ATI Nursing Care of Children Proctored Final Exam Questions
and Answers 2025
A nurse is caring for a child who has a terminal illness and revise palliative care with an assistive
personnel (AP). Which of the following statements by the AP indicates understanding of this review?
A. I’m sure the family is hopeful that the new medication will stop the illness
B. I’ll miss working wit this client now that only nurses will be caring for him
C. I will get all the client’s personal object out of his room
D. I will listen and response as the family talks about their child's life
D
Meningitis
Viral often resolves with supportive care, bacterial is more dangerous, PCV and Hib vaccine help prevent,
s/s include photophobia, n/v, irritability, h/a
newborns: poor muscle tone, weak cry, refusal to eat, vomiting, diarrhea, poor sucking, possible fever or
hypothermia, neck is supple without nuchal rigidity, budging fontanels are a late sign
3m to 2years: seizures with a high pitch cry, fever and irritability, building fontanels, nuchal rigidity, poor
feeding and vomiting
2 years to adolescents: seizures, nuchal rigidity, fever and child, headache, n/v, irritability, petechia,
positive Brudzinski’s sign (pull head forward - extremities will also flex (bro why are you pulling on my
neck)
positive Kernig’s signs - leg is flexed and you try to extend, it causes pain
Meningitis labs
CSF analysis through lumbar puncture, empty bladder before, EMLA cream, side lying position, after
procedure remain in bed 4-8 hours in a supine position
,Bacterial: cloudy, increased WBC, increased protein, decrease glucose and +gram stain
Viral: clear, slightly elevated WBC, normal or slightly elevated protein, normal glucose, negative gram
stain
Nursing management for meningitis
it is suspected put them into droplet precautions, decrease LOC = NPO, provide quite environment, dim
the lights, seizure precautions, bacterial will need IV abx, maintain contact precautions for bacterial for
24 hours after abx treatment has started, monitor for increased ICP**
infants: bulging fontanels, increase in head circumference, high pitch cry, bradycardia, and respiration
changes
children: irritability, headache, n/v, seizures, bradycardia, and respiratory changes
Reyes syndrome
liver dysfunction and cerebral edema, associated with giving children aspirin for a fever, follows a viral
illness like the flu, gastroenteritis, or varicella, lab tests include: liver enzymes (AST/ALT increase),
increased ammonia levels, liver biopsy for diagnosis, CSF analysis
s/s: lethargy, irritability, confusion, delirium, vomiting, LOC
A nurse is caring for a client who has suspected meningitis and a decreased level of consciousness.
Which of the following actions by the nurse is appropriate?
A. place the patient on NPO status
B. prepare the client for a liver biopsy
C. position the patient in dorsal recumbent
D. put the client in a protective environment
A
,A nurse is reviewing cerebrospinal fluid analysis for a client who has suspected meningitis. Which of the
following findings should the nurse identify as indicating viral meningitis? (select all that apply)
A. negative gram stain)
B. normal glucose content
C. Cloudy color
D. decreased WBC count
E. normal protein count
A, B, E
A nurse is caring for a 4 month old infant who has meningitis, which of the following findings is
associated with this diagnosis?
A. depressed anterior fontanel
B. constipation
C. presence of rooting reflex
D. high pitched crying
D
A nurse is caring for a patient who possibly has Reye syndrome. Which of the following is a risk factor for
developing Reye syndrome?
A. recent history of infectious cystitis caused by candida
B. recent historical of bacterial otitis media
C. recent episode of gastroenteritis
D. Recent episode of Haemophilus influenzae meningitis
C
, A nurse is developing an Inservice about viral and bacterial meningiting. The nurse should include that
the introduction of which of the following immunizations decreased the incidence of bacterial
meningitis in children? (select all that apply)
A. IPV
B. PCV
C. Dtap
D. Hib
E TIB
B, D
Risk factors for seizures
cerebral edema, fever, trauma, bleeding, toxins in body (lead), hypoglycemia, electrolyte imbalance,
infection
What are the three phases of tonic-clonic seizures?
tonic- arms and legs flex up and head and neck extend; stiff, LOC
clonic- jerking movements
postictal- awake and confused
absence seizure
school age children (4-12), loss of consciousness 5-10 seconds, daydreaming look, drop what’s in hands,
lip smacking or twitching of face
myoclonic
no postictal
and Answers 2025
A nurse is caring for a child who has a terminal illness and revise palliative care with an assistive
personnel (AP). Which of the following statements by the AP indicates understanding of this review?
A. I’m sure the family is hopeful that the new medication will stop the illness
B. I’ll miss working wit this client now that only nurses will be caring for him
C. I will get all the client’s personal object out of his room
D. I will listen and response as the family talks about their child's life
D
Meningitis
Viral often resolves with supportive care, bacterial is more dangerous, PCV and Hib vaccine help prevent,
s/s include photophobia, n/v, irritability, h/a
newborns: poor muscle tone, weak cry, refusal to eat, vomiting, diarrhea, poor sucking, possible fever or
hypothermia, neck is supple without nuchal rigidity, budging fontanels are a late sign
3m to 2years: seizures with a high pitch cry, fever and irritability, building fontanels, nuchal rigidity, poor
feeding and vomiting
2 years to adolescents: seizures, nuchal rigidity, fever and child, headache, n/v, irritability, petechia,
positive Brudzinski’s sign (pull head forward - extremities will also flex (bro why are you pulling on my
neck)
positive Kernig’s signs - leg is flexed and you try to extend, it causes pain
Meningitis labs
CSF analysis through lumbar puncture, empty bladder before, EMLA cream, side lying position, after
procedure remain in bed 4-8 hours in a supine position
,Bacterial: cloudy, increased WBC, increased protein, decrease glucose and +gram stain
Viral: clear, slightly elevated WBC, normal or slightly elevated protein, normal glucose, negative gram
stain
Nursing management for meningitis
it is suspected put them into droplet precautions, decrease LOC = NPO, provide quite environment, dim
the lights, seizure precautions, bacterial will need IV abx, maintain contact precautions for bacterial for
24 hours after abx treatment has started, monitor for increased ICP**
infants: bulging fontanels, increase in head circumference, high pitch cry, bradycardia, and respiration
changes
children: irritability, headache, n/v, seizures, bradycardia, and respiratory changes
Reyes syndrome
liver dysfunction and cerebral edema, associated with giving children aspirin for a fever, follows a viral
illness like the flu, gastroenteritis, or varicella, lab tests include: liver enzymes (AST/ALT increase),
increased ammonia levels, liver biopsy for diagnosis, CSF analysis
s/s: lethargy, irritability, confusion, delirium, vomiting, LOC
A nurse is caring for a client who has suspected meningitis and a decreased level of consciousness.
Which of the following actions by the nurse is appropriate?
A. place the patient on NPO status
B. prepare the client for a liver biopsy
C. position the patient in dorsal recumbent
D. put the client in a protective environment
A
,A nurse is reviewing cerebrospinal fluid analysis for a client who has suspected meningitis. Which of the
following findings should the nurse identify as indicating viral meningitis? (select all that apply)
A. negative gram stain)
B. normal glucose content
C. Cloudy color
D. decreased WBC count
E. normal protein count
A, B, E
A nurse is caring for a 4 month old infant who has meningitis, which of the following findings is
associated with this diagnosis?
A. depressed anterior fontanel
B. constipation
C. presence of rooting reflex
D. high pitched crying
D
A nurse is caring for a patient who possibly has Reye syndrome. Which of the following is a risk factor for
developing Reye syndrome?
A. recent history of infectious cystitis caused by candida
B. recent historical of bacterial otitis media
C. recent episode of gastroenteritis
D. Recent episode of Haemophilus influenzae meningitis
C
, A nurse is developing an Inservice about viral and bacterial meningiting. The nurse should include that
the introduction of which of the following immunizations decreased the incidence of bacterial
meningitis in children? (select all that apply)
A. IPV
B. PCV
C. Dtap
D. Hib
E TIB
B, D
Risk factors for seizures
cerebral edema, fever, trauma, bleeding, toxins in body (lead), hypoglycemia, electrolyte imbalance,
infection
What are the three phases of tonic-clonic seizures?
tonic- arms and legs flex up and head and neck extend; stiff, LOC
clonic- jerking movements
postictal- awake and confused
absence seizure
school age children (4-12), loss of consciousness 5-10 seconds, daydreaming look, drop what’s in hands,
lip smacking or twitching of face
myoclonic
no postictal
