ATI RN
ATI Nursing Care of Children
1. Two 3-year-old clients are playing together in a hospital playroom. One is working on a puzzle, while the other is stacking blocks. Which type of play is this?
- A. Cooperative play
- B. Solitary play
- C. Parallel play
- D. Associative play
Correct answer: C
Rationale: The correct answer is C, parallel play. Parallel play is observed when children play alongside each other but do not directly interact. In this scenario, each child is engaged in their own activity without engaging or influencing each other's play, which characterizes parallel play. Cooperative play (choice A) involves children playing together towards a common goal, which is not evident in the given situation. Solitary play (choice B) is when a child plays alone, unrelated to the presence of others. Associative play (choice D) involves more interaction and sharing of toys between children, which is not happening in the described play scenario.
2. The nurse is preparing to assess a 10-month-old infant. He is sitting on his father's lap and appears to be afraid of the nurse and of what might happen next. Which initial actions by the nurse should be most appropriate?
- A. Initiate a game of peek-a-boo.
- B. Ask the infant's father to place the infant on the examination table
- C. Talk softly to the infant while taking him from his father
- D. Undress the infant while he is still sitting on his father’s lap
Correct answer: A
Rationale: Engaging the infant in a familiar game like peek-a-boo can help reduce fear and build rapport before starting the assessment.
3. What physiologic state(s) produces the clinical manifestations of nervous system stimulation and excitement, such as overexcitability, nervousness, and tetany?
- A. Metabolic acidosis
- B. Respiratory alkalosis
- C. Metabolic and respiratory acidosis
- D. Metabolic and respiratory alkalosis
Correct answer: D
Rationale: Both metabolic and respiratory alkalosis can cause overexcitability and nervous system stimulation due to a decrease in ionized calcium levels, which can cause symptoms such as tetany and paresthesias. Acidosis typically has the opposite effect, leading to depression of the nervous system.
4. The Denver II is a test used to assess children. What does it evaluate?
- A. Behavior problems
- B. Developmental status
- C. Body mass index
- D. Infection likelihood
Correct answer: B
Rationale: The Denver II Developmental Screening Test is used to assess a child's development in four areas: personal-social, fine motor-adaptive, language, and gross motor skills. It helps identify children who may need further evaluation. Choice A, behavior problems, is incorrect as the Denver II primarily focuses on developmental milestones rather than behavior. Choice C, body mass index, is unrelated to the assessment of child development. Choice D, infection likelihood, is also not evaluated by the Denver II test.
5. What time frame has the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists recommended that pregnant adolescents and women who are not protected against pertussis receive the tetanus, diphtheria, and pertussis (Tdap) vaccine?
- A. Between 27 and 36 weeks of gestation or postpartum before discharge from the hospital
- B. During the first prenatal visit when pregnancy is confirmed
- C. The vaccine should be administered 24 hours prior to delivery
- D. This vaccine is only recommended during the first trimester
Correct answer: A
Rationale: The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists recommend that pregnant adolescents and women without protection against pertussis should receive the Tdap vaccine ideally between 27 and 36 weeks of gestation or postpartum before discharge from the hospital. This timeframe allows for the development of antibodies in the mother to protect her and provide passive immunity to the infant. Administering the vaccine during the first trimester (Choice D) is not recommended as the optimal time is between 27 and 36 weeks. Choice B, during the first prenatal visit, is too early for optimal protection, and Choice C, 24 hours prior to delivery, does not provide enough time for the vaccine to be effective before birth.