ATI RN
Nursing Care of Children Final ATI
1. A parent brings their 4-year-old child for a check-up. Which finding would concern the nurse?
- A. Ectomorphic body type
- B. Resting pulse rate of 120
- C. Weight gain of 5 lb (2.27 kg) in the past year
- D. No increase in appetite compared with that in toddler years
Correct answer: B
Rationale: 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.
2. Which parameter correlates best with measurements of total muscle mass?
- A. Height
- B. Weight
- C. Skinfold thickness
- D. Upper arm circumference
Correct answer: D
Rationale: Upper arm circumference correlates best with total muscle mass because it includes both muscle and fat components, making it a reliable indicator of muscle mass.
3. The physician tells the parents of a 2-year-old that the child probably has RSV. The parents ask how the diagnosis will be confirmed. How should the nurse respond?
- A. We will swab your child's nose and send the secretions for testing.
- B. There is no specific test for RSV. The diagnosis is based on symptoms.
- C. We will send a viral culture to an outside lab for testing.
- D. There is no specific test for RSV. The diagnosis is based on symptoms.
Correct answer: A
Rationale: The correct answer is A. RSV is typically diagnosed by swabbing the nose and testing the secretions. This method helps confirm the presence of the respiratory syncytial virus. Choice B is incorrect because while symptoms are important in diagnosis, specific tests like swabbing for RSV do exist. Choice C is incorrect as sending a viral culture to an outside lab is not the primary method for diagnosing RSV. Choice D is a duplicate of choice B and is incorrect for the same reasons.
4. The nurse is teaching a parent of a 6-month-old infant with gastroesophageal reflux (GER) before discharge. What instructions should the nurse include?
- A. Elevate the head of the bed in the crib to a 90-degree angle while the infant is sleeping.
- B. Hold the infant in the prone position after a feeding.
- C. Discontinue breastfeeding so that a formula and rice cereal mixture can be used.
- D. Prescribed cimetidine (Tagamet) should be given 30 minutes before feedings.
Correct answer: D
Rationale: Cimetidine is an H2 blocker that reduces stomach acid, helping manage GER. Holding the infant in the prone position is not recommended due to the risk of SIDS. Breastfeeding should not be discontinued unless advised by a physician. Elevating the head to 90 degrees is excessive.
5. What component should be included in the nutritional management of a child with Crohn's disease?
- A. High fiber
- B. Increased protein
- C. Reduced calories
- D. Herbal supplements
Correct answer: B
Rationale: The correct answer is B: Increased protein. Children with Crohn's disease require a diet high in protein to support growth and tissue repair. High fiber should be avoided as it can exacerbate symptoms of Crohn's disease. Reducing calories can lead to malnutrition, which is detrimental in this condition. Herbal supplements should be used cautiously and only under medical advice as they may interact with medications or worsen symptoms.