ATI RN
ATI Nursing Care of Children 2019 B
1. Which condition is characterized by a 'seal-like' barking cough in children?
- A. Croup
- B. Asthma
- C. Bronchitis
- D. Pneumonia
Correct answer: A
Rationale: Croup is the correct answer. Croup is characterized by a 'seal-like' barking cough due to inflammation and narrowing of the upper airways, particularly the larynx and trachea. It is most common in young children and can cause significant respiratory distress, especially at night. Treatment often includes humidified air and corticosteroids. Asthma (choice B) typically presents with wheezing and shortness of breath, not a barking cough. Bronchitis (choice C) is characterized by productive cough with mucus, not a barking cough. Pneumonia (choice D) often presents with fever, productive cough, and chest pain, not a barking cough.
2. Pretending a sheet is a cape to mimic a superhero is characteristic of which childhood phenomenon?
- A. Artificialism
- B. Symbolic functioning
- C. Critical thinking
- D. Dramatic play
Correct answer: B
Rationale: The correct answer is B, symbolic functioning. Symbolic functioning refers to children using objects, actions, or ideas to represent other objects, actions, or ideas. In this scenario, pretending a sheet is a cape to mimic a superhero demonstrates the child's ability to engage in symbolic play. Choice A, artificialism, is incorrect as it refers to the belief that inanimate objects have lifelike qualities. Choice C, critical thinking, does not directly relate to the imaginative play described in the question. Choice D, dramatic play, is close but not as precise as symbolic functioning, which specifically highlights the use of objects to represent something else.
3. A child with acetylsalicylic acid (aspirin) poisoning is being admitted to the emergency department. What early clinical manifestation does the nurse expect to assess on this child?
- A. Hematemesis
- B. Hematochezia
- C. Hyperglycemia
- D. Hyperventilation
Correct answer: D
Rationale: Early signs of aspirin poisoning include hyperventilation due to the stimulation of the respiratory center and the resultant respiratory alkalosis. Hematemesis, hematochezia, and hyperglycemia can occur later in the poisoning process or may not be directly related to aspirin toxicity.
4. What tool would be most useful to assess maternal and newborn attachment behaviors?
- A. Apgar
- B. Ballard scale
- C. NCAST (Nursing Child Assessment Satellite Training) Feeding Scale
- D. Brazelton Neonatal Behavioral Assessment Scale
Correct answer: C
Rationale: The NCAST Feeding Scale is the most suitable tool to evaluate maternal and newborn attachment behaviors during feedings. It focuses on observing the interaction between the parent and infant, providing insights into their bonding. The Apgar score is used to assess a neonate's immediate transition to life outside the womb, not specifically maternal and newborn attachment behaviors. The Ballard scale is used to estimate gestational age, not to assess attachment behaviors. The Brazelton Neonatal Behavioral Assessment Scale is designed to evaluate a newborn's responses to various stimuli, not specifically maternal and newborn attachment behaviors.
5. An intravenous line is needed in a school-age child. What medication is an appropriate analgesic for use with this patient?
- A. TAC (tetracaine, epinephrine [Adrenalin], cocaine) 15 minutes before the procedure.
- B. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
- C. EMLA (eutectic mixture of local anesthetics) immediately before the procedure.
- D. LMX (4% liposomal lidocaine cream) 30 minutes before the procedure.
Correct answer: D
Rationale: LMX is an effective analgesic agent when applied to the skin 30 minutes before a procedure. It eliminates or reduces the pain from most procedures involving skin puncture. TAC provides skin anesthesia about 15 minutes after application to nonintact skin, making it more suitable for wound suturing. Transdermal fentanyl patches are designed for continuous pain control, not rapid pain control needed for a procedure like venipuncture. EMLA, for maximum effectiveness, must be applied approximately 60 minutes before the procedure, making it less suitable for immediate pain relief required for intravenous line placement.
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