her the option of her mother staying in the room or leaving. This action should be considered which?
- A. Appropriate because of the child's age
- B. Appropriate, but the mother may be uncomfortable
- C. Inappropriate because of the child's age
- D. Inappropriate because the child is the same sex as the mother
Correct answer: A
Rationale: It is appropriate to give a 10-year-old the choice of having a parent present or not during an exam, respecting the child's growing need for privacy.
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