2021
NURSING CARE OF
CHILDREN FINAL ATI
QUESTIONS AND
ANSWERS
, Nursing Care of Children Final
A1) A nurse is caring for a child who is receiving treatment for diabetic ketoacidosis and has a
current blood glucose level of 250mg/dL. Which of the following actions should the nurse take?
A. Administer 5% dextrose in 0.9% sodium chloride by continuous IV infusion.
When the child’s blood glucose level falls between 250 and 300 mg/dL,
the nurse should begin IV infusion of 5% or 10% dextrose in 0.9%
sodium chloride. The goal is to maintain blood glucose levels between
120 and 240 mg/dL. If dextrose is not added, hypoglycemia might
occur.
B. Give potassium as a rapid IV bolus.
Giving potassium as a rapid IV bolus is contraindicated because it can
result in cardiac arrest.
C. Administer 3 units of ultralente insulin subcutaneously.
Ultralente is long-acting insulin that takes 6 to 14 hr to begin working.
Regular insulin will be given via IV infusion until the blood sugar
reaches 250 to 300 mg/dL. If the regular insulin infusion continues,
hypoglycemia can occur.
D. Obtain an HbA1c level stat.
An HbA1c level measures the blood glucose level over the last 2 to 3
months and will not give useful information for the client’s current
status.
2) A nurse is caring for a child who has Tetralogy of Fallot. Which of the following laboratory
values should the nurse expect to find?
A. Platelet count of 20,000/mm 3
A platelet count of 20,000/mm is below the expected range. A child
3
who has Tetralogy of Fallot will not have a decreased platelet count.
B. WBC 4,000/mm 3
, A WBC count of 4,000/mm is below the expected reference range. A
3
child who has Tetralogy of Fallot will not have neutropenia.
C. Thyroid stimulating hormone 7.0 microunits/mL
This TSH level is above the expected reference range. A child who has
Tetralogy of Fallot will not have changes in the thyroid function levels.
D. RBC 6.8 million/uL
A child who has Tetralogy of Fallot causes cyanosis; therefore, the body
responds by increasing RBC production (polycythemia) in an attempt to
supply oxygen to all body parts.
3) A nurse is planning care for a preschool-age child who has autism and is being admitted to
the facility. Which of the following actions should the nurse plan to take?
A. Encourage the parents to bring in the child's stuffed animal.
Encouraging parents to bring in a child’s favorite stuffed animal helps
lessen the disruptiveness of hospitalization.
B. Give the child choices when planning daily activities.
Children who have autism have difficulty organizing behaviors;
therefore, it is best to not give choices.
C. Administer phenytoin three times per day.
Phenytoin is taken by children who have seizure disorders.
D. Provide a shared room with another child his age.
Children who have autism need decreasing stimulation and avoidance
of auditory or visual distraction. These children should have a private
room.
4) A nurse is caring for a child who has a vesicular rash. The parents of the child asks the nurse
what illness can cause this rash for 6 days. The nurse should expect that the child has which of
the following conditions?
A. Measles
, A child who has measles might develop Koplik spots, a transient
cephalocaudal rash of maculopapular eruptions of the upper trunk and
face, becoming more confluent as it spreads to the lower areas of the
body.
B. Fifth disease
A child who has fifth disease usually begins with bright red cheeks
producing a "slapped-cheek" appearance. Following this, a rash
appears on the extremities and trunk. The rash fades centrally, giving
a lacy (reticulated) appearance to the rash.
C. Tetanus
A child who has tetanus will develop lockjaw and muscle rigidity;
however, there is no rash associated with tetanus. Nurses recommend
the DTaP immunization to aid in prevention of this disease.
D. Varicella
Children who have varicella might commence with a maculopapular
rash that progresses to vesicles on erythematous bases that eventually
rupture and crust over.
5) A nurse is admitting a child who has acute lymphocytic leukemia. Which of the following
laboratory values should the nurse expect?
A. Platelet count 500,000 mm 3
A platelet count of 500,000 mm is above the expected reference
3
range. A child who has acute lymphocytic leukemia has a low platelet
count.
B. RBC 2.5 million/uL
An RBC of 2.5 million/uL is below the expected reference range. A child
who has acute lymphocytic leukemia has a low RBC.
C. WBC 4,000/mm 3
A WBC of 4,000/mm is below the expected reference range. A child
3
who has acute lymphocytic leukemia has a very high WBC.
D. Hct 60%
NURSING CARE OF
CHILDREN FINAL ATI
QUESTIONS AND
ANSWERS
, Nursing Care of Children Final
A1) A nurse is caring for a child who is receiving treatment for diabetic ketoacidosis and has a
current blood glucose level of 250mg/dL. Which of the following actions should the nurse take?
A. Administer 5% dextrose in 0.9% sodium chloride by continuous IV infusion.
When the child’s blood glucose level falls between 250 and 300 mg/dL,
the nurse should begin IV infusion of 5% or 10% dextrose in 0.9%
sodium chloride. The goal is to maintain blood glucose levels between
120 and 240 mg/dL. If dextrose is not added, hypoglycemia might
occur.
B. Give potassium as a rapid IV bolus.
Giving potassium as a rapid IV bolus is contraindicated because it can
result in cardiac arrest.
C. Administer 3 units of ultralente insulin subcutaneously.
Ultralente is long-acting insulin that takes 6 to 14 hr to begin working.
Regular insulin will be given via IV infusion until the blood sugar
reaches 250 to 300 mg/dL. If the regular insulin infusion continues,
hypoglycemia can occur.
D. Obtain an HbA1c level stat.
An HbA1c level measures the blood glucose level over the last 2 to 3
months and will not give useful information for the client’s current
status.
2) A nurse is caring for a child who has Tetralogy of Fallot. Which of the following laboratory
values should the nurse expect to find?
A. Platelet count of 20,000/mm 3
A platelet count of 20,000/mm is below the expected range. A child
3
who has Tetralogy of Fallot will not have a decreased platelet count.
B. WBC 4,000/mm 3
, A WBC count of 4,000/mm is below the expected reference range. A
3
child who has Tetralogy of Fallot will not have neutropenia.
C. Thyroid stimulating hormone 7.0 microunits/mL
This TSH level is above the expected reference range. A child who has
Tetralogy of Fallot will not have changes in the thyroid function levels.
D. RBC 6.8 million/uL
A child who has Tetralogy of Fallot causes cyanosis; therefore, the body
responds by increasing RBC production (polycythemia) in an attempt to
supply oxygen to all body parts.
3) A nurse is planning care for a preschool-age child who has autism and is being admitted to
the facility. Which of the following actions should the nurse plan to take?
A. Encourage the parents to bring in the child's stuffed animal.
Encouraging parents to bring in a child’s favorite stuffed animal helps
lessen the disruptiveness of hospitalization.
B. Give the child choices when planning daily activities.
Children who have autism have difficulty organizing behaviors;
therefore, it is best to not give choices.
C. Administer phenytoin three times per day.
Phenytoin is taken by children who have seizure disorders.
D. Provide a shared room with another child his age.
Children who have autism need decreasing stimulation and avoidance
of auditory or visual distraction. These children should have a private
room.
4) A nurse is caring for a child who has a vesicular rash. The parents of the child asks the nurse
what illness can cause this rash for 6 days. The nurse should expect that the child has which of
the following conditions?
A. Measles
, A child who has measles might develop Koplik spots, a transient
cephalocaudal rash of maculopapular eruptions of the upper trunk and
face, becoming more confluent as it spreads to the lower areas of the
body.
B. Fifth disease
A child who has fifth disease usually begins with bright red cheeks
producing a "slapped-cheek" appearance. Following this, a rash
appears on the extremities and trunk. The rash fades centrally, giving
a lacy (reticulated) appearance to the rash.
C. Tetanus
A child who has tetanus will develop lockjaw and muscle rigidity;
however, there is no rash associated with tetanus. Nurses recommend
the DTaP immunization to aid in prevention of this disease.
D. Varicella
Children who have varicella might commence with a maculopapular
rash that progresses to vesicles on erythematous bases that eventually
rupture and crust over.
5) A nurse is admitting a child who has acute lymphocytic leukemia. Which of the following
laboratory values should the nurse expect?
A. Platelet count 500,000 mm 3
A platelet count of 500,000 mm is above the expected reference
3
range. A child who has acute lymphocytic leukemia has a low platelet
count.
B. RBC 2.5 million/uL
An RBC of 2.5 million/uL is below the expected reference range. A child
who has acute lymphocytic leukemia has a low RBC.
C. WBC 4,000/mm 3
A WBC of 4,000/mm is below the expected reference range. A child
3
who has acute lymphocytic leukemia has a very high WBC.
D. Hct 60%
