ATI RN
ATI Nursing Care of Children
1. A four-year-old child has a history of repeated otitis media despite antibiotic treatment. Which treatment measure should the nurse discuss with the parents?
- A. Antibiotic treatment
- B. Adenoidectomy
- C. The insertion of tympanostomy (pressure equalizing) tubes
- D. Tonsillectomy
Correct answer: C
Rationale: The correct answer is C: The insertion of tympanostomy (pressure equalizing) tubes. This treatment measure is appropriate for a child with recurrent otitis media as it helps drain fluid from the middle ear and prevent further infections. Adenoidectomy (choice B) involves the removal of the adenoids, which may not directly address the ear infections. Antibiotic treatment (choice A) has already been ineffective in this case, so alternative measures are necessary. Tonsillectomy (choice D) is not typically indicated for otitis media unless there are specific reasons such as enlarged tonsils contributing to the condition.
2. Which explains the importance of detecting strabismus in young children?
- A. Color vision deficit may result.
- B. Amblyopia, a type of blindness, may result.
- C. Epicanthal folds may develop in the affected eye
- D. Corneal light reflexes may fall symmetrically within each pupil
Correct answer: B
Rationale: Undetected strabismus can lead to amblyopia, where the brain favors one eye over the other, potentially resulting in permanent vision loss in the affected eye.
3. When caring for a child with an intravenous (IV) infusion, what is an appropriate nursing action?
- A. Change the insertion site every 24 hours.
- B. Check the insertion site frequently for signs of infiltration.
- C. Use a macrodropper to facilitate reaching the prescribed flow rate.
- D. Avoid restraining the child to prevent undue emotional stress.
Correct answer: B
Rationale: Frequent monitoring of the IV site for signs of infiltration is crucial to prevent tissue damage, especially in pediatric patients. Changing the site every 24 hours is unnecessary unless complications arise, and using a macrodropper is not specific to pediatric care.
4. A 14-month-old child is admitted to the hospital with laryngotracheobronchitis (LTB). Which assessment findings should the nurse expect?
- A. Cyanosis and dyspnea
- B. Productive cough and high fever
- C. Barking cough and inspiratory stridor
- D. Pale laryngeal and dyspnea
Correct answer: C
Rationale: The correct answer is C: 'Barking cough and inspiratory stridor.' Classic signs of laryngotracheobronchitis (LTB) include a barking cough, often described as a seal-like cough, and inspiratory stridor, which is a high-pitched sound heard during inspiration. These symptoms occur due to inflammation and narrowing of the upper airway. Choices A, B, and D are incorrect as they do not align with the typical assessment findings of LTB. Cyanosis and dyspnea (Choice A) may occur in severe cases but are not specific to LTB. Productive cough and high fever (Choice B) are more indicative of lower respiratory tract infections. Pale laryngeal and dyspnea (Choice D) are not characteristic findings of LTB.
5. When teaching a discipline class for parents of pre-schoolers, the nurse will be guided by which principle?
- A. Using the strictest form of punishment at the time of infraction is most effective
- B. Punishment increases unwanted behavior
- C. Discipline is to teach and gradually shift control from parents to child, promoting self-discipline
- D. Discipline and punishment are the same
Correct answer: C
Rationale: The correct principle to guide the nurse when teaching a discipline class for parents of pre-schoolers is that discipline is meant to teach and gradually shift control from parents to the child, promoting self-discipline. This approach focuses on educating children on appropriate behavior rather than solely relying on punishment. Choice A is incorrect because using the strictest punishment is not the most effective method for discipline. Choice B is incorrect because punishment can reinforce unwanted behavior if not used appropriately. Choice D is incorrect because discipline and punishment are not synonymous; discipline involves a broader aspect of teaching and guiding behavior.
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