ATI RN NURSING CARE OF CHILDREN PROCTORED EXAM 2023/2024 (LATEST ACTUAL EXAM QUESTIONS WITH CORRECT AND VERIFIED ANSWERS)

ATI RN NURSING CARE OF CHILDREN PROCTORED EXAM 2023/2024 (LATEST ACTUAL EXAM QUESTIONS WITH CORRECT AND VERIFIED ANSWERS) 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? A- Urine specific gravity of 1.045 B- sodium 155 C- blood glucose 45 D- urine output 35 ml per hour Answer- b 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. A- Urine specific gravity of 1.045 is above the expected reference range. A child who has diabetes insipidus is more likely to have diluted urine and urine specific gravity below the expected reference range. C- Blood glucose of 45 mg/dL is below the expected reference range. A child who has diabetes insipidus should have a blood glucose level within the expected reference range. D- Urine output of 35 mL/hr is within the expected reference range. A child who has diabetes insipidus is more likely to have polyuria. A nurse is creating a plan of care for a toddler who has minimal change nephrotic syndrome mcns and 3 + pitting edema. Which of the following interventions should the nurse include in the plan? A- Encourage an increased fluid intake for the toddler B- place the child in an Airborne infection isolation room C- increase the toddler's dietary sodium intake D- administer corticosteroids to the toddler Answer- d The nurse should recognize that corticosteroids are the treatment of choice for providers caring for children who have MCNS. Therefore, the nurse should include administration of prescribed corticosteroids in the plan of care for this toddler. A- Children who have MCNS are on dietary fluid restriction during the edema phase. Therefore, the nurse should not encourage fluid intake for the toddler who has 3+ pitting edema. B- Children who have MCNS do not require isolation precautions. Airborne infection isolation room is used for clients who have airborne infections, such as tuberculosis. C- Children who have MCNS are on a low-sodium diet during the edema phase. Therefore, the nurse should not increase dietary sodium intake for the toddler who has 3+ pitting edema. Page 9 of 31 ATI RN Nursing Care of Children A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent asthma. Which of the following instructions should the nurse include? A- You should give your child his salmeterol inhaler every 4 hours when he is having an acute episode of wheezing. B- You should monitor your child's weight weekly while he is receiving inhaled corticosteroid therapy C- pulmonary function test will be performed every 12 to 24 months to evaluate how your child is responding to therapy D- when using the peak expiratory flow meter, record your child average of three readings Answer- c The nurse should inform the parent that her child will need pulmonary function tests every 12 to 24 months to evaluate the presence of lung disease and how the child is responding to the current treatment regimen. As children grow, sometimes their symptoms can improve or decline and treatment needs to change accordingly. A- salmeterol - The nurse should inform the parent that long-acting beta2 agonists are to be used in conjunction with a low or medium dosage inhaled corticosteroid, and never used alone. Using this medication alone on an as-needed basis during an acute asthma attack is dangerous and can lead to worsening of the child's condition. B- The nurse should instruct the parent that the use of inhaled corticosteroids has not been shown to have any negative effects on growth. The provider might monitor the child's growth for systemic absorption; however, it is not necessary for the parent to weigh the child weekly. D- The nurse should instruct the parent to measure the child's airflow using a peak expiratory flow meter. This should be done twice daily with the skill repeated in a sequence of three, waiting 30 seconds between each measurement. The parent should record the highest of the three readings, rather than the average. A nurse is assessing a three-year-old toddler at a well-child visit. Which of the following manifestations should the nurse report to the provider? A- Blood pressure 90/ 50 B- respiratory rate 45/min C- weight 14.5 kg or 32 lb D- heart rate 110/min Answer- b A respiratory rate of 45/min is above the expected reference range for a 3-year-old toddler and can indicate respiratory dysfunction and acute respiratory distress. Therefore, the nurse should report this finding to the provider immediately. A- A blood pressure of 90/50 mm Hg is within the expected reference range for a 3-year-old toddler. C- A weight of 14.5 kg (32 lb) is within the expected reference range for a 3-year-old toddler. D- A heart rate of 110/min is within the expected reference range for a 3-year-old toddler. Page 10 of 31 ATI RN Nursing Care of Children A nurse is preparing an adolescent for a lumbar puncture. Which of the following actions should the nurse take? A- Place a cardiac monitor on the Adolescent prior to the procedure B- apply topical analgesic cream to the site one hour prior to the procedure C- keep the Adolescent in a semi Fowler's position for 4 hours following the procedure D- restrict fluids for 2 hours following the procedure Answer- b The nurse should apply a topical analgesic to the lumbar site 60 min prior to the procedure to decrease the adolescent's pain while the lumbar needle is inserted. A- Cardiac monitoring is not necessary during a lumbar puncture. C- The nurse should place the adolescent in the prone position or flat in bed for up to 12 hr to prevent post procedural spinal headache. D- The adolescent should be encouraged to drink extra fluids following the procedure to replace the cerebrospinal fluid removed during the procedure. A nurse is providing teaching to the parents of a toddler about the administration of a prescribed eye drops and eye ointment. Which of the following instructions should the nurse include? A- Apply the eye ointment within 30 minutes of your toddler Awakening in the morning B- apply the eye ointment from the outer canthus to the inner campus C- use one hand to pull the upper eyelid upward when instilling the eye drops D- administer the eye drops 3 minutes before the ointment Answer- d The nurse should instruct the parents to administer the eye drops first and then wait 3 min before administering the eye ointment. This action provides adequate time and spacing for each separate medication to work. A- The nurse should instruct the parents to administer the eye ointment prior to a nap or bedtime since the medication can cause temporary blurred vision. B- The nurse should apply the eye ointment from the inner canthus to the outer canthus to prevent the entry of infectious organisms into the lacrimal duct. C- The nurse should instruct the parents to use one hand to pull the lower eyelid downward when instilling the eye medication to ensure placement of the medication in the conjunctival sac. The nurse is providing discharge teaching to the parent of an 18 month old toddler who has dehydration as a result of acute diarrhea. Which of the following statements by the parent indicates an understanding of the teaching? A- I will offer my child small amounts of fruit juice frequently B- I will avoid giving my child solid foods until his diarrhea has stopped C- I will monitor my child's number of wet diapers D- I will give my child polyethylene glycol daily for 7 days Page 11 of 31 ATI RN Nursing Care of Children Answer- c 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 the best way for the parent to monitor adequate output and hydration status. A- Children recovering from dehydration should not be encouraged to drink frequent, small amounts of fruit juice because it is high in carbohydrates, low in electrolytes, and has a high osmolality value. B- The nurse should teach the parent to encourage solid foods even when the child has diarrhea. D- Polyethylene glycol is an osmotic agent that will pull fluid into the bowel, increasing the frequency of stools, which will increase the level of dehydration. 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? A- Obtain a sputum specimen B- perform an allen test C- perform a finger stick D- obtain a stool specimen Answer- c 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. A- Sputum specimens are collected to identify the infectious organism in a child who has as acute respiratory tract infection. Therefore, this is not a component of the sickle-turbidity test. B- An Allen test determines adequate circulation by observing capillary refill before an arterial puncture. Therefore, this is not a component of the sickle-turbidity test. D- Stool specimens are collected to identify organisms or parasites that cause diarrhea or to check for the presence of occult blood. Therefore, this is not a component of the sickle-turbidity test. A nurse is caring for a school-age child who has peripheral edema. Which of the following assessments should the nurse perform to confirm peripheral edema? A- Palpate the dorsum of the child's feet B- play the child daily using the same scale C- assess the child's skin turgor D- observe the child for periorbital swelling Answer- a The nurse should palpate the dorsum of the feet by pressing her fingertip against a bony prominence for 5 seconds to assess for peripheral edema. B- Weighing the child daily might indicate that the child has retained fluid; however, this is not an acceptable method for assessing for peripheral edema. Page 12 of 31 ATI RN Nursing Care of Children C- Assessing the child's skin turgor measures the elasticity and mobility of the skin; however, this is not an acceptable method for assessing for peripheral edema. D- Observing the child for periorbital swelling is an appropriate method for assessing central edema; however, this is not an acceptable method for assessing for peripheral edema. A nurse in the emergency department is caring for a toddler who has partial thickness burns on his right arm. Which of the following actions should the nurse take? A- Insert a nasogastric tube B- initiate prophylactic antibiotics therapy C- cleanse the affected area with mild soap and water D- apply a topical corticosteroid to the affected area Answer- c The nurse should wash the affected area with mild soap and water to remove any loose tissue that could cause infection. A- Inserting a nasogastric tube to empty the contents of the stomach and maintain decompression is an intervention for major burn management. B- Prophylactic antibiotics are not recommended for burns of any type. D- The nurse should apply an antibiotic ointment to the affected area to prevent infection. A nurse is performing hearing screenings for children at a community health fair. Which of the following children should the nurse refer to a provider for a more extensive hearing evaluation? A- A toddler who is 18 months old and has unintelligible speech B- an infant who is 3 months old and has an exaggerated startle response C- a preschooler who is 4 years old and prefers playing with others rather than alone D- an infant who is 8 months old and is not yet making babbling sounds Answer- d The nurse should refer an infant who is not making babbling sounds by the age of 7 months to a provider for more extensive evaluation of hearing. A- The nurse should refer a toddler who does not possess intelligible speech by the age of 24 months to a provider for more extensive evaluation of hearing. B- The nurse should refer infants who are under the age of 4 months and lack a startle response to a provider for more extensive evaluation of hearing. C- The nurse should refer a preschooler who prefers playing alone and avoids interaction with others to a provider for more extensive evaluation of hearing. A nurse is providing dietary teaching to the parent of a school-age child who has cystic fibrosis. Which of the following statements should the nurse make? Page 13 of 31 ATI RN Nursing Care of Children A- You should offer your child high protein meals and snacks throughout the day B- your child should decrease dietary fats to less than 10% of her caloric intake C- your child will need to take a 1 gram sodium chloride tablet daily throughout her lifetime D- you should calculate your child carbohydrate needs based on her daily activities Answer- a The parent should 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 in order to meet their energy requirements. Children who have good nutritional intake have improved lung function and decreased risk of infection. B- Children who have cystic fibrosis need a diet that is unrestricted in fat. They also require 35% to 40% of their calories to come from fats. C- Children who have cystic fibrosis are at risk for losing sodium and chloride through perspiration, especially when the weather is hot. The parent should monitor the child during hot weather and ensure adequate fluid intake. There is no need for the child to take supplemental sodium chloride tablets, because the child's regular diet should provide adequate amounts. D- Children who have cystic fibrosis need to eat a diet high in calories, protein, and carbohydrates. Children who have diabetes mellitus usually calculate carbohydrate needs according to their daily activities. The nurse is providing 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? A- Wheat bread B- vanilla malt C- barley soup D- rice pudding Answer- d The nurse should instruct the parent that the child will remain on a lifelong gluten-free diet. The child cannot consume oats, rye, barley or wheat, and sometimes lactose deficiency can be secondary to this disease. The nurse should recognize that rice pudding is a gluten-free food. Therefore, it is an acceptable choice for the nurse to recommend to the parent of a child who has celiac disease. A- Wheat bread contains gluten and should be avoided by children who have celiac disease. B- Malt contains gluten and should be avoided by children who have celiac disease. C- Barley soup contains gluten and should be avoided by children who have celiac disease. A nurse is providing teaching to the parents of a preschooler who has heart failure and who is to begin taking Digoxin twice-daily. Which of the following instructions should the nurse include in the teaching? A- Use a kitchen teaspoon to measure the medication B- brush the child teeth after giving the medication Page 14 of 31 ATI RN Nursing Care of Children C- double the next dose If the child misses a dose D- repeat the dose If the child vomits Answer- b The nurse should instruct the parents to brush the child's teeth after administering digoxin to prevent tooth decay caused by the medication, which comes as a sweetened liquid to enhance