ATI RN
Nursing Care of Children Final ATI
1. Which laboratory value at the time of diagnosis should the nurse anticipate would determine the worst prognosis for a child with leukemia?
- A. Slow response to chemotherapy
- B. Platelets of 150,000/mcL
- C. Leukocytes less than 10,000/mcL
- D. Leukocytes of 275,000/mcL
Correct answer: D
Rationale: A high white blood cell count (leukocytes of 275,000/mcL) at diagnosis is associated with a worse prognosis in leukemia because it indicates a more aggressive disease with a higher tumor burden. Slow response to chemotherapy (choice A) is a consequence of the aggressive disease and not a determining factor at diagnosis. Platelets of 150,000/mcL (choice B) and leukocytes less than 10,000/mcL (choice C) are within normal ranges and not indicative of a worse prognosis in leukemia.
2. The nurse is interviewing the father of a 10-month-old girl. The child is playing on the floor when she notices an electrical outlet and reaches up to touch it. Her father says no firmly and moves her away from the outlet. The nurse should use this opportunity to teach the father what?
- A. That the child should be given a time-out
- B. That the child is old enough to understand the word no
- C. That the child will learn safety issues better if she is spanked
- D. That the child should already know that electrical outlets are dangerous
Correct answer: B
Rationale: At 10 months, children are beginning to understand simple commands like "no." It is important for parents to reinforce this understanding consistently to help the child learn about boundaries and safety.
3. The nurse is performing an oral examination on a preschool child. Which strategies should the nurse use to encourage the child to open the mouth for the examination? (Select all that apply.)
- A. Lightly brush the palate with a cotton swab
- B. Perform the examination in front of a mirror
- C. Let the child examine someone else's mouth first
- D. All of the above
Correct answer: D
Rationale: Using a cotton swab, allowing the child to observe, and demonstrating on someone else are effective ways to encourage a preschooler to open their mouth for examination.
4. As children grow and develop, their style of play changes. Which play style is seen in the preschooler?
- A. Solitary
- B. Associative
- C. Cooperative
- D. Parallel
Correct answer: B
Rationale: The correct answer is B: Associative. Associative play is common in preschoolers, where children engage in separate activities but interact by sharing toys and talking with each other. This stage is characterized by more social interaction than solitary play (option A), where children play alone without interacting with others. Cooperative play (option C) involves children working together towards a common goal, which is typically seen in older children. Parallel play (option D) is when children play alongside each other but do not actively engage with one another, which is more common in toddlers.
5. Pertussis vaccination should begin at which age?
- A. Birth
- B. 2 months
- C. 6 months
- D. 12 months
Correct answer: B
Rationale: The DTaP vaccine, which includes pertussis, is typically started at 2 months of age as part of the recommended immunization schedule.