ATI RN
Nursing Care of Children ATI
1. The clinic nurse is assessing a child with a heavy ascariasis lumbricoides (common roundworm) infection. Which assessment findings should the nurse expect?
- A. Anemia
- B. Anorexia
- C. All are applicable
- D. Intestinal colic
Correct answer: D
Rationale: A heavy roundworm infection can cause anemia, anorexia, irritability, and an enlarged abdomen due to the worms’ effects on nutrient absorption and intestinal function.
2. Which assessment findings should the nurse expect in a child with sickle cell anemia experiencing an acute vaso-occlusive crisis?
- A. Circulatory collapse, hypovolemia
- B. Cardiomegaly, systolic murmur
- C. Hepatomegaly, intrahepatic cholestasis
- D. Painful swelling of joints in hands and feet, tissue engorgement
Correct answer: D
Rationale: The correct answer is D. Vaso-occlusive crises in sickle cell anemia are characterized by painful swelling of the joints in the hands and feet (hand-foot syndrome) and tissue engorgement due to the obstruction of blood flow by sickled cells. Choices A, B, and C are incorrect because circulatory collapse, hypovolemia, cardiomegaly, systolic murmur, hepatomegaly, and intrahepatic cholestasis are not typically associated with an acute vaso-occlusive crisis in sickle cell anemia.
3. Which condition is most commonly associated with a 'sunset sign' in infants?
- A. Hydrocephalus
- B. Meningitis
- C. Cerebral palsy
- D. Encephalitis
Correct answer: A
Rationale: The 'sunset sign,' characterized by downward-driven eyes, is most commonly associated with hydrocephalus. This condition causes increased intracranial pressure, leading to the eyes appearing to be forced downward. Meningitis (choice B) typically presents with symptoms such as fever, headache, and a stiff neck, but not the 'sunset sign.' Cerebral palsy (choice C) is a group of disorders affecting movement and muscle coordination, not directly related to the 'sunset sign.' Encephalitis (choice D) is inflammation of the brain, which can cause symptoms like fever, headache, and confusion, but not the specific downward eye gaze seen in the 'sunset sign.'
4. As children grow and develop, their style of play changes. Which play style is seen in the preschooler?
- A. Solitary
- B. Associative
- C. Cooperative
- D. Parallel
Correct answer: B
Rationale: The correct answer is B: Associative. Associative play is common in preschoolers, where children engage in separate activities but interact by sharing toys and talking with each other. This stage is characterized by more social interaction than solitary play (option A), where children play alone without interacting with others. Cooperative play (option C) involves children working together towards a common goal, which is typically seen in older children. Parallel play (option D) is when children play alongside each other but do not actively engage with one another, which is more common in toddlers.
5. During the 2-month well-child checkup, the nurse expects the infant to respond to sound in which manner?
- A. Respond to name
- B. React to loud noise with Moro reflex
- C. Turn his or her head to side when sound is at ear level
- D. Locate sound by turning his or her head in a curving arc
Correct answer: B
Rationale: At 2 months, infants typically react to loud noises with the Moro reflex, a startle response that is normal at this stage of development.
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