ATI RN
RN Nursing Care of Children Online Practice 2019 A
1. Which nursing action is developmentally appropriate when caring for a hospitalized school-age child?
- A. Providing brochures regarding sexuality
- B. Giving clear instructions about details of treatment
- C. Offering medical equipment to play with prior to a procedure
- D. Using toys for distraction during a painful procedure
Correct answer: C
Rationale: Offering medical equipment to play with prior to a procedure is developmentally appropriate when caring for a hospitalized school-age child. Allowing the child to familiarize themselves with the equipment helps reduce fear and anxiety about the upcoming procedure. Choices A, B, and D are not as appropriate for a school-age child. Providing brochures regarding sexuality is not developmentally appropriate for this age group. Giving clear instructions about treatment details may overwhelm a child of this age. Using toys for distraction during a painful procedure is more suitable for younger children.
2. A breastfed infant is being seen in the clinic for a 6-month checkup. The mother tells the nurse that the infant recently began to suck her thumb. Which is the best nursing intervention?
- A. Reassure the mother that this is normal at this age
- B. Recommend the mother substitute a pacifier for her thumb
- C. Assess the infant for other signs of sensory deprivation
- D. Suggest the mother breastfeed the infant more often to satisfy her sucking needs
Correct answer: A
Rationale: Thumb sucking is a normal self-soothing behavior in infants and usually does not indicate a problem. Reassuring the mother that this is normal is the appropriate response.
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 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. A school-age child with cancer is being prepared for a procedure. The child says, “I have had one of these before. They hurt.†The nurse bases her response on what knowledge related to pain in this patient?
- A. Often misrepresent experiencing pain
- B. Tolerate pain better than adults
- C. Become accustomed to painful procedures
- D. Commonly experience treatment-related moderate to severe pain when they have cancer
Correct answer: D
Rationale: The correct answer is D. Pain is frequently reported by children with cancer, with around 84% experiencing it. Most children report moderate to severe pain, with about half finding it highly distressing. There is no evidence to suggest that children often misrepresent their pain experiences. Pain tolerance is not solely based on age but is a complex phenomenon. Children do not become accustomed to painful procedures, as each experience of pain is unique.
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