ATI RN
Nursing Care of Children ATI
1. The clinic nurse is reviewing the immunization guidelines for hepatitis B. Which are true of the guidelines for this vaccine?
- A. The hepatitis B vaccination series should be begun at birth
- B. All are applicable
- C. Any child not vaccinated at birth should receive two doses at least 4 months apart
- D. An unimmunized 10-year-old child should receive three doses administered 4 weeks apart
Correct answer: B
Rationale: Hepatitis B vaccination should start at birth, and any child or adolescent not vaccinated should complete the series. Adolescents should receive three doses if they were not previously vaccinated.
2. A 7-year-old child with acute glomerulonephritis has gross hematuria and has been confined to bed. What is the most appropriate nursing intervention for this child?
- A. Providing activities for the child on restricted activity
- B. Feeding the child a protein-restricted diet
- C. Carefully handling edematous extremities
- D. Observing the child for evidence of hypotension
Correct answer: A
Rationale: The most appropriate nursing intervention for a 7-year-old child with acute glomerulonephritis experiencing gross hematuria and bed rest is to provide activities for the child on restricted activity. It is important to keep the child engaged in light activities to prevent boredom and maintain some level of physical and mental well-being. Feeding a protein-restricted diet (Choice B) is not typically indicated in this scenario unless ordered by a healthcare provider to manage kidney function. Carefully handling edematous extremities (Choice C) is important in conditions like nephrotic syndrome but is not directly related to providing appropriate care for a child with acute glomerulonephritis. Observing the child for evidence of hypotension (Choice D) is important in general nursing care but is not the most immediate or specific intervention needed for a child with acute glomerulonephritis experiencing gross hematuria and bed rest.
3. A client with diabetes mellitus is receiving discharge instructions about foot care from a nurse. Which statement indicates an understanding of the teaching?
- A. I will soak my feet in hot water daily
- B. I will wear shoes at all times
- C. I will cut my toenails in a rounded shape
- D. I will apply lotion between my toes after bathing
Correct answer: B
Rationale: The correct answer is B: 'I will wear shoes at all times.' This statement demonstrates an understanding of foot care for a client with diabetes. Wearing shoes at all times helps protect the feet, reducing the risk of injury and complications such as wounds or infections. Option A is incorrect because soaking feet in hot water can lead to skin dryness and increase the risk of burns or injury for individuals with diabetes. Option C is incorrect as cutting toenails in a rounded shape can cause ingrown toenails and potential infections. Option D is also incorrect as applying lotion between the toes can create a moist environment, increasing the risk of fungal infections.
4. What do the clinical manifestations of minimal change nephrotic syndrome include?
- A. Hematuria, bacteriuria, and weight gain
- B. Gross hematuria, albuminuria, and fever
- C. Hypertension, weight loss, and proteinuria
- D. Massive proteinuria, hypoalbuminemia, and edema
Correct answer: D
Rationale: Minimal change nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia, and edema due to the loss of protein in the urine. Hematuria, bacteriuria, and weight loss are not typical features of this condition.
5. A foster parent is talking to the nurse about the health care needs for the child who has been placed in the parent's care. Which statement best describes the health care needs of foster children?
- A. Foster children always come from abusive households and are emotionally fragile.
- B. Foster children tend to have a higher than normal incidence of acute and chronic health problems.
- C. Foster children are usually born prematurely and require technologically advanced health care.
- D. Foster children will not stay in the home for an extended period, so health care needs are not as important as emotional fulfillment.
Correct answer: B
Rationale: Foster children often have higher rates of acute and chronic health problems due to a variety of factors, including previous neglect, trauma, and inconsistent healthcare access.
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