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ATI RN NURSING CARE OF CHILDREN ONLINE
PRACTICE 2019 A WITH NGN ALL 60
QUESTIONS & CORRECT ANSWERS WITH
RATIONALES GRADED A+ (NEW!!)
A nurse is caring for a newly admitted school-age child who has
hypopituitarism. Which of the following medications should the nurse expect
the provider to prescribe?
Desmopressin
Luteinizing hormone-releasing hormone
Recombinant growth hormone
Levothyroxine
Recombinant growth hormone
Recombinant growth hormone injections are used to treat hypopituitarism, which
inhibits cell growth and results in growth failure. The nurse should expect the
provider to prescribe this treatment.
A nurse is providing dietary teaching to the guardian of a school-age child
who has cystic fibrosis. Which of the following statements should the nurse
make?
"You should offer your child high-protein meals and snacks throughout the day."
"You should decrease your child's dietary fat intake to less than 10% of their
caloric intake."
"You should restrict your child's calorie intake to 1,200 per day."
"You should give your child a multivitamin once weekly."
You should offer your child high-protein meals and snacks throughout the
day."
The nurse should instruct the guardian to provide a diet that is well-balanced and
high in protein and calories. Children who have cystic fibrosis require a higher
percentage of the recommended dietary allowances of all nutrients to meet their
energy requirements. Children who have good nutritional intake have improved
lung function and decreased risk of infection.
A nurse is assessing a 6-month-old infant during a well-child visit. Which of
the following findings should the nurse report to the provider?
Presence of a central incisor tooth
Presence of strabismus
Presence of an open anterior fontanel
Presence of external cerumen
Presence of strabismus
Strabismus, or crossing of the eyes, typically disappears at 3 to 4 months of age. If
not corrected early, this can lead to blindness. Therefore, the nurse should report
this finding to the provider.
A nurse is providing anticipatory guidance to the parent of a toddler. Which
of the following expected behavior characteristics of toddlers should the nurse
include?
Controls impulsive feelings
Understands right from wrong
Easily separates from parents for long periods of time
Expresses likes and dislikes
Expresses likes and dislikes
The nurse should include that expressing likes and dislikes is an expected behavior
of toddlers. This is the time in life when a toddler is developing autonomy and self-
concept. They will try to assert themselves and frequently refuse to comply. The
"Stay home from school for 1 week following the procedure."
"Follow a diet that is low in fiber for 1 week."
"Wait 3 days before taking a tub bath."
"Apply a pressure dressing to the site for 3 days."
"Wait 3 days before taking a tub bath."
The child should keep the site clean and dry for at least 3 days to reduce the risk of
infection. Tub baths should be avoided for 3 days to avoid immersion of the
incision in water.
A nurse is planning care for a newly admitted school-age child who has
generalized seizure disorder. Which of the following interventions should the
nurse plan to include?
Ensure that a padded tongue blade is at the child's bedside.
Allow the child to play video games on a tablet computer.
Allow the child to take a tub bath independently.
Ensure the oxygen source is functioning in the child's room.
Ensure the oxygen source is functioning in the child's room
The nurse should recognize that maintaining the child's airway is important during
a seizure. The nurse should ensure that the oxygen source is functioning because
the child might require supplemental oxygen following a seizure.
A nurse is providing discharge teaching to the guardians of a toddler who had
a lower leg cast applied 24 hr ago. The nurse should instruct the guardians to
report which of the following findings to the provider?
Capillary refill time less than 2 seconds
Restricted ability to move the toes
Swelling of the casted foot when the leg is dependent
Pedal pulse +3 bilateral
Restricted ability to move the toes
The nurse should inform the guardians that a restricted ability of the toddler to
move their toes is an indication of neurovascular compromise and requires
immediate notification of the provider. Permanent muscle and tissue damage can
occur in just a few hours.
A nurse is creating a plan of care for a preschooler who has Wilms' tumor and
is scheduled for surgery. Which of the following interventions should the
nurse include?
Avoid palpating the abdomen when bathing the child before surgery.
Refrain from auscultating the child's bowel sounds during the postoperative
assessment.
Encourage the child to play with other children on the unit prior to surgery.
Explain to the child that their pain will be managed after the surgery.
Avoid palpating the abdomen when bathing the child before surgery.
The nurse should avoid palpating the abdomen when bathing the child before
surgery because movement of the tumor can cause cancer cells to disseminate to
other sites, adjacent and distant to the tumor site.
A nurse in an emergency department is assessing a 3-month-old infant who
has rotavirus and is experiencing acute vomiting and diarrhea. Which of the
following manifestations should the nurse identify as an indication that the
infant has moderate to severe dehydration?
Heart rate 124/min
Increased tear production
Sunken anterior fontanel
Capillary refill 2 seconds
Sunken anterior fontanel
The nurse should recognize that a sunken anterior fontanel is an indication of
moderate to severe dehydration due to the acute loss of fluid.
cream.0930:Child is alert. Multiple small erythematous papules with some scaling
noted on the child's eyebrows, forearms, and lower legs bilaterally.1015:Provider
in to evaluate the child. Discharge to home after medication administration of new
prescriptions and discharge teaching for atopic dermatitis.
Medical History
Family history of atopic dermatitis
Medication Administration Record
Loratadine (oral solution) 5 mg PO daily. Administer first dose now prior to
discharge.
Tacrolimus 0.03% ointment. Apply thin layer to affected areas twice daily; rub in
gently and completely.Return to primary care
"We should apply a skin emollient immediately after bathing our child" is
correct. An emollient is an oil that moisturizes the skin and should be applied
immediately after bathing while the skin is damp to prevent drying. Therefore, this
statement by the guardian indicates the teaching has been effective.
"We should keep our child's fingernails trimmed short" is correct.
The child's
fingernails and toenails should be kept short, trimmed, and filed to prevent
scratching with sharp edges. Therefore, this statement by the guardian indicates the
teaching has been effective.
"We should use a mild detergent for our laundry" is correct. The use of mild
detergents for laundry helps prevent allergens and itching. Therefore, this
statement by the guardian indicates the teaching has been effective.
A nurse is caring for a 10-year-old child following a head injury. Which of the
following findings should the nurse identify as an indication that the child is
developing diabetes insipidus?
Urine specific gravity 1.
Sodium 155 mEq/L
Blood glucose 45 mg/dL
Urine output 35 mL/hr
Sodium 155 mEq/L
A child who has a head injury can develop diabetes insipidus as a result of pituitary
hypofunction leading to a deficiency of antidiuretic hormone. Underexcretion of
antidiuretic hormone leads to polyuria and polydipsia, and possibly dehydration.
With the excessive loss of free water, sodium levels rise above the expected
reference range of 136 to 145 mEq/L.
A nurse in a health department is caring for an emancipated adolescent who
has an STI and is unaccompanied by a guardian. Which of the following
actions should the nurse take?
Have the adolescent sign a consent form for treatment.
Instruct the adolescent to return with a guardian.
Obtain consent from the adolescent's guardian over the phone.
Treat the adolescent without a consent form.
Have the adolescent sign a consent form for treatment.
The nurse should identify that an emancipated minor can sign the consent form for
treatment of an STI or any other form of medical treatment requiring consent.
A school nurse is providing an in-service for faculty about improving
education for students who have ADHD. Which of the following statements by
a faculty member indicates an understanding of the teaching?
"I will plan to increase the amount of homework I assign to students who have
ADHD."
"I will give students who have ADHD the same amount of time as other students to
complete tests."
"I will allow students who have ADHD one rest break throughout the day."
WBC count is correct. The child's WBC count is above the expected reference
range, which could be an indication of infection or inflammation. Therefore, the
nurse should report this finding to the provider.
Oxygen saturation level is correct.
The child's oxygen saturation level has
decreased below the expected reference range despite the use of supplemental
oxygen. Therefore, the nurse should report this finding to the provider.
Respiratory assessment is correct. The child's respiratory assessment indicates
increased respiratory distress, as evidenced by the presence of tachypnea,
retractions, and increased wheezing. Therefore, the nurse should report these
findings to the provider.
A nurse is caring for a 1-month-old infant who is breastfeeding and requires a
heel stick. Which of the following actions should the nurse take to minimize
the infant's pain?
Use a manual lancet to obtain the heel blood sample.
Apply an ice pack to the infant's heel prior to obtaining the sample.
Allow the mother to breastfeed while the sample is being obtained.
Apply a topical lidocaine cream prior to obtaining the sample.
Allow the mother to breastfeed while the sample is being obtained.
The nurse should allow the mother to breastfeed the infant prior to or during the
procedure. Evidence-based practice indicates breastfeeding or non-nutritive
sucking with a pacifier can provide nonpharmacological pain management in
infants.
A nurse is assessing an 8-year-old child who has early indications of shock.
After establishing an airway and stabilizing the child's respirations, which of
the following actions should the nurse take next?
Insert an indwelling urinary catheter.
Measure weight and height.
Initiate IV access.
Maintain ECG monitoring.
I
nitiate IV access.
After establishing an airway and stabilizing the child's respirations, the next action
the nurse should take when using the airway, breathing, and circulation approach
to client care is to establish IV access to maintain the child's circulatory volume.
A nurse is caring for a school-age child following an appendectomy.
Vital Signs
Day of admission:
Temperature 37.1° C (98.8° F)Heart rate 100/minRespiratory rate 20/minBlood
pressure 94/60 mm HgPulse oximetry 97%24 hr following the procedure:
Temperature 38.6° C (101.5° F)Heart rate 110/minRespiratory rate 24/minBlood
pressure 100/60 mm HgPulse oximetry 95%
Nurses' Notes
Day of admission:Child is drowsy but easily aroused and responsive to verbal
stimuli. Child rates pain as 4 on a scale of 0 to 10. Lungs clear to auscultation.
Abdomen is soft, flat, and non-distended. Bowel sounds hypoactive in all four
quadrants. Extremities are warm and dry to touch. Gauze pads with clear
transparent dressings noted to the umbilicus, left lower quadrant, and suprapubic
area.24 hr following the procedure:Child is alert and responsive to verbal stimuli.
Appears irritable and restless. Child rates pain as 8 on a scale of 0 to 10.
WBC count is correct.
The child's WBC count has increased significantly
following the procedure. The nurse should identify that this is a potential indication
of a postoperative infection.
Abdomen assessment is correct. The child's abdomen is rigid and distended and
they are reporting increased pain. The nurse should identify that this is a potential
indication of a postoperative infection.
A nurse on a pediatric unit is caring for a toddler.
Medical History
Hemophilia A
Nurses' Notes
Guardian reports that the toddler fell at home while playing with toys. Since the
fall, the toddler has been very irritable, crying uncontrollably, and grabbing at their
left knee. The toddler can walk but insists on being picked up.
Physical Examination
Toddler is alert during the exam. Extremities are warm and dry to touch. Decreased
movement of the left leg observed. Tenderness noted with palpation of the left
knee joint. Pain level assessed as 6 on a scale of 0 to 10 using the FLACC
scale.1145:Toddler is fussy and crying. Pain assessed as 8 on scale of 0 to 10 using
the FLACC scale.
Left knee observed to be ecchymotic and edematous.
Physical Examination
1115:Toddler is alert during the exam. Extremities are warm and dry to touch.
Decreased movement of the left leg observed. Tenderness noted with palpation o
Administer factor VIII is anticipated. The child is experiencing an acute episode
of hemophilia due to a recent fall. During this acute episode, there is potential for
internal bleeding into the joint spaces. Therefore, administering factor VIII is
anticipated to control bleeding.
Apply ice packs to the affected joints is anticipated.
The child is experiencing
an acute episode of hemarthrosis due to a recent fall, as evidenced by the bruising
and swelling of the knee joint. Therefore, applying ice packs to the affected joints
is anticipated to manage discomfort and decrease bleeding into the joint.
Administer morphine PRN pain is anticipated. The child is experiencing severe
pain. Opioids can be administered in the inpatient setting to relieve pain.
Otherwise, acetaminophen can be given at home for pain. Aspirin and NSAIDs
should be avoided because they inhibit platelet function and might increase
bleeding.
Perform passive range-of-motion (ROM) exercises during the first 12 hr
following injury is contraindicated. The child is experiencing an acute episode of
hemarthrosis. Passive ROM exercises can increase bleeding into the joint for the
first 48 hr following injury. The toddler should be encouraged to exercise the joint
as tolerated.
Elevate the affected joints is anticipated.
The child is experiencing an acute
episode of hemarthrosis due to a recent fall, as evidenced by the bruising and
swelling of the knee joint. Elevation of the joint, along with the application of ice,
is anticipated to help decrease bleeding and swelling in the joint.
A nurse is planning an educational program for school-age children and their
parents about bicycle safety. Which of the following information should the
nurse plan to include?
The child should be able to stand on the balls of their feet when sitting on the bike.
The child should ride their bike 2 feet to the side of other bike riders.
The child should wear dark-colored clothing with a fluorescent stripe when riding
at night.
The child should ride the bike facing traffic when it is necessary to ride in the
street.
The child should be able to stand on the balls of their feet when sitting on the
bike.
To decrease the risk for injury, parents should ensure that the bike is the correct
size for the child. When seated on the bike, the child should be able to stand with
A nurse in an emergency department is assessing a toddler who has Kawasaki
disease. Which of the following findings should the nurse expect? (Select all
that apply.)
Increased temperature
Gingival hyperplasia
Xerophthalmia
Bradycardia
Cervical lymphadenopathy
Increased temperature is correct.
Kawasaki disease is an acute illness associated
with a fever that is unresponsive to antipyretics or antibiotics.
Xerophthalmia is correct.
Ophthalmic manifestations of Kawasaki disease
include reddening of the conjunctiva and dryness of the eyes, or xerophthalmia.
Cervical lymphadenopathy is correct. A child who has Kawasaki disease can
develop enlarged cervical nodes on one side of the neck that are nontender and
greater than 1.5 cm in size.
A nurse is providing discharge teaching to the parents of a 3-month-old infant
following a cheiloplasty. Which of the following instructions should the nurse
include?
"Clean your baby's sutures daily with a mixture of chlorhexidine and water."
"Expect your baby to swallow more than usual over the next few days."
"Inspect your baby's tongue for white patches using a tongue depressor every 8
hours."
"Apply a thin layer of antibiotic ointment on your baby's suture line daily for the
next 3
"Apply a thin layer of antibiotic ointment on your baby's suture line daily for
the next 3 days."
The nurse should instruct the parents to apply a thin layer of antibiotic ointment on
the infant's suture line daily for 3 days and then continue to apply petroleum jelly
to the area for several weeks to promote healing.
A nurse is creating a plan of care for a newly-admitted adolescent who has
bacterial meningitis. How long should the nurse plan to maintain the
adolescent in droplet precautions?
Until the adolescent is afebrile
For 7 days following admission to the facility
Until the adolescent has a negative blood culture
For 24 hr following initiation of antimicrobial therapy
For 24 hr following initiation of antimicrobial therapy
The nurse should plan to maintain the adolescent on droplet precautions for at least
24 hr following initiation of antimicrobial therapy. This practice will ensure that
the adolescent is no longer contagious, which protects family members and the
personnel caring for the client. Prophylactic antibiotics might be prescribed to
individuals who were in close contact with the adolescent.
A nurse on a pediatric unit is caring for a school-age child.
Physical Examination
Child is restless and crying. Swelling noted at hand joints. Capillary refill less than
3 seconds. Mucous membranes dry and sticky. Respirations regular and unlabored.
Abdomen soft, flat, and non-distended. Tenderness with light palpation. Child
reports pain as 8 on a scale of 0 to 10.
Diagnostic Results
CBC:
Hemoglobin 8.0 g/dL (10 to 15.5 g/dL)Hematocrit 28% (32% to 44%)RBC count
4.2 million/mm3 (4 to 5.5 million/mm3)WBC count 12,000/mm3 (5,000 to
10,000/mm3)Platelets 350,000/mm3 (150,000 to 400,000/mm3)Reticulocyte count
Increased abdominal girth
Decreased appetite
Increased protein in the urine
Decreased edema
A child who has nephrotic syndrome can experience edema due to the increased
glomerular permeability, which increases protein loss. Prednisone decreases
glomerular permeability, which causes fluid to shift from the extracellular spaces,
resulting in decreased edema.
A nurse is providing discharge teaching to the parent of an 18-month-old
toddler who has dehydration due to acute diarrhea. Which of the following
statements by the parent indicates an understanding of the teaching?
"I will offer my child small amounts of fruit juice frequently."
"I will avoid giving my child solid foods until the diarrhea has stopped."
"I will monitor my child's number of wet diapers."
"I will give my child polyethylene glycol daily for 7 days."
"I will monitor my child's number of wet diapers."
The nurse should teach the parent to closely monitor the child's number of wet
diapers. Monitoring the number of wet diapers per day is an effective way for the
parent to monitor adequate output and hydration status.
Graphic Record
Temperature 37.5° C (99.5° F)
Heart rate 70/min
Respiratory rate 30/min
Birth weight 3.2 kg (7 lb)
Current weight 5.9 (13 lb)
Nurses' Notes
3 episodes of vomiting
6 wet diapers in 24 hr
Consumed 3 oz concentrated formula every 3 hr
Medication Administration Record
Digoxin 0.5 mcg PO Q12H
Furosemide 20 mg PO Q12H
A nurse is admitting a 4-month-old infant who has heart failure. Which of the
following findings is the nurse's priority? (Click on the "Exhibit" button for
additional information about the client. There are three tabs that contain
separate categories of data.)
Episodes of vomiting
Formula consumption
Weight
Temperature
Episodes of vomiting
When using the urgent vs. nonurgent approach to client care, the nurse should
determine that the priority finding is three episodes of vomiting. This can indicate
digoxin toxicity, which requires immediate intervention. Therefore, this is the
nurse's priority finding.
A nurse is reviewing the dietary choices of an adolescent who has iron
deficiency anemia. The nurse should identify that which of the following menu
items has the highest amount of nonheme iron?
½ cup whole milk
1 cup orange juice
½ cup raisins
1 cup raw carrots
½ cup raisins
