ATI RN
ATI RN Nursing Care of Children 2019 Questions
Extract:
2-year-old child at a well-child visit with vital signs
Question 1 of 5
A nurse in a provider's office is assessing the vital signs of a 2-year-old child at a well-child visit. Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: The correct answer is A: Blood pressure 118/74 mm Hg. This finding is abnormal for a 2-year-old child as the blood pressure is elevated. Normal blood pressure in children varies with age, height, and gender. Elevated blood pressure in children can be a sign of underlying health issues such as heart or kidney problems. The nurse should report this finding to the provider for further evaluation and management.
Choice B: Respiratory rate 26/min is within the normal range for a 2-year-old child.
Choice C: Pulse rate 98/min is within the normal range for a 2-year-old child.
Choice D: Temperature 37.2°C (99°F) is within the normal range for a 2-year-old child.
Therefore, choices B, C, and D are not concerning findings for a 2-year-old child's well-child visit.
Extract:
2-month-old infant with developmental dysplasia of the hip and Pavlik harness
Question 2 of 5
A nurse is providing teaching to the parents of a 2-month-old infant who has developmental dysplasia of the hip and has a prescription for a Pavlik harness. Which of the following statements by the parents indicates an understanding of the teaching?
Correct Answer: C
Rationale:
Correct
Answer: C - We will place the diaper under the straps.
Rationale: Placing the diaper under the straps ensures proper positioning and prevents skin irritation. The harness should be worn 24/7, except during baths. Adjusting the straps daily (choice
A) is unnecessary and may disrupt the harness' effectiveness. Applying lotion (choice
B) could interfere with the harness's grip on the skin. Expecting the baby to wear the harness for only 2 months (choice
D) may be too short a duration for effective treatment.
Extract:
Family whose infant died from sudden infant death syndrome (SIDS)
Question 3 of 5
A nurse is providing support to a family whose infant died from sudden infant death syndrome (SIDS). Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Acknowledge the family members' feelings of guilt. This is important because parents often experience guilt after the sudden loss of a child. By acknowledging their feelings, the nurse validates their emotions and opens up communication for processing grief.
Choice A is incorrect because allowing siblings to view the body can be a personal decision based on cultural or individual beliefs.
Choice B is incorrect as discussing details of the resuscitation attempt can be traumatic for the family.
Choice C is incorrect as a follow-up phone call may not provide sufficient support.
Extract:
School-age child immediately following a tonsillectomy
Question 4 of 5
A nurse in a PACU is caring for a school-age child immediately following a tonsillectomy. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Place the child in a side-lying position. This is crucial post-tonsillectomy to prevent airway obstruction due to potential bleeding. Lying on the side helps drainage and minimizes the risk of aspiration. Encouraging deep breathing and coughing (choice
A) is generally important for preventing respiratory complications but not specific to this situation. Offering ice cream (choice
B) and drinking through a straw (choice
C) can increase the risk of bleeding by irritating the surgical site.
Extract:
School-age child undergoing cranial nerve assessment
Question 5 of 5
A nurse is assessing a school-age child's cranial nerve function. Which of the following actions should the nurse ask the child to take when assessing the accessory nerve?
Correct Answer: D
Rationale: The correct answer is D: Shrug their shoulders against mild pressure. The accessory nerve (cranial nerve XI) controls the movement of the trapezius and sternocleidomastoid muscles. By asking the child to shrug their shoulders against mild pressure, the nurse is assessing the strength and function of these muscles, which are innervated by the accessory nerve. This action helps determine if the nerve is functioning properly.
Choice A is incorrect because it pertains to testing the extraocular muscles controlled by cranial nerves III, IV, and VI.
Choice B is incorrect as it involves testing the hypoglossal nerve for tongue movement.
Choice C is incorrect as it relates to testing facial nerve function by smiling.