ATI RN
ATI Nursing Care of Children
1. The parents of a child with sickle cell anemia ask why their child did not have a sickle cell crisis until he was approximately 6 months old. How should the nurse respond?
- A. Your child probably had a crisis, and you were unaware of the symptoms.
- B. Are you sure your child has sickle cell anemia and not sickle cell trait?
- C. Affected children can be asymptomatic in early infancy because of high levels of fetal hemoglobin that inhibit sickling.
- D. Have you asked your doctor about this yet?
Correct answer: C
Rationale: The correct answer is C. Fetal hemoglobin (HbF) is present in high levels during early infancy, inhibiting sickling unlike adult hemoglobin (HbS). As the levels of HbF decrease and HbS increases, the risk of sickling and crises becomes more pronounced, typically after 6 months of age. Choice A is incorrect because it assumes the crisis went unnoticed, which is not supported by medical knowledge. Choice B is incorrect as it questions the child's diagnosis rather than explaining the phenomenon of delayed crises. Choice D is incorrect as it does not provide the parents with the necessary information regarding their query.
2. The nurse manager is compiling a report for a hospital committee on the quality of nursing-sensitive indicators for a nursing unit. Which does the nurse manager include in the report?
- A. The average age of the nurses on the unit
- B. The salary ranges for the nurses on the unit
- C. The education and certification of the nurses on the unit
- D. The number of nurses who have applied but were not hired for the unit
Correct answer: C
Rationale: The education and certification of nurses are key nursing-sensitive indicators that reflect the quality of care provided on the unit.
3. What approach is the most appropriate when performing a physical assessment on a toddler?
- A. Demonstrate the use of equipment
- B. Perform traumatic procedures last
- C. Use minimum physical contact initially
- D. Always proceed systematically in a head-to-toe direction
Correct answer: C
Rationale: The most appropriate approach when performing a physical assessment on a toddler is to use minimum physical contact initially. This helps gain the toddler's cooperation and reduces their distress. Performing traumatic procedures last is crucial as they are likely to upset the child and should be handled with care. Demonstrating the use of equipment may be complex for toddlers to understand, so it is not the most appropriate initial approach. Proceeding systematically in a head-to-toe direction is a good practice but using minimum physical contact initially is more important to establish trust and cooperation with the toddler.
4. What component should be included in the nutritional management of a child with Crohn's disease?
- A. High fiber
- B. Increased protein
- C. Reduced calories
- D. Herbal supplements
Correct answer: B
Rationale: The correct answer is B: Increased protein. Children with Crohn's disease require a diet high in protein to support growth and tissue repair. High fiber should be avoided as it can exacerbate symptoms of Crohn's disease. Reducing calories can lead to malnutrition, which is detrimental in this condition. Herbal supplements should be used cautiously and only under medical advice as they may interact with medications or worsen symptoms.
5. When a pre-school child says the sun shines to keep her warm, this is an example of:
- A. Animism
- B. Artificialism
- C. Egocentrism
- D. Centering
Correct answer: B
Rationale: The correct answer is B: Artificialism. Artificialism is the belief that natural phenomena are created by human beings for human purposes. In this scenario, the child attributes human-like intentions to the sun, assuming it shines specifically to keep her warm. Choice A, Animism, is the belief that natural objects and phenomena are alive and have feelings. Choice C, Egocentrism, refers to a child's difficulty in seeing things from another person's perspective. Choice D, Centering, involves focusing on only one aspect of a situation while ignoring other relevant aspects.
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