ATI Nursing Care of Children Proctored Exam Version 2| Questions and Answers with Rationale| Latest 2022/2023

ATI Nursing Care of Children Proctored Exam Version 2| Questions and Answers 1. 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 an expected finding for this age group? A. Brightly colored mobile B. Plastic stethoscope C. Small piece jigsaw puzzle D. A book of short stories Rationale: Preschool play centers on imitative activities. Providing a stethoscope allows the child an opportunity for therapeutic play. Imitating health care personnel helps to ease the fear of unfamiliar equipment. 2. 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? A. Diphtheria, tetanus, and acellular pertussis (DTaP) vaccine B. A single injection of tetanus immune globulin (TIG) mixed with the pediatric tetanus booster (DT) C. Tetanus, diphtheria, and acellular pertussis (Tdap) vaccine 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. 3. A nurse is providing teaching about promoting sleep with the parent of a 3-year-old toddler. Which of the following information should the nurse include? A. Follow a nightly routine and established bedtime. B. Encourage active play prior to bedtime. C. Let the child remain awake until tired enough to go to sleep. D. Reward the child with a food treat just prior to sleep if the child goes to bed on time. 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. 4. A nurse is planning to implement relaxation strategies with a young child prior to a painful procedure. Which of the following actions should the nurse take? A. Ask the child to hold his breath and then blow it out slowly. B. Ask the child to describe a pleasurable event. C. Bounce the child gently while holding him upright. 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 long, wide movements. 5. 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 B. Decreased head circumference compared to full height C. Increased leg length related to height D. Presence of a loose, central incisor 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. 6. 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? (Select all that apply.) A. The child views death as similar to sleep. B. The child is interested in what happens to his body after death. C. The child recognizes that death is permanent. D. The child believes his thoughts can cause death. E. The child thinks death is a punishment. Rationale: The child views death as similar to sleep is correct. Preschool-age children might make this comparison. The child is interested in what happens to his body after death is not correct. A school-age child is interested in post-death services and what happens to the body after death due to an improved ability to comprehend what is happening. The child recognizes that death is permanent is not correct. Preschool-age children have difficulty understanding the concept of time and are therefore not likely to believe that death is permanent. They perceive death as reversible. The child believes his thoughts can cause death is correct. Preschool-age children believe that their thoughts and wishes can make things happen since they are egocentric. This is one reason why the death of a family member can be very difficult for a child at this age. The child thinks death is a punishment is correct. Preschool-age children sometimes believe that death is the result of guilt or punishment due to something they have done, said, or thought. 7. A nurse is teaching the parent of an infant about home safety. Which of the following information should the nurse include? A. Use a wheeled infant walker. B. Place soft pillows around the edge of the infant's crib. 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). Rationale: Using a wheeled infant walker is incorrect. A stationary infant walker is recommended. Wheeled infant walkers can quickly move across uneven surfaces and result in injury. Placing soft pillows and cushions around the edge of the infant’s crib is incorrect. Soft pillows and cushions should not be used in cribs due to the increased risk of suffocation. Positioning the car seat so it is rear-facing is correct. Infants and children should remain in the rear-facing position when in a car seat until the age of 2 years or until they reach the recommended height and weight per the manufacturer’s guidelines. Securing a safety gate at the top and bottom of the stairs is correct. As the infant begins to crawl and becomes more mobile, the risk of falls increases. Maintaining the water heater temperature at 49° C (120° F) is correct. To prevent a burn injury, the temperature of the water heater should not exceed 49° C (120° F). 8. 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 100, 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 hr. Which of the following actions should the nurse take? A. Ask the provider to discontinue the PCA so the nurse can administer PRN pain medication. B. Suggest the client's parent push the button for the client if the parent thinks the adolescent is having pain. C. Reevaluate the client in 1 hr since a pain level of 5 is acceptable on a scale of 1 to 10. D. Reinforce teaching with the client about how to push the button to deliver the med. 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. 9. 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. Heart rate 175/min B. Respiratory rate 26/min C. Blood pressure 88/40 mm Hg) D. Temperature 37.6° C (99.7° F Rationale: A heart rate 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. 10. 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? A. "I can give my baby 4 ounces of juice to drink each day." B. "I will offer my baby dry cereal and chilled banana slices as snacks." C. "I am introducing my baby to the same foods the family eats." 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. 11. 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? A. Side-lying B. Semi-recumbent C. Flexed sitting D. Supine