ATI RN
Nursing Care of Children Final ATI
1. The nurse is using a bulb syringe to suction a neonate after delivery. What is an important consideration?
- A. Compress the bulb before insertion.
- B. Clear the mouth and pharynx before the nasal passages.
- C. Use two bulb syringes, one for the mouth and pharynx and one for the nasal passages.
- D. Continue using a bulb syringe until secretions are removed as mechanical suction is contraindicated.
Correct answer: B
Rationale: The correct consideration when using a bulb syringe to suction a neonate after delivery is to clear the mouth and pharynx before the nasal passages to prevent aspiration of amniotic fluid. Compressing the bulb syringe before insertion is important to create suction. Using two bulb syringes is unnecessary, as one is sufficient for both the mouth/pharynx and nasal passages. It is not recommended to continue using a bulb syringe until all secretions are removed; instead, mechanical suction can be employed if more forceful removal of secretions is required.
2. An adolescent patient wants to make decisions about treatment options, along with his parents. Which moral value is the nurse displaying when supporting the adolescent to make decisions?
- A. Justice
- B. Autonomy
- C. Beneficence
- D. Nonmaleficence
Correct answer: B
Rationale: Supporting an adolescent in making decisions about their care reflects the moral value of autonomy, emphasizing the importance of respecting the patient's right to make informed choices.
3. A 5-year-old is hospitalized with a fractured femur. Which pain assessment tool is appropriate for this child?
- A. CRIES Scale
- B. Faces Pain Rating Scale
- C. SUN Scale
- D. NIPS Scale
Correct answer: B
Rationale: The Faces Pain Rating Scale is appropriate for assessing pain in children who can express their feelings visually. For a 5-year-old child who can communicate effectively, using a tool like the Faces Pain Rating Scale, which uses facial expressions to indicate pain levels, is more suitable than the CRIES Scale (used for neonates), the SUN Scale (used for infants), or the NIPS Scale (used for preterm and term newborns).
4. At which age should the nurse expect most infants to begin to say mama and dada with meaning?
- A. 4 months
- B. 6 months
- C. 10 months
- D. 14 months
Correct answer: C
Rationale: By around 10 months, infants often start to say "mama" and "dada" with meaning, associating these words with their parents.
5. The nurse is preparing a presentation on compensated, decompensated, and irreversible shock in children. What clinical manifestations related to decompensated shock should the nurse include? (Select all that apply.)
- A. All below
- B. Oliguria
- C. Confusion
- D. Pale extremities
Correct answer: A
Rationale: Decompensated shock is characterized by signs such as oliguria, confusion, pale extremities, hypotension, and a thready pulse. These indicate that the body is no longer able to maintain adequate circulation to vital organs.
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