at an 8 month old well baby visit the parent tells the nurse that her infant falls asleep at night during the last bottle feeding but wakes up when mo
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Nursing Elites

ATI RN

Nursing Care of Children ATI

1. At an 8-month-old well-baby visit, the parent tells the nurse that her infant falls asleep at night during the last bottle feeding but wakes up when moved to the infant’s crib. What is the most appropriate response for the nurse to make?

Correct answer: D

Rationale: Encouraging the baby to fall asleep in the crib while still awake can help establish healthy sleep habits and reduce night waking.

2. Where in the health history does a record of immunizations belong?

Correct answer: A

Rationale: Immunizations are part of the patient’s health history and are recorded under the history section to ensure the child is up-to-date with vaccinations.

3. The nurse is preparing to admit a 5-year-old child with hepatitis A. What clinical features of hepatitis A should the nurse recognize?

Correct answer: C

Rationale: The correct answer is C. Hepatitis A typically presents with a rapid onset, early fever, and nausea/vomiting. These are common clinical features seen in patients with hepatitis A. A pruritic rash is not commonly associated with hepatitis A, so choice C is incorrect. Choice A and B alone are not sufficient to cover all the clinical features of hepatitis A.

4. Why does the nurse have a 2-year-old boy sit in a “tailor” position while palpating for the presence of the testes?

Correct answer: A

Rationale: The tailor position stretches the muscle responsible for the cremasteric reflex, preventing it from contracting and pulling the testes into the pelvic cavity. This position helps accurately palpate the testes. Choice B is incorrect because the position does not facilitate the palpation of undescended testes specifically. Choice C is incorrect as it does not relate to the rationale behind the tailor position. Choice D is incorrect as the reason for using the tailor position is not related to the child's need for privacy.

5. What urine test result is considered abnormal?

Correct answer: A

Rationale: A urine pH of 4.0 is abnormally low, indicating possible acidosis or other metabolic conditions. WBC count of 1-2 cells/ml, absence of protein, and a specific gravity of 1.020 are within normal limits.

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