ATI NGN RN Nursing Care of Children Proctored Exam 2023/2024 Questions & Answers GRADED A

ATI NGN RN Nursing Care of Children Proctored Exam 2023/2024 Questions & Answers GRADED A Teachingtheparents ofaschool-agedchild whohasanew diagnosis of osteomyelitis of thetibia. The nurse should identify that which of the following statements by the parents indicates an understanding of the teaching? mychild willhave acastuntilhealing iscomplete. Mychild willreceive antibiotics forseveral weeks. Mychildcanreturntoplayingsportsonceheisdischarged. My child needs to be in contact isolation. Answer:b The nurseshouldinstruct theparent that thechild willreceive antibiotic therapyforat least4 weeks. Surgery might be indicated if the antibiotics are not successful. A - incorrect Weightbearing mustbeavoided withosteomyelitis. Therefore, thechildis placedina comfortable position with the limb supported. There is no indication for a cast. C- incorrect Weightbearingshouldbeavoidedtopreventcomplicationsand minimizepain. Therefore, it will be several weeks to months before the child can play contact sports. D- incorrect Contact isolationis NOTnecessary,becauseosteomyelitis isnotacommunicableillness. A nurse isauscultating the lungs ofan adolescent who has asthma. The nurse should identifythe sound as which of the following? Click the audio button to listen. A- Biots respiration B- Chaney Stokesrespiration C- tackypnea D - Bradypnea Answer- c The nurseshouldidentify thesoundheardduringauscultationas tachypnea, whichisa rapid, regular breathing pattern. This breathing pattern often occurs with anxiety, fever, metabolic acidosis, or severe anemia. A- Biot's respirations areperiods ofapneaalternating withtwoor three shallow breaths. B- Cheyne-Stokesrespirationsareperiodsofapneaalternating withperiodsof hyperventilation. D- Bradypneaisaslow,regularbreathingpattern. A nurse in an emergency department iscaring foraschool-age child who is experiencing an anaphylactic reaction. Which of the following is the priorityaction by the nurse? A- Elevate theheadof thechild's bed Page 2 of 28 B- insertalarge-boreIVcatheter for thechild C- determinetheallergenthatcausedthechild's reaction D- administer IM epinephrinetothechild Answer- d Page 3 of 28 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, histaminereleasecausesbronchoconstrictionand vasodilation. This isanemergencybecause ultimately it causes decreased blood return to the heart. A-Elevatingtheheadof thechild'sbedis important tofacilitatebreathingandcirculation. However, it is not the priority action the nurse should take. B- InsertingalargeboreIVcatheter is important tofacilitateadministrationof IVfluidsand medications. However, it is not the priority action the nurse should take. C- Determining the allergen that caused the child's reaction is important to prevent any additional episodesofanaphylaxis. However, it isnot thepriorityactionthenurseshouldtake. The nurse is preparing to administeran immunization to a four-year-old child. Which of the following actions should the nurse plan to take? A- Place thechild inapronepositionfor the immunization B- request that thechild's caregiver leave theroom duringthe immunization C- administer the immunization using a 24 gauge needle D- inject theimmunizationslowlyafteraspiratingfor 3 seconds Answer -c The nurseshouldadministeranimmunizationfora4-year-oldchildusinga24-gaugeneedleto minimize the amount of pain experienced by the toddler. A- Thenurseshouldplacethechildinanuprightsittingpositionfor theimmunization because this decreases the child's fear and anxiety. B- Thenurseshouldallow thecaregiver tostaynear thechild duringtheimmunizationto provide a sense of security and reduce the child's anxiety level. D- The nurse should inject the immunization rapidly and avoid aspiration. These actions decrease the risk of needle displacement and lower the child's fear and anxiety level by decreasing the amount of time it takes to administer the immunization. A nurse isreviewing the laboratoryreport ofan infant who isreceiving treatment forsevere 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- urinespecificgravity 1.035 D- BUN 25 mg Answer-b The nurse should identify that a sodium level of 140 mEq/L is within the expected reference range and indicates the current treatment regimenthe infant is receivingfordehydration is effective. A- A potassium levelof2.9 mEq/Lisbelow theexpectedreferencerangeandindicates hypokalemia. Page 4 of 28 C- A urinespecificgravityof 1.035 isabovetheexpectedreferencerangeandindicates concentrated urine. D- A BUN levelof25 mg/dL is abovetheexpectedreferencerangeandindicatesthe kidneys are not excreting BUN as they should be. The nurse is providing teaching about Social Development to the parents ofa preschooler. Which of the following play activities 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,andphysical development. Therefore,playingdress-upisarecommendedplayactivity for this child. A- Playingpat-a-cakeisarecommendedplayactivityforaninfant. B- Usingapushpull toy is arecommendedplayactivity for a toddler. C- Creatingascrapbook isarecommendedplayactivityforaschool-agechild. A nurse is teaching the parents ofa newborn about ways to prevent sudden infant death syndrome SIDS. Which of the following instructions should the nurse include? A- Placethe infant inapronepositiontosleep. B- Allow theinfant tosleeponalarge pillow. C- Usersoft mattress intheinfant's crib. D- Give the infanta pacifierat bedtime. Answer-d Thenurseshouldinform theparent thatprotectivefactorsagainst SIDS includebreastfeeding and the use of a pacifier when the infant is sleeping. A- Thenurseshouldinstruct theparent toplacetheinfant inasupine positiontosleep. Prone and side-lying positions are risk factors for SIDS. B- Placingtheinfantonalargepillow tosleepcanincreasetheriskofsuffocation,asphyxiation, and SIDS. C- Thenurseshouldinstruct 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. Page 5 of 28 A nurseis assessinganinfant whohas pneumonia. Whichof thefollowingfindings is the priority for the nurse to report to the provider? A- Nasal flaring B- WBC 11,300 C- diarrhea D- abdominal distension Answer-a Whenusingtheairway,breathing,circulationapproachtoclientcare, thenurseshouldplace the 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 thecurrent treatment isnoteffective. However,anotherfindingis thepriorityforthe nurse to report. D- Thenurseshouldreportabdominaldistensionbecauseit isa manifestation ofpneumoniain infants and indicates the current treatment is not effective. However, another finding is the priority for the nurse to report. A school nurse isassessing aschool-age child blood pressure while he isseated 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 immediate areaaroundthechildof hazardous objects B- loosenthechildrestrictiveclothing C- assist the child to aside-lying position on the floor D- applyanoxygen mask tothe child 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 downtofloor inaside-lying position immediately. Thispositionenablesthechild's secretionstodrainfrom the mouth,preventing aspiration, and maintaining a patent airway. A- Thenurseshouldclear theareaaroundthechildofhazardousobjects. However, this isnot the first action the nurse should take. B- Thenurseshouldloosenthechild'srestrictiveclothing. However, this isnot thefirstaction the nurse should take. D- Thenurseshouldapplyanoxygen masktothechildtopreventhypoxia. However, this isnot the first action the nurse should take. A nurse is preparing to administer ibuprofen 5 mg perkg every 6 hours PRN fortemperatures above 38.0 degrees Celsius or 100.5 degrees Fahrenheit to an infant who weighs 17.6 lb. The infant hasa temperature of 38.4 degrees Celsius or100 + 1.2 degrees Fahrenheit. Available is ibuprofen liquid 100mg/ 5 ml. how manymilliliters should the nurse administer to the infant Page 6 of 28 per dose? Round the answer to the nearest whole number. Use a leading zero if itapplies. Answer:2 mL A nurse isreceiving change-of-shift Report on forchildren. Which of the following children should the nurse assess first? A- A toddler whohas aconcussionandanepisode of forceful vomiting B- anadolescent whohas infectiveendocarditisandreportshavingaheadache C- anadolescent who was placedinto Halotraction 1houragoandrateshis painata 6 ona 0- 10 scale D- school-agechild whohasacuteglomerulonephritis andbrowncoloredurine Answer-a Wgentapproachtoclientcare, thenurseshouldassessthischild first. An episode of forceful vomiting is an indication of increased intracranial pressure in a toddler who has a concussion. B- A reportofaheadache is nonurgentbecauseit is anexpectedfindingforachild whohas infective endocarditis; therefore, the nurse should assess another child first. C- A reportof moderatepainisnonurgentbecauseit is anexpectedfindingforachild whohas a new halo traction device; therefore, the nurse should assess another child first. D- Brown-coloredurineisnonurgentbecauseit isanexpectedfindingforaschool-agechild who has acute glomerulonephritis; therefore, the nurse should assess another child first. A nurse in the emergency department iscaring foran adolescent who hassevere abdominal pain due to appendicitis. Which of the following locations should the nurse identify as mcburney's point? Answer:a A is correct. The nurseshouldidentifythelower rightquadrantof theabdomenbetweenthe umbilicus and the anterior iliac crest as the location of McBurney's point. B is incorrect. The nurseshouldnot identify theleft lowerquadrantas thelocationof Page 7 of 28 McBurney'spoint. C is incorrect. Thenurseshouldnot identify therightupperquadrantas thelocationof McBurney's point. A nurse is providing teaching to the family ofa school-age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include in the teaching? A- Limit the movementof thechildlarge joints. B- Encouragethechildtoperform independentselfcare. C- Providethechild withasoft mattress forsleeping. D- Schedule a2-hour daily napfor the child inthe afternoon. Answer-b The nurseshouldteachthefamily theimportanceofencouragingthechildtoperform independent self-care. This will minimize the child's pain while maximizing mobility. Encouragingandpraisingthechild'seffortsfor independence willalsoincreasehisself-esteem. A-Largejointsshouldbeexercisedregularly to maintain mobilityandstrengthen muscles. C- Children who have juvenile idiopathic arthritis should sleep on a firm mattress to enhance comfort andrest. A soft mattresscanincreasepressuretotheaffectedjointsandincreasethe child's pain. D- Daytimenapsarediscouragedbecausestiffnesscanoccurquicklyandeasily withinactivity, and naps can interfere with nighttime sleeping. A nurse isassessing aclient who hasa new diagnosis of celiac disease. Which of the following clinical manifestations should the nurse expect? A- Steatorrhea B- projectile vomiting C- sunkenabdomen D- weight gain Answer-a The nurseshouldrealizethatclients whohaveceliacdiseaseareunabletodigestgluten. This will cause damage to the cells in the bowel, leading to malabsorption, steatorrhea, and diarrhea. B- Clients whohave pyloricstenosis willexhibitprojectilevomitingrather thanceliacdisease. C- A distendedabdomen,rather thanasunkenabdomen, is a manifestationofceliacdisease. D- Weight loss,rather than weightgain, isa manifestationofceliacdisease. A nurse is providing teaching to an adolescentabout how to manage tinea pedis. Which of the following statements by the Adolescent indicates an understanding of the teaching? A- Ishouldbuysomeplasticshoes to wear at theswimmingpool B- I should wear sandals as muchas possible C- Ishouldplacethepermethrincream between mytoes twice-daily D- Ishould Iseal mynon washable shoes in plastic bags foracouple of weeks Page 8 of 28 Answer-a The useofplasticshoes increases theoccurrence of tineapedis. The nurseshouldinstruct the adolescent to avoid wearing plastic shoes. B- Sandals allow air to circulate around the feet, decreasing perspiration and eliminating the medium forbacteriaand fungustogrow. Thenurseshouldinform theadolescent that wearing sandals, open-toed, or well-ventilated shoes will promote healing of his fungal infection. C- Permethrin 5% cream is ascabicideusedtoplaceonthe lesionscreatedby scabies. This treatment is not recommended for tinea pedis. D- Sealingnon-washableitems inplasticbagsfor 14days isarecommendedpracticeforclients who have pediculosis. This practice is not recommended for tinea pedis. A nurse at an urgent care clinic is assessing an adolescent client who has an upper respiratory tract infection. Which of the following findings should the nurse recognize asa manifestation of pertussis? A- Inflamedthroat withexudate B- purulenteye drainage C- dry, hacking cough D- koplikspotsonbuccal mucosa Answer-c The nurse should recognize that a dry, hacking cough is a manifestation of pertussis. This diseaseusuallybegins with indicationsofanupper respiratorytract infection, whichincludesa dry, hacking cough that is sometimes more severe at night. A- Aninflamed throat with exudate isa manifestationofacute streptococcal pharyngitis. B- Purulenteyedrainage isa manifestationofbacterialconjunctivitis. D-Koplikspotsonbuccal mucosa area manifestationof rubeola(measles). A nurse is providing teaching about car seat use to the mother of a six-month-old infant. Which of the following statements bythe mother indicatesan understanding of the teaching? A- Ishould secure the carseat using loweranchorsand tethers instead of the seat belt B- Ishouldpositionthecar seat harnessone inchabove mybaby's shoulders C- I will make sure that the carseat is placedata 90 degree angle D- I willpad mybaby's carseat withabla