ATI RN NURSING CARE OF CHILDREN PROCTORED EXAM

ATI RN NURSING CARE OF CHILDREN PROCTORED EXAM VERSION 1 1. A nurse is caring for a child who has absence seizures. Which of the following findings should the nurse expect? (Select all that apply.) A. Loss of consciousness B. Appearance of daydreaming C. Dropping held objects D. Falling to the floor E. E. Having a pierc ing cry 55a 1. A. CORRECT: Loss of consciousness for 5 to 10 seconds is a manifestation of an absence seizure. B. CORRECT : Behavior that resembles daydreaming is a manifestation of an absence seizure. C. CORRECT: A child who is having absence seizures might drop a held object. D. Falling to the floor is a manifestation of a tonic -clonicseizure. E. A piercing cry is a manifestation of a tonic -clonicseizure. 55b 2. A nurse is caring for a child who just experienced a generalized seizure. Which of the following is the priority action fo r the nurse to take? A. Maintain the child in a side -lying position . B. Loosen the child's restrictive clothing. C. Reorient the child to the environment. D. Note the time and characteristics of the child's seizure. 56a 2. A. CORRECT: Following a seizure, children often experience vomiting. Using the airway, breathing, circulation priority -setting framework, the first action the nurse should take is to place the child in a side -lying position to maintain a patent airway and prevent aspiration of se cretions . B. Loosening the child's restrictive clothing is an appropriate action. However, it is not the priority action. C. R eorienting the child to the environment following a generalized seizure is an appropriate action. However, it is not the priorit y action. D. Noting the time and characteristics of the child's seizure is an appropriate action. However, it is not the priori ty action. 56b 3. A nurse is providing teaching to the parent of a child who is to have an electroencephalogram (EEG). Which of t he following responses should the nurse include in the teaching? A. "Decaffeinated beverages should be offered on the morning of the procedure . " B. "Do not wash your child's hair the night before the procedure." C. "Withhold all foods the morning of the procedure." D. "Give your child an analgesic the night before the procedure." 57a 3. A. CORRECT: Caffeine can alter the results of an EEG and should be avoided prior to the test. B. The child's hair should be washed to remove oils that permit adherence of the EEG electrodes. C. Foods are not withheld prior to an EEG. D. Analgesics can alter the results of an EEG and should be avoided prior to the test. 57b 4. A nurse is teaching a group of parents about the risk factors for seizures. Which of the following factors should the nurse include in the teaching? (Select all that apply.) A. Febrile episodes B. Hypoglycemia C. Sodium imbalances D. Low serum lead levels E. Presence of diphtheria 58a 4. A. CORRECT: Febrile episodes can cause general tonic ‑clonic seizures in infants and young children. B. CORRECT: Seizure activity is a late manifestation ofhypoglycemia. C. CORRECT: Seizure activity is a manifestation of hyponatremia and hyper natremia. D. High serum lead levels are a risk factor for seizureactivity. E. Diphtheria is a respiratory illness causing difficulty breathing and is not a risk factor for seizures 58b 5. A nurse is reviewing treatment options with the parent of a child who has worsening seizures. Which of the following treatment options should the nurse include in the discussion? (Select all that apply.) A. Vagal nerve stimulator B. Additional antiepi leptic medications C. Corpus callosotomy D. Focal resection E. Radiation therapy 59a 5. A. CORRECT: The implantation of a vagal nerve stimulator is an option to provide seizure control. B. CORRECT: Additional antiepileptic medication can be added to the current medication regime to control seizures. C. CORRECT: A corpus callosotomy can be performed for uncontrolled seizures. D. CORRECT: A focal resection can be performed for uncontrolled seizures . E. R adiation therapy is used in cancer treatment and is not used to control seizures. 59b 1. A nurse is in the emergency department is assessing a child following a motor ‑vehicle crash. The child is unresponsive, has spontaneous respirations of 22/min, and has a laceration on the forehead that is bleeding. Which of the following actions should the nurse take first? A. Stabilize the child's neck. B. Clean the child's lacerati on with soap and water. C. Implement seizure precautions for the child. D. D. Initiate IV access for the child. 60a 1. A. CORRECT: The greatest risk to a child following a motor vehicle crash is cervical injury. Therefore, keeping the neck stabilized until cervical injury can be ruled out is the priority action. B. Cleaning the child's laceration with soap and water is important. However, this is not the priority action. C. Implementing seizure precautions is important. However, this is no t the priority action. D. E stablishing IV access is important. However, this is not the priority action. 60b 2. A nurse is caring for an adolescent who has a closed head injury. Which of the following findings are indications of increased intracranial pr essure (ICP)? (Select all that apply.) A. Report of headache B. Alteration in pupillary response C. Increased motor response D. Increased sleeping E. Increased sensory response 61a 2. A. CORRECT: A headache is an indication of ICP. B. CORRECT: Alterations in pupillary response is an indication of ICP . C. D ecreased motor response is an indication ofICP. D. CORRECT: Increased sleeping is an indication ofICP. E. D ecreased sensory response is an indication ofICP. 61b 3. A nurse is caring for a child who has ICP. Which of the following actions should the nurse take? (Select all that apply.) A. Suction the endotracheal tube every 2 hr. B. Maintain a quiet environment. C. C. Use two pillows to elevate the head. D. Administer a stool softener. E. Maintain body alignment. 62a 3. A. R outine suctioning of the endotracheal tube is contraindicated because there is a risk of the catheter entering the bra in through a skull fracture. B. CORRECT: Stimulation can cause increased intracranial pressure; therefore, the nur se should maintain a quiet environment. C. Pillows under the head cause flexion of the neck and increase intracranial pressure. D. CORRECT: Increased pressure in the abdomen with the Valsalva maneuver can increase intracranial pressure; therefore, the nurse should administer a stool softener. E. CORRECT: Flexion and extension of the neck or hips increase intracranial pressur e; therefore, the nurse should maintain body alignment. 62b 4. A nurse is assessing a child who has a concussion. W hich of the following findings should the nurse expect? (Select all that apply.) A. Amnesia B. Systemic hypertension C. Bradycardia D. Respiratory depression E. Confusion 63a 4. A. CORRECT: Amnesia is a manifestation of a concussion. B. Systemic hypertension is a manifestation of Cushing's triad in a child who has an epidural hematoma. C. CORRECT: Bradycardia is a manifestation of Cushing's triad in a child who has an epidural hema toma. D. CORRECT: Respiratory depression is a manifestation of Cushing's triad in a child who has an epidural hematoma. E. CORRECT: Confusion is a manifestation of a concussion. 63b 5. A nurse is caring for a child who is taking mannitol for cerebral edema. Wh ich of the following adverse effects should the nurse monitor the child for and report to the provider? A. Bradycardia B. Weight loss C. Confusion D. Constipation 64a 5. A. Tachycardia is an adverse effect of mannitol. B. Weight gain due to urinary retention is an adverseeffect of mannitol. C. CORRECT: The nurse should monitor the child forincreased confusion and report this adverse effect to the provider. This could be an indication of electrolyte imbalance. D. Diarrhea is an adverse effect of mannitol. 64b Chapter 15 Cognitive and Sensory Impairments 1. A nurse is planning to perform a peripheral vision test on a child. Which of the following actions should the nurse t ake? A. Place the child 10 feet away from a Snellen chart. B. Show a set of cards to the child one at a time. C. Cover the child's eye while performing the test on the other eye. D. Have the child focus on an object while performing the test. 65a 1. A. T he nurse should place the child 10 feet away from a Snellen chart when performing a visual acuity test. B. T he nurse should show a set of cards to the child one at a time when performing a color test. C. T he nurse should cover the child's eye whilepe rforming the test on the other eye when performing a cover test. D. CORRECT: When performing a peripheral vision test, the nurse asks the child to focus on an object while bringing a pencil into the chi ld's peripheral vision. 65b 2. A nurse is teaching a g roup of parents about possible manifestations of Down syndrome. Which of the following findings should the nurse include in the teaching? (Select all that apply.) A. A large head with bulging fontanels B. Larger ears that are set back C. Protruding abdomen D. Broad, short feet and hands E. Hypotonia 66a 2. A. A child who has hydrocephalus will exhibit a large head with bulging fontanels due to the increased CSF in the head. B. A child who has Down syndrome will e xhibit small features, such as small ears with a short pinna. C. CORRECT: A child who has Down syndrome will exhibit a protruding abdomen. D. CORRECT: A child who has Down syndrome will exhibit small features, such as broad, short feet and hands. E. CORRE CT: A child who has Down syndrome will exhibit hyperflexibility and hypotonia. 66b 2. A nurse is teaching a group of parents about possible manifestations of Down syndrome. Which of the following findings should the nurse include in the teaching? (Select a ll that apply.) A. A large head with bulging fontanels B. Larger ears that are set back C. Protruding abdomen D. Broad, short feet and hands E. Hypotonia 67a ... 67b 3. A nurse is assessing a child who has myopia. Which of the following findings should the nurse expect? (Select all that apply.) A. Headaches B. Photophobia C. Difficulty reading D. Difficulty focusing on close objects E. Poor school performance 68a 3. A. CORRECT: Headaches are a manifestation of myopia. B. P hotophobia is a manifestation of strabismus. C. CORRECT: Difficulty reading is a manifestation of myopi a. D. D ifficulty focusing on close objects is amanifestation of hyperopia.