ATI RN
Nursing Care of Children ATI
1. Which is usually the only symptom of pediculosis capitis (head lice)?
- A. Itching
- B. Vesicles
- C. Scalp rash
- D. Localized inflammatory response
Correct answer: A
Rationale: Itching is typically the primary and most common symptom of pediculosis capitis due to the lice bites on the scalp.
2. An infant with short bowel syndrome will be on total parenteral nutrition (TPN) for an extended period of time. What should the nurse monitor the infant for?
- A. Central venous catheter infection, electrolyte losses, and hyperglycemia
- B. Hypoglycemia, catheter migration, and weight gain
- C. Venous thrombosis, hyperlipidemia, and constipation
- D. Catheter damage, red currant jelly stools, and hypoglycemia
Correct answer: A
Rationale: Infants with short bowel syndrome requiring prolonged total parenteral nutrition (TPN) are susceptible to central venous catheter infections, electrolyte losses, and hyperglycemia. Monitoring for these complications is crucial to prevent serious outcomes. Choices B, C, and D are incorrect because they do not reflect the common complications associated with prolonged TPN in infants.
3. A child is hospitalized in acute renal failure and has a serum potassium greater than 7 mEq/L. What temporary measures that will produce a rapid but transient effect to reduce the potassium should the nurse expect to be prescribed? (Select all that apply.)
- A. Dialysis
- B. All below
- C. Sodium bicarbonate
- D. Glucose 50% and insulin
Correct answer: A
Rationale: Calcium gluconate, sodium bicarbonate, and glucose with insulin are used as temporary measures to rapidly reduce serum potassium levels. They help shift potassium into cells and stabilize the heart but do not remove potassium from the body like dialysis does.
4. 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.
5. What is the most important intervention in the management of a child with sickle cell crisis?
- A. Administration of iron supplements
- B. Initiation of high-calorie diet
- C. Administration of pain relief
- D. Limiting fluid intake
Correct answer: C
Rationale: The most important intervention in managing a child with sickle cell crisis is the administration of pain relief. During a sickle cell crisis, severe pain is a prominent symptom due to vaso-occlusive episodes. Effective pain management, along with adequate hydration and oxygen therapy, is crucial in treating a sickle cell crisis and preventing further complications. Choice A, the administration of iron supplements, is not the priority during a sickle cell crisis. Iron supplements are typically used to manage anemia in individuals with sickle cell disease but are not the primary intervention during a crisis. Choice B, the initiation of a high-calorie diet, is not the most critical intervention during a sickle cell crisis. While proper nutrition is important in managing sickle cell disease, it is not the immediate priority during a crisis. Choice D, limiting fluid intake, is not recommended during a sickle cell crisis. Hydration is essential in managing sickle cell crisis to prevent complications like dehydration and further vaso-occlusive episodes.
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