RN ATI NURSING CARE OF CHILDREN 2019 A EXAM WITH NGN (WITH RATIONALE)

RN ATI NURSING CARE OF CHILDREN 2019 A EXAM WITH NGN (WITH RATIONALE) 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 RATIONALE: The nurse should perform a finger stick on a toddler as a component of the sickleturbidity test. If the test is positive, hemoglobin electrophoresis is required to distinguish between children who have the genetic trait & children who have the disease. A nurse is reviewing the lumbar puncture results of a school-aged child who is suspected of having bacterial meningitis. Which of the following findings should the nurse identify as an indication of bacterial meningitis? Increased protein concentration RATIONALE: The nurse should identify that an increased protein concentration in the spinal fluid is a finding that can indicate bacterial meningitis. A nurse is preparing to administer an immunization to a 4-year-old child. Which of the following actions should the nurse plan to take? - Administer the immunization using a 24-gauge needle RATIONALE: The nurse should administer an immunization for a 4-year-old child using a 22- to 25- gauge needle to minimize the amount of pain the child experiences. A nurse is providing teaching to the parent of an infant who has diaper dermatitis. The nurse should instruct the parent to apply which of the following to the affected area? - Zinc oxide RATIONALE: Diaper dermatitis is a common inflammatory skin disorder caused by contact with an irritant such as urine, feces, soap, or friction, & takes the form of scaling, blisters, or papules with erythema. Providing a protective barrier, such as zinc oxide, against the irritants allows the skin to heal. 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 RATIONALE: The metabolic rate of a child who has heart failure is high because of poor cardiac function. Therefore, the nurse should provide small, frequent meals for the child because it helps to conserve energy. 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 RATIONALE: The nurse should recognize that an expected developmental milestone of a 4-year-old child is using scissors to cut out a shape. A nurse is assessing a toddler who has gastroenteritis & is exhibiting manifestations of dehydration. Which of the following findings is the nurse's priority? - Tachypnea RATIONALE: When using the airway, breathing, & circulation approach to client care, the nurse's priority finding is the toddler's tachypnea. Tachypnea is a result of the kidneys being unable to excrete hydrogen ions & produce bicarbonate, which lead to metabolic acidosis. A nurse is receiving change-of-shift report for four children. Which of the following children should the nurse see first? - - A school-age child who has sickle cell anemia & reports decreased vision in the left eye RATIONALE: When using the urgent vs. nonurgent approach to client care, the nurse should determine the priority finding is a report of decreased vision in the left eye. This finding indicates that the child is experiencing a vaso-occlusive crisis & should be reported to the provider immediately. Therefore, the nurse should see this child first. A school nurse is preparing to administer atomoxetine 1.2 mg/kg/day PO to a school-age child who weighs 75 lbs. Available is atomoxetine 40 mg/capsule. How many capsules should the nurse administer per day? - - 1 capsule RATIONALE: 75 lb x 1 kg/2.2 lb x 1.2mg/1 kg x 1 capsule/40 mg = 1 capsule A nurse is teaching a school-age child who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements by the child indicates an understanding of the teaching? - - "I will give myself a shot of regular insulin 30 minutes before I eat breakfast." RATIONALE: The child should administer regular insulin 30 minutes before meals so that the onset coincides with food intake. A nurse in an emergency department is caring for a school-age child who has appendicitis and rates their abdominal pain as 7 on a scale of 0 to 10. Which of the following actions should the nurse take? - Give morphine 0.05 mg/kg IV RATIONALE: A pain level of 7 on a scale of 0 to 10 is considered severe. The nurse should administer a analgesic medication for pain relief. A nurse is interviewing the parent of an 18-month-old toddler during a well-child visit. The nurse should identify that which of the following findings indicates a need to assess the toddler for hearing loss? - The toddler has a vocabulary of 25 words - The toddler developed a mild rash following a recent varicella immunization - The toddler's Moro reflex is absent - The toddler received tobramycin during a hospitalization 2 weeks ago. - - The toddler received tobramycin during a hospitalization 2 weeks ago. RATIONALE: The nurse should identify tobramycin as an aminoglycoside, which is an ototoxic medication that can cause mild to moderate hearing loss, and should assess the toddler for a hearing impairment. 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% RATIONALE: 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 supply. A nurse is providing discharge teaching to the parent of a child who is 1 week postoperative following a cleft palate repair. For which of the following members of the interprofessional team should the nurse initiate a referral? - Occupational therapist - Speech therapist - Respiratory therapist - Physical therapist - - Speech therapist RATIONALE: The nurse should initiate a referral for a speech therapist for a child who is postoperative following a cleft palate repair. A child who has a cleft palate will require speech therapy immediately following the repair to support speech development and future articulatio