ATI RN
ATI Nursing Care of Children 2019 B
1. For a child with Kawasaki disease, which symptom is most indicative of the acute phase?
- A. Strawberry tongue
- B. Joint pain
- C. Rash
- D. Peeling skin
Correct answer: A
Rationale: The correct answer is A: Strawberry tongue. In Kawasaki disease, a 'strawberry tongue' is most indicative of the acute phase. This refers to the tongue appearing red and swollen with enlarged fungiform papillae, giving it a strawberry-like appearance. Joint pain (Choice B) is more commonly associated with other conditions like rheumatoid arthritis. Rash (Choice C) and peeling skin (Choice D) are also seen in Kawasaki disease but are not as specific to the acute phase as the presence of a strawberry tongue.
2. Where is the best place to observe for the presence of petechiae in dark-skinned individuals?
- A. Face
- B. Buttocks
- C. Oral mucosa
- D. Palms and soles
Correct answer: C
Rationale: The oral mucosa and conjunctivae are the best places to observe petechiae in dark-skinned individuals because these areas have less pigmentation.
3. The nurse is teaching parents about the types of behaviors children exhibit when living with chronic violence. Which statement made by the parents indicates further teaching is needed?
- A. "We should watch for aggressive play."
- B. "Our child may show lasting symptoms of stress."
- C. "We know that our child will show caring behaviors."
- D. "Our child may have difficulty concentrating in school."
Correct answer: C
Rationale: Children exposed to chronic violence may struggle with stress and concentration but are less likely to consistently exhibit caring behaviors without intervention and support.
4. Which distraction technique should be used for an adolescent child during a painful procedure?
- A. Blowing bubbles
- B. Guided imagery
- C. EMLA cream
- D. Sucrose solution
Correct answer: B
Rationale: The correct answer is B: Guided imagery. Guided imagery is an effective distraction technique for adolescents as it helps them focus on positive mental images instead of the pain. This technique can be a powerful tool in managing pain and anxiety during procedures. Blowing bubbles (choice A) may be more suitable for younger children as it can engage them visually and help distract them. EMLA cream (choice C) is a topical anesthetic and not a distraction technique. Sucrose solution (choice D) is used for pain relief in infants, not typically for adolescents undergoing painful procedures.
5. The mother of a child with type 1 diabetes asks the nurse why her child cannot avoid all those ‘shots’ and take pills like an uncle does. How should the nurse respond?
- A. The pills work with adult pancreases only.
- B. Your child needs insulin replaced, and the oral hypoglycemic only add to an existing supply of insulin.
- C. The drugs affect fat and protein metabolism, not sugar.
- D. Perhaps when your child is older the pancreas will produce its own insulin, and then your child can take oral hypoglycemic agents.
Correct answer: B
Rationale: The correct answer is B. Children with type 1 diabetes require insulin replacement because their pancreas produces little or no insulin. Oral hypoglycemics used in type 2 diabetes work by improving the effectiveness of insulin the body already makes, which is not sufficient in type 1 diabetes. Choice A is incorrect because the issue is not about the pancreas being adult or child-specific but rather the type of diabetes. Choice C is incorrect because it misstates the mechanism of action of the medications. Choice D is incorrect because it provides inaccurate information about the potential for the child's pancreas to produce insulin in the future, which is unlikely in type 1 diabetes.
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