ATI RN
Nursing Care of Children ATI
1. A child with nephrotic syndrome is severely edematous. The primary healthcare provider has placed the child on bed rest. Which nursing intervention should be included in the plan of care?
- A. Monitor blood pressure every 30 minutes.
- B. Reposition the child every two hours.
- C. Limit visitors.
- D. Encourage fluids.
Correct answer: B
Rationale: Repositioning the child every two hours is essential to prevent pressure ulcers and promote circulation, especially when the child is on bed rest and experiencing severe edema. Monitoring blood pressure is important but does not need to be done every 30 minutes unless indicated. Limiting visitors and encouraging fluids are not directly related to managing edema and preventing complications from immobility. Therefore, choice B is the most appropriate nursing intervention in this scenario.
2. In teaching parents about appropriate pacifier selection, the nurse should recommend which characteristic?
- A. Easily grasped handle
- B. Detachable shield for cleaning
- C. Soft, pliable material
- D. Ribbon or string to secure to clothing
Correct answer: A
Rationale: A pacifier with an easily grasped handle is safer and more convenient for the infant to use without the risk of choking hazards that detachable parts might pose.
3. What is the priority nursing intervention for a child with epiglottitis?
- A. Administer antibiotics
- B. Maintain airway patency
- C. Provide hydration
- D. Monitor vital signs
Correct answer: B
Rationale: The correct answer is B: Maintain airway patency. When dealing with a child with epiglottitis, the priority nursing intervention is to ensure airway patency to prevent airway obstruction, which can lead to respiratory distress or failure. Administering antibiotics (choice A) is important to treat the infection, but airway management takes precedence. Providing hydration (choice C) and monitoring vital signs (choice D) are essential aspects of care but are secondary to securing the airway in a child with epiglottitis.
4. The school nurse is teaching a group of adolescents about avoiding contaminated water during a mission trip. What should the nurse include in the teaching?
- A. Ice
- B. All are applicable
- C. Raw vegetables
- D. Unpeeled fruits
Correct answer: B
Rationale: The correct answer is B: All are applicable. Ice, raw vegetables, and unpeeled fruits can be sources of contamination in areas where water purity is questionable. It's safer to avoid these during a mission trip to prevent waterborne illnesses. Choice A (Ice), C (Raw vegetables), and D (Unpeeled fruits) are all potential sources of contamination in areas with questionable water quality. Including all these items in the teaching will help adolescents make informed decisions to stay healthy during their mission trip.
5. The parents of a 2-month-old boy are concerned about spoiling their son by picking him up when he cries. What is the nurse's best response?
- A. Allow him to cry for no longer than 15 minutes and then pick him up
- B. Babies need comforting and cuddling. Meeting these needs will not spoil him
- C. Babies this young cry when they are hungry. Try feeding him when he cries
- D. If he isn’t soiled or wet, leave him, and he'll cry himself to sleep
Correct answer: B
Rationale: Comforting and cuddling a 2-month-old baby when they cry helps build trust and security. At this age, responding to cries does not lead to spoiling, but rather supports healthy emotional development.
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