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ATI Capstone- Nursing Care of Children Practice Test Exam Questions & Answers 2024-2025 A nurse is educating new parents about risk factors for sudden infant death syndrome (SIDS). Which of the following statements should indicate to the nurse the need for additional teaching? “Our baby will sleep in our bed because | am breastfeeding." “We will give my baby a pacifier during naps and at bedtime." “We will place my baby on her back when sleeping." “We will remove blankets and toys from the crib." - ANSWER-"Our baby will sleep in our bed because | am breastfeeding."; Allowing an infant to sleep in the same bed as an adult can lead to suffocation and falls. The parent should place the infant back in her crib or bassinet after breastfeeding. A nurse is providing health promotion teaching to an adolescent. Which of the following information should the nurse include in the teaching? "Share piercing needles only with close friends you trust." "Limit your caloric intake to avoid becoming overweight." "Your need for sleep will increase during periods of growth." “Tanning beds are much safer than lying in the sun." - ANSWER-"Your need for sleep will increase during periods of growth."; The nurse should inform the adolescent that sleep needs increase during growth spurts. Adequate sleep and rest during the adolescent period are important for optimal health. A nurse is teaching new parents the proper way to use an infant safety seat. Which of the following should indicate to the nurse a need for further teaching? "L will dress my baby in a one-piece outfit so | can use the harness to secure her in the car seat." "My baby will be able to watch me drive while sitting in the back seat." "| will place the infant safety seat in the middle of the back seat, away from the windows." “We will need to go by the weight and height of the child when deciding to change to a booster seat." - ANSWER-"My baby will be able to watch me drive while sitting in the back seat."; The safest area for a car seat is in the back seat. Infants should travel in a rear-facing position for the best protection from airbags and neck and head injury. While in a rear- facing position, the back of the car seat supports the infant's weak neck muscles, soft fontanels, and spine in the event of a frontal motor vehicle crash. A nurse is caring for a child on the oncology unit. The child's parents are asking the nurse about the cancer diagnosis. Which of the following information should the nurse provide the parents about the most common malignant renal and intra-abdominal tumor of childhood? Ewing sarcoma Osteosarcoma Neuroblastoma Wilms’ tumor - ANSWER-Wilms' tumor; Wilms’ tumor, or nephroblastoma, is the most common malignant renal and intra- abdominal tumor of childhood. A nurse in the emergency department is caring for a child who is experiencing an acute asthma attack, which of the following medications should the nurse expect to administer first? Fluticasone Budesonide Montelukast Albuterol - ANSWER-Albuterol; Albuterol is considered a "rescue" medication due to its rapid onset of action. Asthma is a chronic inflammatory disorder of the airways. Asthmatic episodes are associated with airflow limitation or reversible obstruction. Albuterol is a beta2 adrenergic agonist used for the treatment of acute exacerbations of asthma by promoting bronchodilation and suppressing histamine release in the lungs. This medication can be given by inhalation, orally, or as a parenteral preparation. The inhaled medication has a more rapid onset of action than the oral form and also reduces the risk for the adverse effects of irritability, tremor, nervousness, and insomnia. A nurse is assessing a preschooler. Which of the following findings should indicate to the nurse a need for speech therapy? (Select all that apply) The preschooler stutters when speaking. The preschooler mispronounces words. The preschooler speaks in three-word sentences. The preschooler talks to himself when reading. The preschooler speaks in a nasally tone. - ANSWER-The preschooler mispronounces words. The preschooler speaks in a nasally tone; Clustering creates an unnecessarily lengthy and painful period for the client, which is likely to increase her fear. Perform procedures as quickly as possible is correct. Moving quickly through the steps of a painful procedure is a supportive intervention for children undergoing painful procedures. Allow the child to keep a toy from home with her is correct. Having familiar and cherished objects nearby is therapeutic for children during their hospitalization. Use mummy restraints during painful procedures is incorrect. Mummy restraints help to immobilize very young children and keep them safe during procedures, but it is likely to increase fear in toddlers and preschoolers. A nurse is caring for a toddler who is 24hr post-op cleft palate repair. Which of the following interventions should the nurse include in the plan of care? Feed the infant with a spoon for 48 hr. Apply and release elbow restraints every hour. Keep the infant supine. Suction the mouth with an oral suction tube. - ANSWER-Apply and release elbow restraints every hour; It is essential to apply elbow restraints after surgery to keep the infant from placing her hands in and around her mouth. The nurse should remove them periodically to inspect the skin and allow the infant to exercise her arms. A nurse is planning care for an adolescent who is postoperative following scoliosis repair with Harrington rod instrumentation which of the following intervention should the nurse include in the plan of care? Keep the head of the bed at a 30° angle. Reposition the client by log rolling every 4 hr. Place the client in protective isolation. Initiate the use of a PCA pump for pain control. - ANSWER-Initiate the use of a PCA pump for pain control; The nurse should initiate the use of a PCA pump for an adolescent who is postoperative following scoliosis repair. The PCA pump allows the client to control the delivery of pain medications. A nurse is caring for a toddler who has acute laryngotracheobronchitis and has been placed in a cool mist tent. Which of the following indicates treatment is effective? Barking cough Improved hydration Decreased stridor Decreased temperature - ANSWER-Decreased stridor; Laryngotracheobronchitis, or croup, is a condition caused by an infection of the upper airway (larynx, trachea, and bronchus) and is characterized by a barking cough. Edema and obstruction in the upper airways cause the characteristic cough and stridor (noisy breathing). The direct purpose of a cool mist tent is to humidify the inspired air, which decreases respiratory effort. A nurse receives a call from a parent of a child who has Von Willebrand disease and is having a nosebleed. Which of the following instructions should the nurse give the parents? "Place your child in a sitting position with her head tilted back." “Apply ice at the base of the nose for 5 min and then check for bleeding." "Place your child in a supine position with a pillow under her back." “Have your child sit with her head tilted forward and hold pressure on her nose for 10 minutes.” - ANSWER-"Have your child sit with her head tilted forward and hold pressure on her nose for 10 minutes."; The nurse should instruct the parent to have the child sit up with her head tilted forward to reduce the risk of aspiration. The parent should apply pressure with the thumb and forefinger to the child's nose for 10 min and then check for further bleeding. A nurse is providing teaching about self-administration of insulin to the parent of a school-age child who has a new diagnosis of diabetes mellitus. Which of the following statements by the parents indicates a need for further teaching? "| will be sure my child aspirates before injecting the insulin." "The insulin can be injected anywhere there is adipose tissue." "| will be sure my child rotates sites after 5 injections in one area." “The insulin should be injected at a 90-degree angle." - ANSWER-"I will be sure my child aspirates before injecting the insulin."; It is not necessary to aspirate before injecting the insulin. A nurse is preparing to perform an abdominal assessment on a child. Identify the sequence the nurse should follow. Deep palpitation Auscultation Inspection Superficial palpitation - ANSWER-Inspection Auscultation Superficial palpitation Deep palpitation When performing an abdominal assessment on a child, the nurse should first inspect the abdomen without touching and observe for anything that could indicate a medical concern. Because palpation prior to auscultation can alter the bowel sounds, the nurse should auscultate the abdomen for bowel sounds next. Then, the nurse should palpate Keep home environment <68 °F is a contraindicated action. The home environment should be maintained at a stable temperature between 68-72°F to prevent cold sensitivity in clients with sickle cell anemia. Exposure to a cold environment can lead to sickle cell exacerbation. Encourage at least 64 oz of fluid daily is contraindicated. 64 oz of fluid is too much for a four-year-old. For infants 3.5 to 10 kg the daily fluid requirement is 100 mL/kg. For children 11-20 kg the daily fluid requirement is 1000 mL + 50 mL/kg for every kg over 10. For children >20 kg the daily fluid requirement is 1500 mL + 20 mL/kg for every kg over 20, up to a maximum of 2400 mL daily. This child weighs 16.4 kg so adequate fluid intake would be 1320 ml daily or 44 ounces or approximately 5.5 cups of fluid per day. Reinforce how to measure ibuprofen with a teaspoon is contraindicated. Do not use household teaspoons, which can vary in size. Provide parents with a 3 ml oral syringe to measure the dose. A nurse is assessing an adolescent who has an exacerbation of Graves’ disease. Which of the following findings should the nurse expect? Weight gain Bradycardia Lethargy Heat intolerance - ANSWER-Heat intolerance; An exacerbation of Graves' disease can cause heat intolerance due to an increased metabolic rate, which leads to warm flushed moist skin and extreme diaphoresis. A home health nurse is teaching a child's parents about endotracheal suctioning. Which of the following information should the nurse include in the teaching? Apply suction when inserting the catheter. Apply suction for less than 10 seconds. Set the suction pressure to 110 mm Hg. Allow the child to rest for 10 to 15 seconds after each suctioning attempt. - ANSWER- Apply suction for less than 10 seconds; Prolonged suctioning can cause damage to tissues and induce hypoxia. Hypoxia can interfere with stages of respiration, cellular absorption, and blood transport. A nurse is caring for an adolescent who has spina bifida and is paralyzed from the waist down. Which of the following statements by the client should indicate to the nurse a need for further teaching? "| only need to catheterize myself twice every day." “| carry a water bottle with me because | drink a lot of water." “| use a suppository every night to have a bowel movement." "| do wheelchair exercises while watching TV." - ANSWER-"I only need to catheterize myself twice every day."; The client has paralysis from the level of the defect down. In the majority of cases, this condition affects bladder and bowel continence. Catheterization should be performed every 4 hr. Infrequent emptying of the bladder can result in stasis and urinary tract infections. A nurse is providing discharge instructions to a parent and his school age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include? Encourage the child to take a 45 min nap daily. Allow the child to stay at home on days when her joints are painful. Apply cool compresses for 20 min every hour. Administer prednisone on an alternate-day schedule. - ANSWER-Administer prednisone on an alternate-day schedule; Prednisone is an effective anti-inflammatory agent that can have serious adverse effects. Taking prednisone on an alternate-day schedule can help maintain joint mobility and minimize adverse effects. A nurse is preparing to administer a vaccine to a 4-year-old child. Which of the following vaccines should the nurse administer? Haemophilus influenza type b (Hib) Hepatitis B (HepB) Varicella (VAR) Meningococcal (MCV4) - ANSWER-Varicella (VAR); The child should have received the first dose between 12 to 15 months of age. The child should then receive a second dose between 4 and 6 years of age. A nurse is caring for a 6-week-old infant who has a ventricular septal defect (VSD). Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress. - ANSWER-The nurse should assess the apical pulse for 1 full min and assess the rhythm strip for a prolonged P-R interval because the infant is most likely experiencing digoxin toxicity. The manifestations of digoxin toxicity that are seen in infants most commonly include vomiting, poor feeding, and bradycardia. The P-R interval is also prolonged if digoxin toxicity is occurring. It is critical the nurse quickly identifies and reports these symptoms to the provider for treatment of digoxin toxicity. Furosemide is a potassium wasting diuretic and can cause hypokalemia. Hypokalemia increases the potential for digoxin toxicity. The nurse should continue to monitor the infant's heart rate and withhold digoxin per the provider's prescription. It may be necessary to treat the digoxin toxicity with the antidote digoxin immune fab fragment. It is important to continue to monitor digoxin level as treatment is initiated. "Lam leaving a humidifier on in my child's room when he naps." - ANSWER-"I give my child aspirin to reduce his fever."; The administration of aspirin for fever associated with a viral illness increases the child's tisk for Reye syndrome. Reye syndrome is a metabolic encephalopathy with manifestations of cerebral edema and fatty changes in the liver. The nurse is assessing a 3-year-old child at a routine wellness checkup. Which of the following findings should the nurse expect? Skips and hops on one foot Has a vocabulary of 1,500 words Walks backwards heel to toe Stands on one foot for a few seconds - ANSWER-Stands on one foot for a few seconds; The nurse should expect a 3-year-old-child to be able to stand on one foot for a few seconds, ascend stairs on alternate feet, and jump off of the bottom step. A nurse is assessing a 3-month-old infant. Which of the following findings should the nurse report to the provider? Inability to raise head when in prone position Inability to sit without support Inability to pick up an object with her fingers Inability to bring an object to her mouth - ANSWER-Inability to raise head when in prone position; A 3-month-old infant should be able to raise her head and shoulders from prone position; therefore, the nurse should report this finding to the provider. A nurse is caring for a 12-month-old toddler who is hospitalized and confined to a room with contact precautions in place. Which of the following toys should the nurse recommend in order to meet the developmental needs of the client? Large building blocks Hanging crib toys Modeling clay Crayons and a coloring book - ANSWER-Large building blocks; Large building blocks are age-appropriate toys for a 12-month-old toddler. A nurse is planning care for an infant who has spina bifida and is to undergo surgical closure of the myelomeningocele sac? Which of the following interventions should the nurse include in the plan of care? Maintain the infant in the supine position. Initiate contact precautions. Provide a latex-free environment. Limit visitors to immediate family members. - ANSWER-Provide a latex-free environment; Children who have spina bifida have a very high risk for developing a latex allergy, which can be life-threatening. The specific cause is unknown. However, because the incidence of latex allergy increases with repeated exposure to latex products, it is critical for the nurse to eliminate every possible exposure to supplies and equipment that contain latex. A nurse is planning care for an adolescent who has sickle cell anemia and is experiencing a vasoocclusive crisis (VOC). Which of the following actions should the nurse take? Initiate contact precautions. Apply cold compresses to affected areas. Encourage bed rest. Provide maximum fluid intake of 1L/day. - ANSWER-Encourage bed rest; The nurse should encourage bed rest for adolescents who have sickle cell anemia and are experiencing a VOC. A VOC is a non-life-threatening, painful episode, which is caused by ischemia and can last from several minutes to several days. Manifestations include generalized migratory pain, acute abdominal pain, and increased body temperature. Bed rest decreases pain and promotes tissue perfusion, which minimizes deoxygenation. A nurse is caring for an infant who has intussusception. After the infant's parents discuss treatment options with the provider. Which of the following information should the nurse plan to discuss with the parents? Postprocedural care following the placement of tympanostomy tubes Postprocedural care following a pneumoenema administration Initiation of contact precautions Initiation of gastrostomy feedings - ANSWER-Postprocedural care following a pneumoenema administration; After the provider discusses treatment options with the parents, the nurse should plan to discuss postprocedural care following the administration of a pneumoenema. This is a nonsurgical procedure that is performed by a radiologist to relieve the obstruction and push the bowels back into an extended position. A nurse is teaching home management to the parents of a preschooler who has cystic fibrosis. Which of the following instructions should the nurse include? Limit the child's intake of foods containing protein. The nurse should allow 60 seconds for adequate ventilation between each pass of the suction catheter to prevent hypoxia. A nurse is teaching a group of guardians about fire safety in the home. Which of the following actions should the nurse instruct the guardians to take first if a child's clothing catches fire and the child is burned? Cover the burn injury with a clean, dry cloth. Monitor the condition of the child. Roll the child in a blanket. Remove the child's burned clothing. - ANSWER-Roll the child in a blanket; Using evidenced-based practice, the first action the guardian should take is to place the child in a horizontal position and roll the child in a blanket or rug to smother the flames. This stops the burning process and prevents the spread of flames. A nurse is teaching about car seat safety to the guardians of a preschooler. Which of the following instructions should the nurse include? "Use a car seat until your child is a minimum of 145 cm (57 in) tall." "Place a small pillow behind your child's head for comfort." “Use a no-back belt positioning seat if the vehicle does not have a headrest." "Stretch the shoulder-lap safety belt across your child's abdomen." - ANSWER-"Use a car seat until your child is a minimum of 145 cm (57 in) tall."; The nurse should instruct the guardians that the child should remain in a specially designed car seat until they are at least 145 cm (57 in) or 8 to 12 years of age. They should also be reminded to use the car seat each time the car is moving, even for short distances. A nurse is providing teaching about safe sleep practices for the guardian of a 1-month- old infant. Which of the following statements by the guardian indicates an understanding of the teaching? "If my baby has a stuffy nose, | should put a pillow under their head." "| will offer my baby a pacifier anytime they are placed in the bed to sleep." “If my baby has been vomiting, | should place them on their belly to sleep." “My baby can nap on the couch if | surround them with rolled blankets." - ANSWER-"I will offer my baby a pacifier anytime they are placed in the bed to sleep."; The nurse should recommend the use of a pacifier when the infant is sleeping. Research has demonstrated that pacifier use is associated with a decrease in the risk for SUID. Studies show that even if the pacifier is dislodged during sleep, it arouses the infant, thereby decreasing the likelihood of SUID. A nurse is providing teaching for the parent of a preschooler who has pinworms. Which of the following instructions should the nurse provide? "Give your child a tub bath daily." "Dress your child in two-piece sleeping outfits." “Trim your child's fingernails short." “Repeat your child's treatment in 4 weeks." - ANSWER-"Trim your child's fingernails short."; The nurse should instruct the parent to trim the child's fingernails short to reduce the collection of eggs under the fingernails when scratching, thereby reducing the chance of reinfection. A nurse is providing teaching about a ketogenic diet to the guardian of a child who has epilepsy. Which of the following information should the nurse include? Provide concentrated carbohydrates as the primary food on this diet. Avoid giving your child foods containing gluten. Excessive weight gain is an adverse effect of this diet. Choose high-fat, protein-rich foods for your child. - ANSWER-Choose high-fat, protein- tich foods for your child; A ketogenic diet consists of high-fat, high-protein, and low-carbohydrate foods. This diet has demonstrated effectiveness in controlling seizures in some children. Butter is an example of a high-fat food that has long-chain triglycerides and is recommended for those who have a prescription for a ketogenic diet. A nurse is preparing to perform a heel stick on a 3-day old infant. Which non- pharmacological method of pain management should the nurse use to decrease the infant's pain? Offer the infant a sucrose pacifier. Hold a cold vibration device on the heel for 5 min. Promise a reward after the procedure. Place the infant in a prone position. - ANSWER-Offer the infant a sucrose pacifier; The nurse should offer the infant a sucrose pacifier to decrease their pain level. Nonnutritive sucking is a non-pharmacological intervention that can help soothe an infant before, during, and after a painful procedure, such as a heel stick. A nurse is creating a plan of care for a child who was placed in a halo brace 4 days ago. Which of the following actions should the nurse plan to take? Clean the pin sites once daily. Ensure that the sling is secured under the child's knee. Remove the traction weights prior to repositioning the child. A nurse is assessing a 4-year-old child at a well-child visit. Which of the following developmental milestones should the nurse expect to observe? Child can build a tower using 10 cubes Parent reports their child is very dependent Child speaks a vocabulary of 300 words Parent reports their child displays temper tantrums - ANSWER-Child can build a tower using 10 cubes; Building a tower using 10 cubes is an expected finding for a preschooler. This is part of fine motor development during the preschool years. The nurse should include the following interventions in the plan of care for an adolescent who has scoliosis and is postoperative following a spinal fusion. Which of the following interventions should the nurse include? Use alog-rolling technique to reposition the adolescent. Monitor the lower extremity pulses every 4 hr for the first 24 hr Clean the screw sites with diluted hydrogen peroxide. Maintain the client on strict bed rest for 5 to 7 days following surgery. - ANSWER-Use a log-rolling technique to reposition the adolescent; The nurse should include the need to use a log-rolling technique when repositioning the adolescent. After surgery, the adolescent must lay flat and be log-rolled by two staff members every 2 hr to promote respiratory function and clearance. Also, the head of the bed should not be elevated due to the implantation of surgical steel rods into the vertebrae. 
