ATI PROCTORED NURSING CARE OF CHILDREN 2019 EXAM (A)

ATI PROCTORED NURSING CARE OF CHILDREN 2019 EXAM

(A)

Question - 1

A nurse is creating a plan of care for a school-age child who has heart disease and has developed heart

failure. Which of the following interventions should the nurse include in the plan?

 Provide small, frequent meals for the child. The metabolic rate of a child who has heart failure is

hight because of poor cardiac function. Therefore, the nurse should provide small, frequent meals for the

child because it helps to conserve energy.

Question - 2

A nurse is teaching the parent of an infant who has a Pavlik harness for the treatment of developmental

dysplasia of the hip. The nurse should identify that which of the following statements by the parent indicates

an understanding of the teaching?

 "I will place my infant's diapers under the harness straps". To prevent soiling of the harness, the

parent should apply the infant's diaper under the straps.

Question - 3

A nurse is planning care for a school-age child who is in the oliguric phase of acute kidney injury (AKI) and has

a sodium level of 129 mEq/L. Which of the following interventions should the nurse include in the plan?

 Initiate seizure precautions for the child. A sodium level of 129 mEq/L indicates hyponatremia and

places the child at increased risk for neurological deficits and seizure activity. The nurse should complete a

neurologic assessment and implement seizure precautions to maintain the child's safety.

Question - 4

A nurse is assessing a school-age child immediately following a perforated appendix repair. Which of the

following findings should the nurse expect?

 Absence of peristalsis. The nurse should expect absence of peristalsis immediately following a

perforated appendix repair, until the bowel resumes functioning.

Question - 5

A nurse is preparing an adolescent for a lumbar puncture. Which of the following actions should the nurse

take?

 Apply topical analgesic cream to the site 1 hr prior to the procedure. The nurse should apply a

topical analgesic to the lumbar site 1 hr prior to the procedure to decrease the adolescent's pain while the

lumbar needle is inserted.

Question - 6

A nurse is caring for a school-age child who is receiving cefazolin via intermittent IV bolus. The child suddenly

develops diffuse flushing of the skin and angioedema. After discontinuing the medication infusion, which of

the following medications should the nurse administer first?

 Epinephrine. This child is most likely experiencing an anaphylactic reaction to the cefazolin.

According to evidence-based practice, the nurse should first administer epinephrine to treat the anaphylaxis.

Epinephrine is a beta adrenergic agonist that stimulates the heart, causes vasoconstriction of blood vessels

in the skin and mucous membranes, and triggers bronchodilation in the lungs. Question - 7

A nurse is teaching the parent of a preschooler about ways to prevent acute asthma attacks. Which of the

following statements by the parent indicates an understanding of the teaching?

 "I should keep my child indoors when I mow the yard’’. The nurse should instruct the parent to

keep the preschooler indoors during lawn maintenance or when the pollen count is increased. Guarding

against exposure to known allergens found outdoors, such as grass, tree, and weed pollen, will decrease

the frequency of the preschooler's asthma attacks. Question - 8

A nurse is proving dietary teaching to the parent of a school-age child who has celiac disease. The nurse

should recommend that the parent offer which of the following foods to the child?

 White rice. The nurse should recommend that the parent offer white rice to the child because it is a

gluten-free food. The nurse should instruct the parent that the child will remain on a lifelong gluten-free diet

and the child should not consume oats, rye, barley, or wheat, and sometimes lactose deficiency can be

secondary to this disease.

Question - 9

A nurse is reviewing the laboratory report of a school-age child who is experiencing fatigue. Which of the

following findings should the nurse recognize as an indication of anemia?

 Hematocrit 28%. The nurse should recognize that this hematocrit level is below the expected

reference range of 32% to 44% for a school-age child. The child can exhibit fatigue, lightheadedness,

tachycardia, dyspnea, and pallor due to the decreased oxygen-carrying capacity.

Question - 10

A nurse is preparing to collect a sample from a toddler for a sickle-turbidity test. Which of the following

actions should the nurse plan to take?

 Perform a finger stick. The nurse should perform a finger stick on a toddler as a component of the

sickle-turbidity test. If the test is positive, hemoglobin electrophoresis is required to distinguish between

children who have the genetic trait and children who have the disease.

Question - 11

A nurse is assessing a school-age child who has meningitis. Which of the following findings is the priority for

the nurse to report to the provider?

 Petechiae on the lower extremities. The presence of a petechial or purpuric rash on a child who is ill

can indicate the presence of meningococcemia. This type of rash indicates the greatest risk of serious rapid

complications from sepsis and should be reported immediately to the provider.

Question - 12

A nurse is assessing an infant who has a ventricular septal defect. Which of the following findings should the

nurse expect?

 Loud, harsh murmur. The nurse should expect to hear a loud, harsh murmur with a ventricular septal

defect due to the left-to-right shunting of blood, which contributes to hypertrophy of the infant's heart

muscle.

Question - 13

A nurse is creating a plan of care for an infant who has an epidural hematoma from a head injury.

Which of the following interventions should the nurse include in the plan?

 Implement seizure precautions for the infant. An infant who has an epidural hematoma is at great

risk for seizure activity. Therefore, the nurse should implement seizure precautions for the child.

Question - 14

A nurse is caring for an adolescent who received a kidney transplant. Which of the following findings should

the nurse identify as an indication the adolescent is rejecting the kidney?

 Serum creatinine 3.0 mg/dL. Creatinine is a byproduct of protein metabolism and is excreted from

the body through the kidneys. An elevated serum creatinine level, therefore, can be an indication that the

kidneys are not functioning. The nurse should identify that the adolescent's serum creatinine level is higher

than the expected reference range of 0.4 to 1.0 mg/dL for an adolescent and can indicate rejection of the

kidney.

Question - 15

A nurse in an emergency department is performing an admission assessment on a 2 week-old male newborn.

Which of the following findings is the priority for the nurse to report to the provider?

 Substernal retractions. When using the airway, breathing, and circulation approach to client care,

the nurse should determine that the priority finding to report to the provider is substernal retractions. This

finding indicates the newborn is experiencing increased respiratory effort, which could quickly progress to

respiratory failure.

Question - 16

A hospice nurse is caring for a preschooler who has a terminal illness. The father tells the nurse that he

cannot cope anymore and has decided to move out of the house. Which of the following statements should

the nurse make?

 "Let's talk about some of the ways you have handled previous stressors in your life”. This statement

offers a general lead to allow the parent to express their feelings and previous actions when faced with

stressful situations. It also helps the parent to focus on ways that they can cope with the current situation.

Question - 17

A nurse in an emergency department is caring for an adolescent who has severe abdominal pain due to

appendicitis. Which of the following locations should the nurse identify as McBurney's point?

 The nurse should identify this area of the client's abdomen as McBurney's point. This area of the

right lower quadrant located about two-thirds of the way between the umbilicus and the client's

anterosuperior iliac spine is the area where a client who has appendicitis is most likely to report pain and

tenderness. Question - 18

A nurse is reviewing the laboratory report of a 7 year-old child who is receiving chemotherapy. Which of the

following lab values should the nurse report to the provider?

 Hgb 8.5 g/dL. A child receiving chemotherapy is at risk for anemia due to the chemotherapy effects

on the blood-forming cells of the bone marrow. The development of anemia is diagnosed through laboratory

testing of hemoglobin and hematocrit levels. The nurse should recognize that a hemoglobin level of 8.5 g/dL

is below the expected reference range of 10 to 15.5 g/dL for a 7-year-old child and should be reported to the

provider.

Question- 19

A nurse is caring for a 15 year-old client who is married and is scheduled for a surgical procedure. The client

asks, "who should sign my surgical consent?" Which of the following responses should the nurse make?

 "You can sign the consent form because you are married”. The nurse should inform the adolescent

that marriage gives adolescents the legal right to consent to surgical procedures and sign other legal

documents that they would not otherwise be able to sign due to their age.

Question - 20

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?

 Cuts an outlined shape using scissors. The nurse should recognize that an expected developmental

milestone of a 4-year-old child is using scissors to cut out a shape.