ATI RN
ATI Nursing Care of Children
1. The parents of an 8-month-old infant voice concern to the nurse that their infant is not developing motor skills as the infant should. What question would be appropriate for the nurse to ask in determining if their fears are warranted?
- A. Does the infant move a toy back and forth from one hand to the other?
- B. Is the infant able to drink from a cup by oneself?
- C. Is the infant able to hold a pencil and scribble on paper?
- D. Does the infant place toys into a box or container and take them out?
Correct answer: A
Rationale: The correct answer is A. By 8 months, an infant should be able to transfer objects between hands, which is an important motor skill milestone. This action shows coordination and developing fine motor skills. Choices B, C, and D involve more advanced motor skills that are typically not expected at 8 months of age. Drinking from a cup, holding a pencil to scribble, and engaging in purposeful play with toys are skills that develop later in infancy.
2. An infant, age 5 months, is brought to the clinic by his parents for a well-baby checkup. What is the best advice that the nurse should include at this time about injury prevention?
- A. Keep buttons, beads, and other small objects out of his reach.
- B. Do not permit him to chew paint from window ledges because he might absorb too much lead.
- C. When he learns to roll over, you must supervise him whenever he is on a surface from which he might fall.
- D. Lock the crib sides securely because he may stand and lean against them and fall out of bed.
Correct answer: A
Rationale: Small objects are a choking hazard for infants, so it is crucial to keep them out of reach to prevent injury.
3. 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.
4. The nurse is performing an assessment on a 10-week-old infant. The nurse understands that the developmental characteristic of hearing at this age is which?
- A. The infant responds to his own name.
- B. The infant localizes sounds by turning his head directly to the sound.
- C. The infant turns his head to the side when sound is made at the level of the ear.
- D. The infant locates sound by turning his head to the side and then looking up or down.
Correct answer: C
Rationale: By 10 weeks, infants typically turn their heads to the side to locate the source of a sound made at ear level.
5. Nurses should be alert for increased fluid requirements in which circumstance?
- A. Fever
- B. Mechanical ventilation
- C. Congestive heart failure
- D. Increased intracranial pressure
Correct answer: A
Rationale: Fever increases metabolic rate, leading to insensible water loss, thus requiring increased fluid intake. Mechanical ventilation, CHF, and increased intracranial pressure generally require fluid restriction rather than increased fluid intake.
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