ATI RN
Nursing Care of Children ATI
1. An intravenous line is needed in a school-age child. What medication is an appropriate analgesic for use with this patient?
- A. TAC (tetracaine, epinephrine [Adrenalin], cocaine) 15 minutes before the procedure.
- B. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
- C. EMLA (eutectic mixture of local anesthetics) immediately before the procedure.
- D. LMX (4% liposomal lidocaine cream) 30 minutes before the procedure.
Correct answer: D
Rationale: LMX is an effective analgesic agent when applied to the skin 30 minutes before a procedure. It eliminates or reduces the pain from most procedures involving skin puncture. TAC provides skin anesthesia about 15 minutes after application to nonintact skin, making it more suitable for wound suturing. Transdermal fentanyl patches are designed for continuous pain control, not rapid pain control needed for a procedure like venipuncture. EMLA, for maximum effectiveness, must be applied approximately 60 minutes before the procedure, making it less suitable for immediate pain relief required for intravenous line placement.
2. In the morning, a healthcare professional receives change-of-shift report on four pediatric clients, each of whom has some form of fluid-volume excess. Which of the children should the healthcare professional see first?
- A. The child with tachypnea and pulmonary congestion
- B. The child with hepatomegaly and normal respiratory rate
- C. The child with dependent and sacral edema and regular pulse
- D. The child with periorbital edema and normal respiratory rate
Correct answer: A
Rationale: The child with tachypnea and pulmonary congestion should be seen first. Tachypnea indicates an increased respiratory rate, a sign of possible respiratory distress. Pulmonary congestion suggests fluid accumulation in the lungs, posing a serious risk to respiratory function. Immediate attention is crucial in this case. Choice B is incorrect as hepatomegaly alone does not indicate an acute issue requiring immediate attention. Choices C and D, while showing signs of fluid-volume excess, do not present the same level of respiratory compromise as tachypnea and pulmonary congestion, making them lower priority.
3. The nurse is testing an infant's visual acuity. By which age should the infant be able to fix on and follow a target?
- A. 1 month
- B. 1 to 2 months
- C. 3 to 4 months
- D. 6 months
Correct answer: C
Rationale: By 3 to 4 months of age, an infant should be able to fix on and follow a target, indicating proper visual development.
4. What statement is most descriptive of Meckel diverticulum?
- A. It is present from birth.
- B. Intestinal bleeding may be mild or profuse.
- C. It occurs with equal frequency in both genders.
- D. Surgical interventions are always necessary to treat the problem.
Correct answer: B
Rationale: The correct answer is B. Meckel diverticulum often presents with intestinal bleeding, which can vary in severity. It is a congenital condition, meaning it is present from birth, not acquired during childhood (choice A). Meckel diverticulum is slightly more common in males than in females, so it does not occur more frequently in females (choice C). While some cases of Meckel diverticulum may require surgical intervention, medical interventions can also be sufficient to treat the problem, so it is not always necessary to resort to surgery (choice D).
5. In population health management, a nurse overseeing a panel of 1,500 patients will primarily engage in which of the following activities?
- A. Proactively assessing the health needs of the entire panel and planning accordingly
- B. Focusing on providing care to young and seemingly vulnerable patients
- C. Spending most time with patients who regularly attend their visits
- D. Prioritizing care by responding to the oldest patients first
Correct answer: A
Rationale: In population health management, a nurse overseeing a large panel of patients needs to proactively assess the health needs of the entire panel to plan and provide appropriate care effectively. This approach ensures that all patients receive necessary attention and interventions, contributing to better health outcomes for the population as a whole.