ATI Real Life 3.0- RN Nursing Care of Children: Well Child
Scenario Nurse Denise calculates and plots Chloe's body mass index (BMI). Question Nurse Denise calculates Chloe's body mass index (BMI) using this formula: weight (kg) divided by stature (cm) divided by stature (cm) multiplied by 10,000 or weight (lb) divided by stature (in) divided by stature (in) multiplied by 703. Select the area of the chart where Denise should plot Chloe's BMI. (Selectable areas, or "Hot Spots," can be found by moving your cursor over the artwork until the cursor changes appearance, usually into a hand. Click only on the Hot Spot that corresponds to your answer.)
Rationale The calculated BMI of 30 is correct. Weight in pounds (height in inches x height in inches) x 703 = BMI 200 / (68 x 68) x 703 = 30.4 = 30
Scenario Nurse Denise reviews infant acetaminophen dosage with Ms. Johnson. Question Nurse Denise reviews the appropriate dosage of acetaminophen with Ms. Johnson. The provider prescribed children's acetaminophen, which is available as 160 mg/5 mL. The recommended dose is 10 to 15 mg/kg. Fay weighs 18 lb. Which of the following is the dosage range that Denise should tell Fay's parents to give at home? (Round the answer to the nearest tenth.)
Selected Option 2.6 to 3.8 mL
Scenario Nurse Denise calculates the ibuprofen dosage for Kellen. Question Nurse Denise is calculating Kellen's dose of ibuprofen. Available is a liquid preparation that contains 100 mg/5 mL. The label indicates to administer 10 mg/kg/dose. Kellen weighs 27.5 lb. How many mL should Denise tell Ms. Ralston to administer? (Round the answer to the nearest tenth.)
Selected Option 6.3
Scenario Nurse Denise is taking Kellen's vital signs. Question Nurse Denise auscultates Kellen's heart. Which of the following heart rates is within the expected range for Kellen?
Selected Option 89/min Rationale A heart rate of 89/min is within the expected reference range for a 24-month-old child.
Scenario Nurse Denise discusses weight loss ideas with Chloe. Question Nurse Denise prepares to discuss weight loss ideas with Chloe. Which of the following should Denise recommend Chloe integrate on a daily basis?
Selected Option Be physically active for at least 60 min. Rationale In addition to calorie reduction, the nurse should recommend physical activity for at least 60 min per day.
Scenario Nurse Denise reviews appropriate food choices for a 6-month-old with Fay's parents. Question Nurse Denise plans to review appropriate food choices with Fay's parents. Which of the following foods are appropriate for Fay?
Selected Option Finely mashed peas Rationale The client should start eating pureed, strained, or finely mashed cooked baby foods at 6 months.
Nurse Denise discusses Kellen's immunization status, and Ms. Ralston appears upset. Which of the following responses by Denise is appropriate?
"You appear upset. Can we discuss your thoughts regarding immunizations?" Rationale This response acknowledges the client is upset and seeks clarification of her perceptions of immunizations.
Scenario Nurse Denise begins a developmental screening of fine motor skills. Question Nurse Denise performs a developmental screening of fine motor skills on Fay. Which of the following fine motor skills should Fay demonstrate?
Selected Option Holds her bottle when feeding Rationale At 6 months, the client should be able to hold her own bottle.
Scenario Nurse Denise is discussing immunizations with Chloe and her father. Question Nurse Denise is discussing immunizations with Chloe and her father. Which of the following vaccinations should Denise anticipate administering to Chloe today? (Select all that apply.)
Selected Option Human Papilloma Virus (HPV) Tetanus, diphtheria, acellular pertussis (Tdap) Meningococcal Hepatitis A (Hep A) Rationale According to the Centers for Disease Control and Prevention guidelines, this client is missing the Tdap booster, HPV series, Hep A, series and meningococcal immunization. The DTaP series has been completed, and the rotavirus is not initiated 15 weeks or older.
Scenario Beth, the nurse practitioner, and Chloe are discussing her dysmenorrhea. Question Nurse Practitioner Beth, is educating Chloe about the use of ibuprofen (Advil) to minimize dysmenorrhea. Which of the following should Beth include in the teaching?
Selected Option Notify the provider immediately if you experience dark tarry stools. Rationale Although research studies show ibuprofen produces less gastric bleeding compared with aspirin, the client should contact the nurse or another health care provider if this occurs.
Scenario Ms. Johnson is asking Nurse Denise about immunizations for Fay. Question Nurse Denise prepares the vaccines for administration to Fay. Which of the following vaccines should Denise plan to administer first?
Selected Option Rotavirus Rationale Rotavirus is an oral vaccine; therefore, the nurse should administer this vaccine first because it is the least invasive.
Scenario Nurse Denise educates Ms. Ralston prior to administering the measles, mumps, rubella (MMR) and varicella vaccines. Question Nurse Denise is teaching Ms. Ralston about immunizations. Which of the following information should Denise include about measles, mumps, rubella (MMR) and varicella vaccines? (Select all that apply.)
Selected Option The client who has an egg allergy can receive the MMR and varicella vaccines. MMR and varicella vaccines should be administered subcutaneously. Mild illness is not a reason to delay vaccination with the MMR and varicella vaccines. Rationale Vaccination should not be delayed because of the presence of mild respiratory tract illness or other acute illness with or without fever. The nurse should administer the MMR and varicella vaccines subcutaneously. An allergy to eggs is not a contraindication to administration of the MMR and varicella vaccines; however, a gelatin allergy is a contraindication to receiving the vaccines. There is no causal link between MMR and varicella vaccines and autism.
Scenario Nurse Denise completes an assessment of Kellen's gross motor skills and is preparing to assess Kellen's fine motor skills. Question Nurse Denise is preparing to assess Kellen's fine motor development. Which of the following fine motor skills should Denise include in the assessment plan? (Select all that apply.)
Selected Option Turn each page of a book Unscrew lids on a container Stack six or seven blocks Rationale At age 2, toddlers can stack six or seven blocks, unscrew lids on a container, and turn each page of a book. At age 2, toddlers are not coordinated enough to draw a circle with eyes and nose or to thread shoelaces through shoe eyelets. These fine motor skills occur in children who are preschool age, 3 or 4.
Scenario Nurse Denise discusses Kellen's developmental milestones and gross motor skills. Question Nurse Denise is preparing to assess Kellen's gross motor development. Which of the following gross motor skills should Kellen accomplish? (Select all that apply.)
Selected Option Use a wide stance when running Walk up and down stairs with two feet on each step Kick a ball forward Rationale At age 2, toddlers should kick a ball forward without overbalancing, go up and down stairs alone with two feet on each step, and run reasonably well with a wide stance. At age 2, toddlers are not coordinated enough to balance on one foot or jump off the bottom step. These gross motor skills occur between the ages of 3 and 4.
Scenario Nurse practitioner Beth, is completing a physical exam of Chloe and considers additional topics to discuss. Question Nurse practitioner Beth is completing a physical exam of Chloe and considers additional topics to discuss. List three topics Beth should include in her discussion with Chloe. (Fill in the blank and click on the Submit button when you finish.)
Selected Option sexuality, school and level of interest, and psychological health Rationale 1. School and level of interest: How well does the client do in school and what is her level of interest? Does she take responsibility for schoolwork and complete it on time?2. Relationship with peers: Has the client ever been stalked or bullied in person or online? How does she feel about cyber bullying?3. Sexuality: How is the client responding to developmental changes? Is she in or has she had a heterosexual, and/or homosexual relationship? Has she had oral, vaginal, or anal sex, wanted or unwanted? Has she ever been forced or pressured to do something sexual that she did not want to do? If sexually active, are her partners younger, older, or the same age? Does she use condoms or other contraceptives?4. Psychological health: Is the client moody or does she have outbursts? Does she feel bored, sad, or irritable most of the time? Does she ever feel so sad she wishes she were not alive or wants to die? How does she manage conflict? How does she find ways to deal with stress? Does she overeat when stressed?5. Development related to risk of injury: Does the client tan? Does she wear her car seat belt? Does she wear a helmet or protective gear when biking or participating in roller sports? Does she have someone she can call for a ride if she feels unsafe riding with someone? Does she feel indestructible?6. Recreational use of substances: Has the client ever experimented with smoking, tobacco, alcohol, drugs, or steroids? Has she sniffed, huffed, or breathed anything to get high? Do her friends do any of these activities?
Scenario The nurse assesses Kellen's language development. Question Nurse Denise assesses Kellen's language development. Which of the following audio clips represents typical language development for a 24-month-old child? (Click to play the audio file.)
Selected option Audio file where the child says, "I love you" Rationale By 24 months of age, a child should be speaking two- to three-word phrases.
Scenario Nurse Denise plots Fay's height and weight on a growth chart. Question Nurse Denise is plotting Fay's height and weight on the growth chart. Identify the two locations that correspond to Fay's height and weight at today's well-baby check. (Select both options that apply.)
Selected option B & D Rationale The client's height reflects the 75th percentile and her weight reflects the 80th percentile, which indicates growth within the expected range for a 6-month-old infant.
Scenario Nurse Denise is educating Fay's parents about home safety. Question Nurse Denise is reviewing home safety with Fay's parents. Which of the following images illustrates a potential safety hazard for an infant?
Selected option Balloons near crib Rationale Parents should avoid latex balloons in the home environment because they pose risks of suffocation and aspiration to children. Latex is also a common allergen during childhood.