ATI Nursing Care of Children Practice Quiz 1 (NUR 418)
A nurse is teaching the parent of a toddler about home safety. Which of the following statements by the parent indicates an understanding of the teaching?
A) "I lock my medications in the medicine cabinet." Rationale: Locking up medications and other potential poisons prevent access. Toddlers have improved gross and fine motor skills that allow for further exploration of the environment and possible access to hazardous substances.
A nurse is caring for a child who bacterial endocarditis. The child is scheduled to receive moderate term antibiotic therapy and requires a peripherally inserted central catheter (PICC). Which of the following statements should the nurse include when teaching the child's parent?
A) "The PICC line will last several weeks with proper care." Rationale: PICC lines are the preferred venous access device for short to moderate term IV therapy. They can remain in place for long periods with proper care.
A nurse is providing teaching to the parents of a 4-year-old child about fine motor development. Which of the following tasks should the nurse include in the teaching as as expected finding for this age group?
A) Copies a circle Rationale: The nurse should explain that copying a circle is a skill achieved by the age of 4
A nurse at a pediatric clinic is assessing a 5-month-old infant during a well-child visit. Which of the following findings should the nurse report to the provider?
A) Head lags when pulled from a lying to a sitting position
A nurse is performing a physical assessment on a 6-month-old infant. Which of the following highlight reflexes should the nurse expect to find?
B) Babinski Rationale: Babinski relax, which is elicited by stroking the bottom of the foot and causing the toes to fan and the big tow to dorsiflex, should be present until the age of 1 year. Persistence of neonatal reflexes might indicate neurological deficits.
A nurse in the emergency department is caring for a 2-year-old child who was found by his parents crying and holding a container of toilet bowl cleaner. The child's lips are edematous and inflamed, and he is drooling. Which of the following is the priority action by the nurse?
B) Check the child's respiratory status Rationale: The nurse should apply ABC priority-setting framework when answering this. This framework emphasizes the basic core of human functioning: having an open airway, being able to breathe in adequate amounts of oxygen, and circulating oxygen to the body's organs via the blood.
A nurse is developing a plan of care for a school-age child who underwent a surgical procedure that resulted in a temporary loss of vision. Which of the following interventions should the nurse include in the plan of care?
B) Explain sounds the child is hearing Rationale: The noises in a facility can be frightening to a child who is experiencing a sensory loss. It is important to explain these noises to allay the child's fears.
A nurse in a pediatric clinic is assessing a toddler at a well-child visit. Which of the following actions should the nurse take?
B) Minimize physical contact with the child initially Rationale: The nurse should initially minimize physical contact with the toddler, and then progress from the least traumatic to the most traumatic procedures
a nurse on a pediatric unis is admitting a 4-year-old child. Which of the following toys should the nurse plan to provide for the child to engage in independent play?
B) Plastic stethoscope Rationale: Preschool play centers on imitative activities. Providing a stethoscope allows the child an opportunity for therapeutic play. Limiting health care personnel helps to ease the fear of unfamiliar equipment.
A nurse is assessing a 3-year-old child who is 1 day postoperative following a tonsillectomy. Which of the following methods should the nurse use to determine if the child is experiencing pain?
B) Use the FACES scale Rationale: Pain is a subjective experience for even a 3-year-old child. The FACES can be used to accurately determine the presence of pain in children as young as 3 years of age
A nurse is providing education to the parent of a toddler who is about to receive an MMR (measles, mumps, and rubella) immunization. Which of the following statements by the parent indicated an understanding of the teaching?
C) "I will help my child to blow bubbles during the injection."
A nurse in the emergency department is caring for a 12-year-old child who has ingested bleach. Which of the following statements by the nurse indicates an understanding of this ingestion?
C) "Injury by a corrosive liquid is more extensive than by a corrosive solid." Rationale: The coating action of liquids permits larger areas of contact with tissues and results in more extensive injury.
A nurse is assessing a 30-month-old toddler during a well-child visit. Which of the following findings requires further assessment by the nurse?
C) Birth weight is tripled Rationale: By this age the birth weight should quadrupled
A nurse is providing anticipatory guidance about accidental ingestion of a toxic substance to the parents of a toddler. The nurse should instruct the parents to take which of the following actions first if the child ingests a hazardous substance?
C) Call the poison control center Rationale: According to evidence-based practice, the nurse should instruct the parents to first call the poison control center, which will then identify what further actions the parents should take.
A nurse is preparing to administer recommended highlight immunizations to a 2-month-old infant. Which of the following immunizations should the nurse plan to administer?
C) Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV)C) Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV) Rationale: The recommended immunizations for a 2-month-old infant include Hib and IPV. The Hib immunization series consist of 3 to 4 doses, depending on the immunization used, and at a minimum is administered at the ages of 2 months, 4 months, and 12 to 15 months. The IPV immunization series consists of 4 doses and is administered at the ages of 2 months, 4 months, 6 to 18 months, and 4 to 6 years.
A nurse is assessing a 6-month-old infant at a well-child visit. Which of the following findings indicates the need for further assessment?
C) Legs remain crossed and extended when supine Rationale: Legs crossed and extended when supine is an unexpected finding and requires further assessment. At 6-months of age, the legs flex at the knees when the infant is supine. Crossed and extended legs when supine is a finding associated with cerebral palsy.
A nurse is caring for an 18-year-old adolescent who is up-to-date on immunizations and is planning to attend college. The nurse should inform the client that he should receive which of the following immunizations prior to moving into a campus dormitory?
B) Meningococcal polysaccharide Rationale: Immunization that prevent infection by certain groups of meningococcal bacteria. Meningococcal infection can cause life0-threatening illnesses, such as a meningococcal meningitis, which affects the brain, and meningococcemia, which affects the blood. Both of these conditions can be fatal. College freshman, particularly those who live in dormitories, are at an increased risk for meningococcal disease relative to other persons their age. Therefore, the CDC has issued a recommendation that all incoming college students receive the meningococcal immunization.
A nurse is caring for a 2-year-old child who has cystic fibrosis. The nurse is planning to take the child to the playroom. Which of the following activities would be appropriate for the child?
D) Building towers of blocks Rationale: Building towers of blocks is an appropriate activity for a 2-year-old child. It promotes fine-motor development, and knocking blocks down provides a means of dealing with the stress of hospitalization.
A nurse in a pediatric clinic is caring for a 3-year-old child who has a blood lead level of 3 mcg/dL. When teaching the toddler's parent about the correlation of nutrition with lead poisoning, which of the following information is appropriate for the nurse to include in the teaching?
D) Ensure the child's dietary intake of calcium and iron is adequate Rationale: A child who has an elevated blood lead level should have an adequate intake of calcium and iron to reduce the absorption and effects of the lead. Dietary recommendations should include milk as a good source of calcium.
A nurse is assisting a provider during a femoral venipuncture on a toddler. The nurse should place the child in which of the following positions?
D) Supine Rationale: The client is placed in the supine position, with the client's legs in a frog position
A nurse is teaching the parent of an infant about food allergens. Which of the following foods should the nurse include as being the most common food allergy in children?
A) Cow's milk Rationale: According to evidence-based practice, the nurse should instruct the parent that cow's milk is the most common food allergy in children. Some children are sensitive to the protein, called casein, found in cow's milk. They have difficulty metabolizing the casein and are, therefore, allergic to cow's milk
A nurse providing teaching about promoting sleep with the parent of a 3-year-old toddler. Which of the following should the nurse include?
A) Follow a nightly routine and establish bedtime Rationale: Preschool-age children test limits. Consistency in approach to bedtime is very important. Bedtime is more likely to be pleasant for everyone if a routine is established and followed every night.
A nurse is assessing a 12-month-old male infant's vital signs during a well-child visit. The infant is in the 90th percentile of height. Which of the following findings should the nurse report to the provider?
A) HR 175/min Rationale: A HR of 175/min is above the expected reference range for a 12-month-old infant; therefore, the nurse should report this finding to the provider.
A nurse is planning care for a 10-month-old infant who has suspected failure to thrice (FTT). Which of the following interventions should the nurse include in the plan of care? (SATA)
A) Observe the parent' actions when feeding the child Rationale: Inappropriate feeding techniques and meal patterns provided by parents can contribute to a child's growth failure B) Maintain a detailed record of food and fluid intake Rationale: A nutritional goal for the child who has suspected FTT is to correct nutritional deficiencies, which can be identified by recording all food and fluid intake.
A nurse is planning to collect a specimen from a male infant using a urine collection bag. Which of the following actions should the nurse take?
A) wash and dry the infant's genitalia and perineum thoroughly
A nurse is caring for a preschool-age child who is dying. Which of the following findings is an age-appropriate reaction to death by the child? (SATA)
A) The child views death as similar to sleep D) The child believes his thoughts can cause death E) The child thinks death is a punishment
A nurse is assessing a 7-year-old child's psychosocial development. Which of the following findings should the nurse recognize as requiring further evaluation?
C) The child complains daily about going to school Rationale: Complaining every day about going to school is an unexpected finding for a 7-year-old child. The child is in Erikson's psychosocial development stage of industry vs. inferiority. Children in this stage want to learn and master new concepts. If the child complains daily about going to school, it warrants further evaluation
A nurse is caring for a 15-month-old toddler who requires droplet precautions. Which of the following actions should the nurse take?
C) Wear a mask when assisting the toddler with meals Rationale: The nurse should wear a mask when within 3 to 6 feet of the toddler to prevent the transmission of infections that are spread via large droplet particles expelled in the air.
A nurse is assessing a 6-year-old child at a well-child visit. Which of the following findings requires further assessment by the nurse?
A) Presence of sparse, fine pubic hair rationale: The development of sexual characteristics prior to the age of 9 years in boys, and 8 years in girls, is an indication of precocious puberty and requires further evaluation
A nurse on a pediatric unis is reviewing the health record of a child who is demonstrating increasing levels of stress after admission. The nurse should identify which of the following findings as a risk factor for a stress-related reaction to hospitalization?
B) Frequent hospitalizations Rationale: Children who experience multiple and frequent hospitalizations are at an increased risk for stress-related reactions to hospitalizations
A nurse is preparing to administer a liquid medication to an infant. Which of the following actions should the nurse take?
B) Give the medication at the side of the infant's mouth Rationale: When administering medications to an infant, a needless oral syringe or medicine dropper is placed in the side of the mouth (buccal cavity alongside the tongue) to prevent gagging and aspiration.
A nurse is assessing a 9-month-old infant during a well-child visit. Which of the following indicates that the infant has a developmental delay?
B) Inability to vocalize vowel sounds Rationale: The infant should begin vocalizing vowel sounds at the age of 7 months, and by the age of 10 months, be able to say at least one word
A nurse is observing a mother who is playing peek-a-boo with her 8-month-old child. The mother asks if this game has any developmental significance. The nurse inform the mother that peek-a-boo helps develop which of the following concepts in the child?
C) Object Permanence Rationale: refers to the cognitive skill of knowing an object still exists even when it is out of sight. In discovering a hidden object while playing peek-a-boo, the infant experiences validation of this concept.
A nurse is teaching the parent of an infant about home safety. Which of the following information should the nurse include? (SATA)
C) Position the car seat so it is rear-facing D) Secure a safety gate at the top and bottom of the stairs E) Maintain the water heater temperature at 49 C (120 F)
A nurse is teaching the parent of a 12-month-old infant about nutrition. Which of the following statements by the parent indicates a need for further teaching?
D) "My infant drinks at least 2 quarts of skim milk each day." Rationale: As the infant transitions into toddlerhood, whole milk intake should average 24 to 30 oz per day. Too much milk can affect intake of solid foods and result in iron deficiency anemia. Skim milk is not recommended until after age 2 since it lacks essential fatty acids which are needed for growth and development.
A nurse is teaching a parent of a 12-month-old infant about development during the toddler years. Which of the following statements should the nurse include?
D) "Your child should be able to scribble spontaneously using a crayon at the age of 15 months." Rationale: The nurse should teach the parent that at the age of 15 months, the toddler should be able to scribble spontaneously, and by the age 18 months, the toddler should be able to make strokes imitatively.
A nurse in an emergency department is caring for an 8-year-old who is up-to-date with current immunization recommendations and has a deep puncture injury. Which of the following should the nurse anticipate administering?
D) Adult tetanus booster (Td) Rationale: Td is recommended for wound prophylaxis in children ages 7 years and older. Td is also recommended every 10 years after 18 years of age
A nurse is caring for an adolescent who is receiving pain medication via a PCA pump. When the nurse assesses the client's pain at 0800, the client describes the pain as a 3 on a scale of 1 to 10. At 1000, the client describes the pain as a 5. The nurse discovers the client has not pushed the button to deliver medication in the past 2 hour. Which of the following actions should the nurse take?
D) Reinforce teaching with the client about how to push the button to deliver the medication Rationale: The appropriate action at this time is to reinforce client teaching about the PCA. The nurse should remind the client about the availability of the medication, verify that the client knows how to use the equipment, and emphasize the importance of using it regularly to manage pain effectively
A nurse is planning to implement relaxation strategies with a young child proper to a painful procedure. Which of the following actions should the nurse take?
D) Rock the child in long rhythmic movements Rationale: The nurse can implement relaxation strategies by sitting with the child in a well-supported position such as against the chest, and then rocking or swaying back and forth in lone wide movements
A nurse is caring for a toddler and is preparing to administer 0.9% sodium chloride 100 mL IV to infuse over 4 hr. The drop factor of the manual IV tubing is 60 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Using a leading zero if it applies. Do not use a trailing zero.)
x= 25 Rationale: x gtt/min: 60 gtt/ min x 240 min/ 100 mL convert 4 hour to min = 240 min
