NGN ATI NURSING CARE OF CHILDREN PROCTORED EXAM WITH VERIFIED QUESTIONS AND ANSWERS

NGN ATI NURSING CARE OF CHILDREN PROCTORED EXAM WITH VERIFIED QUESTIONS AND ANSWERS A nurse is reviewing the laboratory report of an infant who is receiving treatment for severe dehydration. The nurse should identify which of the following laboratory values indicates effectiveness of the current treatment? A- Potassium 2.9 mEq/L B- sodium 140 C- urinespecificgravity1.035 D- BUN 25 mg Answer-b The nurseshould identify that a sodium levelof 140 mEq/L is within the expected referencerange and indicates the current treatment regimen the infant is receiving for dehydration iseffective. A- A potassium levelof2.9 mEq/Lisbelow theexpected referencerangeandindicateshypokalemia. C- A urinespecificgravityof 1.035 isabovetheexpected referencerangeandindicatesconcentrated urine. D- A BUN levelof25 mg/dLis abovethe expected referencerangeandindicates the kidneysarenot excreting BUN as they should be. The nurse is providing teaching about Social Development to the parents of a preschooler. Which of the following playactivities should the nurse recommend for the child? A- Playpat-a-cake B- usingapushpull toy C- creatingascrapbook D- playingdress-up Answer - d The nurse should instruct the parents that at the preschool age, play should focus on social, mental,and physicaldevelopment.Therefore,playingdress-upisarecommendedplayactivityfor this child. A- Playingpat-a-cakeisarecommendedplayactivityforaninfant. B- Usinga pushpull toyis arecommendedplayactivity fora toddler. C- Creatingascrapbook is arecommendedplayactivityforaschool-agechild. A nurse isteaching the parents ofa newborn about ways to prevent sudden infant deathsyndrome SIDS. Which of the following instructions should the nurse include? A- Placethe infant inaproneposition tosleep. B- Allow theinfant tosleep ona largepillow. C- Usersoft mattress intheinfant'scrib. D- Give the infanta pacifier at bedtime. Answer-d Thenurseshouldinform theparent thatprotectivefactorsagainst SIDS includebreastfeedingandthe use of apacifier when the infant is sleeping. A- Thenurseshould instruct theparent toplacethe infant inasupineposition tosleep. Proneand sidelying positions are risk factors for SIDS. B- Placingtheinfantonalargepillow tosleepcanincreasetheriskofsuffocation,asphyxiation,and SIDS. C- Thenurseshould instruct theparent touseafirm mattressandavoidtheuseof waterbeds,beanbags, or soft mattresses when placing the infant to bed. The use of a soft mattress in the infant's crib is a risk factor for SIDS and can lead to asphyxiation. A nurse is assessing an infant who has pneumonia. Which of the following findings is thepriority for the nursetoreport to the provider? A- Nasal flaring B- WBC 11,300 C-diarrhea D- abdominaldistension Answer-a Whenusingtheairway,breathing,circulationapproachtoclientcare, thenurseshouldplacethe priority on nasal flaring. Nasal flaring indicates that the infant is experiencing acute respiratory distress. B- The nurse should report a WBC of 11,300/mm3 because it is above the expected reference range and indicates infection. However, another finding is the priority for the nurse to report. C- The nurse should report diarrhea because it is a manifestation of pneumonia in infants and indicates the current treatment isnoteffective. However,anotherfindingisthepriorityfor thenurseto report. D- The nurseshould report abdominaldistensionbecauseit is a manifestationofpneumonia ininfants and indicates the current treatment is not effective. However, another finding is the priority for the nurse to report. Teaching the parents ofaschool-aged child who hasa new diagnosis of osteomyelitis of the tibia. Thenurse should identify that which of the following statements by the parents indicates an understanding of the teaching? mychild willhaveacastuntilhealing iscomplete. Mychild will receive antibiotics forseveral weeks. Mychildcanreturntoplayingsportsoncehe is discharged.My childneeds tobe incontact isolation. Answer:b Thenurseshould instruct theparent that thechild willreceive antibiotictherapyforat least4weeks. Surgery mightbe indicated if the antibiotics are not successful. A - incorrect Weightbearing mustbeavoided withosteomyelitis.Therefore, thechild is placedinacomfortableposition with the limbsupported.There is no indication foracast. C- incorrect Weightbearingshouldbeavoidedtopreventcomplicationsand minimizepain.Therefore, it willbeseveral weeks to monthsbefore thechild can play contactsports. D- incorrect Contact isolationis NOTnecessary,becauseosteomyelitis is nota communicable illness. A nurse is auscultating the lungs of an adolescent who has asthma. The nurse should identify thesound as which of the following? Clickthe audio button to listen. A- Biots respiration B- Chaney Stokesrespiration C- tackypnea D - Bradypnea Answer-c The nurse should identify the sound heard during auscultation as tachypnea, which is a rapid,regular breathing pattern. This breathing pattern often occurs with anxiety, fever, metabolic acidosis,or severe anemia. A- Biot's respirations areperiodsofapneaalternating with twoorthreeshallow breaths. B- Cheyne-Stokesrespirations areperiodsofapneaalternating withperiodsofhyperventilation. D- Bradypneaisaslow,regularbreathingpattern. A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the priorityaction bythe nurse? A- Elevatethe headof the child'sbed B- inserta large-bore IVcatheter forthechild C- determinetheallergen thatcausedthechild's reaction D- administer IM epinephrine to the child Answer-d When using the urgent vs nonurgent approach to client care, the nurse determines that the priority action is administering IM epinephrine to the child. During an anaphylactic reaction, histaminerelease causesbronchoconstrictionandvasodilation.This isanemergencybecauseultimately it causes decreasedblood return tothe heart. A-Elevatingtheheadof thechild'sbedisimportant tofacilitatebreathingandcirculation.However, it is not the priorityaction thenurse should take. B- InsertingalargeboreIVcatheter is important tofacilitateadministrationof IVfluidsandmedications. However, it is not thepriorityaction the nurseshould take. C- Determining the allergen that caused the child's reaction is important to prevent any additional episodesofanaphylaxis. However, it isnot thepriorityactionthenurseshould take. The nurse is preparing to administeran immunization to afour-year-old child. Which of the following actions should the nurse plan to take? A- Placethechild inaproneposition for the immunization B- request that thechild'scaregiver leavetheroom duringtheimmunization C- administerthe immunization using a 24 gauge needle D- inject theimmunization slowlyafteraspiratingfor 3 seconds Answer - c Thenurseshouldadministeranimmunizationfora4-year-oldchildusinga24-gaugeneedletominimize the amountof pain experienced by the toddler. A- The nurse should place the child in an upright sitting position for the immunization becausethis decreases thechild's fear and anxiety. B- The nurse should allow the caregiver to stay near the child during the immunization toprovide a senseofsecurityand reduce thechild's anxiety level. D- The nurse should inject the immunization rapidly and avoid aspiration. These actionsdecrease the risk of needle displacement and lower the child's fear and anxiety level bydecreasing the amountof time it takes toadminister the immunization. A school nurse is assessing a school-age child blood pressure while he is seated in a chair. The child starts to experience a tonic-clonic seizure. Which of the following actions should the nurse take first? A- Clear the immediatearea aroundthechildofhazardous objects B- loosenthechild restrictive clothing C- assist the child to aside-lying position on the floor D- applyanoxygen mask tothechild Answer-c The greatest risk to this child is aspiration, occlusion of the airway, and bodily injury from falling out of the chair. The nurse should ease the child down to floor in a side-lying positionimmediately. Thispositionenables thechild'ssecretions todrainfrom the mouth,preventingaspiration,and maintaining a patent airway. A- Thenurseshould clear theareaaroundthechildofhazardousobjects. However, this isnotthe first action the nurse should take. B-Thenurseshould loosenthechild'srestrictiveclothing. However, this isnot thefirstactionthe nurse should take. D- Thenurseshould applyanoxygen masktothechild topreventhypoxia. However, this isnotthe first action the nurse should take. A nurse is preparing to administer ibuprofen 5 mg per kg every 6 hours PRN for temperatures above 38.0 degrees Celsius or 100.5 degrees Fahrenheit to an infant who weighs 17.6 lb. The infant has a temperature of 38.4 degrees Celsius or 100 + 1.2 degrees Fahrenheit. Available is ibuprofen liquid 100mg/ 5 ml. how many milliliters should the nurse administer to the infant per dose? Round the answer to the nearest whole number. Use aleading zero if itapplies. Answer:2 mL A nurse isreceiving change-of-shift Report on forchildren. Which of the following childrenshould the nurse assess first? A- A toddler whohasa concussionandanepisodeof forceful vomiting B- anadolescent whohas infectiveendocarditisandreportshavingaheadache C- an adolescent who was placed into Halo traction 1 hour ago and rates his pain at a 6 on a 0-10 scale D- school-agechild whohasacuteglomerulonephritis andbrowncoloredurine Answer-a Wgentapproachtoclientcare, thenurseshould assessthis childfirst. An episode of forceful vomiting is an indication of increased intracranial pressure in a toddler who has a concussion. B- A report of aheadache is nonurgentbecause it is anexpected finding fora child whohasinfective endocarditis; therefore, thenurseshould assessanotherchild first. C- A report of moderate pain is nonurgent because it is an expected finding for a child who has a new halo traction device; therefore, the nurse should assess another child first. D- Brown-colored urine is non urgent because it is an expected finding for a school-age child who has acute glomerulonephritis; therefore, the nurse should assess another child first.