ATI RN
ATI Nursing Care of Children
1. The nurse is performing an otoscopic examination on a child. Which are normal findings the nurse should expect? (Select all that apply.)
- A. All below
- B. A well-defined light reflex
- C. A small, round, concave spot near the center of the drum
- D. The tympanic membrane is a nontransparent grayish color
Correct answer: A
Rationale: A well-defined light reflex, a small concave spot, and a grayish, nontransparent tympanic membrane are normal findings during an otoscopic examination in a child.
2. The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which?
- A. 50th percentile
- B. 75th percentile
- C. 80th percentile
- D. 95th percentile
Correct answer: D
Rationale: A child with a BMI greater than the 95th percentile is classified as obese, according to standard growth charts used in pediatric practice.
3. The nurse suspects fluid overload in an infant receiving intravenous fluids. What clinical manifestation is suggestive of water intoxication?
- A. Oliguria
- B. Weight loss
- C. Irritability and seizures
- D. Muscle weakness and cardiac dysrhythmias
Correct answer: C
Rationale: Water intoxication can lead to cerebral edema, causing neurological symptoms such as irritability and seizures. Oliguria, weight loss, and muscle weakness are not typical signs of water intoxication.
4. The nurse is preparing a child for possible alopecia from chemotherapy. What information should the nurse give regarding alopecia?
- A. Hair usually regrows in two years.
- B. When hair regrows, it may have a slightly different color or texture.
- C. Expose your head to sunlight to minimize alopecia.
- D. Wearing hats and scarves are preferred to wearing a wig.
Correct answer: B
Rationale: The correct answer is B. Hair loss from chemotherapy is usually temporary, and when it regrows, it may have a different color or texture. Sun exposure should be minimized, as the scalp may be more sensitive. Wearing hats and scarves can provide comfort and protection, but there is no preference over wearing a wig. Choice A is incorrect because hair regrowth after chemotherapy varies from person to person and usually occurs sooner than two years. Choice C is incorrect as sun exposure should be minimized to protect the sensitive scalp. Choice D is incorrect as the preference between wearing hats, scarves, or a wig is subjective and depends on the individual's comfort and preferences.
5. An infant, age 5 months, is brought to the clinic by his parents for a well-baby checkup. What is the best advice that the nurse should include at this time about injury prevention?
- A. Keep buttons, beads, and other small objects out of his reach.
- B. Do not permit him to chew paint from window ledges because he might absorb too much lead.
- C. When he learns to roll over, you must supervise him whenever he is on a surface from which he might fall.
- D. Lock the crib sides securely because he may stand and lean against them and fall out of bed.
Correct answer: A
Rationale: Small objects are a choking hazard for infants, so it is crucial to keep them out of reach to prevent injury.
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