ATI RN
Nursing Care of Children Final ATI
1. Why is it difficult to assess a child’s dietary intake?
- A. No systematic assessment tool has been developed
- B. Biochemical analysis for assessing nutrition is expensive
- C. Families usually do not understand much about nutrition
- D. Recall of food consumption is frequently unreliable
Correct answer: D
Rationale: The correct answer is D. Recall of food intake, especially amounts eaten, is often unreliable. While systematic tools like the 24-hour recall and dietary history questionnaires exist, recall can still be challenging in accurately assessing a child's dietary intake. Choices A, B, and C are incorrect because systematic assessment tools do exist, biochemical analysis is not the primary method for dietary assessment, and families' understanding of nutrition may vary but is not the main reason for the difficulty in assessing a child's dietary intake.
2. At what age is the first dose of the hepatitis A vaccine recommended to be started?
- A. 1 year
- B. 1 month
- C. 12 years
- D. It is not recommended at any age
Correct answer: A
Rationale: The correct answer is A: 1 year. The hepatitis A vaccine is now recommended for all children starting at age 1 year (i.e., 12 to 23 months). This is due to the recognition of hepatitis A as a significant child health problem, especially in areas with high infection rates. The virus is primarily spread through fecal-oral transmission, person-to-person contact, ingestion of contaminated food or water, and rarely through blood transfusion. Administering the first dose at 1 year helps protect children from this infection. Choices B and C are incorrect as the vaccine is not recommended at 1 month or 12 years. Choice D is also incorrect as the hepatitis A vaccine is recommended at a specific age to prevent the infection.
3. A child is admitted with renal failure. Which of these findings should the nurse expect?
- A. Decreased BUN
- B. Azotemia and oliguria
- C. Increased glomerular filtration rate (GFR)
- D. Polyuria and elevated creatinine clearance
Correct answer: B
Rationale: Azotemia (elevated BUN and creatinine) and oliguria (reduced urine output) are classic signs of renal failure, indicating impaired kidney function. In renal failure, the kidneys are unable to effectively filter waste products, leading to an increase in BUN and creatinine levels in the blood. Additionally, oliguria occurs due to decreased kidney function. Increased GFR (Choice C) is not expected in renal failure as it signifies improved kidney function, which is not the case in renal failure. Polyuria and elevated creatinine clearance (Choice D) are not typical findings in renal failure. Polyuria is more commonly associated with conditions like diabetes insipidus, while elevated creatinine clearance would indicate increased kidney function, which is contrary to the impaired function seen in renal failure.
4. A parent of a school-age child tells the school nurse that the parents are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as what?
- A. Indicative of maladjustment
- B. A common reaction to divorce
- C. Suggestive of a lack of adequate parenting
- D. An unusual response that indicates a need for referral
Correct answer: B
Rationale: Poor academic performance and sleep disturbances are common reactions in children going through their parents' divorce, reflecting stress and adjustment challenges.
5. What information does the nurse include when teaching parents about nonpharmacologic strategies for pain management in children?
- A. May reduce pain perception.
- B. Make pharmacologic strategies unnecessary.
- C. Usually take too long to implement.
- D. Trick children into believing they do not have pain.
Correct answer: A
Rationale: The correct answer is A: 'May reduce pain perception.' When teaching parents about nonpharmacologic strategies for pain management in children, the nurse should include information that these techniques may help reduce pain perception, make the pain more tolerable, decrease anxiety, and enhance the effectiveness of analgesics. It is important to note that nonpharmacologic techniques should be learned before the pain occurs, and it is beneficial to use both pharmacologic and nonpharmacologic measures for pain control. Choice B is incorrect because nonpharmacologic strategies do not make pharmacologic strategies unnecessary but rather complement them. Choice C is incorrect as nonpharmacologic techniques, when properly learned and applied, do not usually take too long to implement. Choice D is incorrect as the goal of nonpharmacologic strategies is not to trick children into believing they do not have pain, but to help them cope with and manage their pain effectively.
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