ATI RN
ATI Nursing Care of Children 2019 B
1. Which of the following is a characteristic finding in Kawasaki disease?
- A. Strawberry tongue
- B. Polyarthritis
- C. Hematuria
- D. Rashes
Correct answer: A
Rationale: A 'strawberry tongue' is a characteristic finding in Kawasaki disease. The presence of a 'strawberry tongue' is a classic sign of Kawasaki disease, along with other features such as conjunctivitis and rash. Choice B, polyarthritis, is not typically seen in Kawasaki disease. Choice C, hematuria, is not a common finding in Kawasaki disease but may be seen in other conditions. Choice D, rashes, are present in Kawasaki disease but are not as specific or characteristic as the 'strawberry tongue'. Therefore, the correct answer is A.
2. The nurse is taking a sexual history on an adolescent girl. Which is the best way to determine whether she is sexually active?
- A. Ask her, "Are you sexually active?"
- B. Ask her, "Are you having sex with anyone?"
- C. Ask her, "Are you having sex with a boyfriend?"
- D. Ask both the girl and her parent if she is sexually active
Correct answer: A
Rationale: Directly asking the adolescent if she is sexually active is the most straightforward and respectful approach, ensuring privacy and fostering trust.
3. A 12-year-old child had an appendectomy 18 hours ago. The nurse is monitoring the child for pain control. Which of the following tools is most appropriate for assessing the child’s pain?
- A. FLACC scale
- B. Numeric scale
- C. NIPS scale
- D. FACES scale
Correct answer: B
Rationale: The Numeric scale is the most appropriate tool for assessing pain in older children, like a 12-year-old, as they can comprehend and use numbers to indicate their pain levels accurately. The FLACC scale is typically used for nonverbal or preverbal children. The NIPS scale is designed for neonates and infants. The FACES scale is more commonly used in younger children who may have difficulty expressing their pain in other ways.
4. Why are neonates predisposed to problems with thermoregulation?
- A. Renal function is not fully developed
- B. Flexed posture favors heat loss
- C. A large body surface area favors heat loss to the environment
- D. A thick layer of subcutaneous fat provides excellent insulation
Correct answer: C
Rationale: Newborns have a large surface area relative to their body weight, making them more susceptible to heat loss and requiring careful thermoregulation. Choice A is incorrect because renal function is not directly related to thermoregulation. Choice B is incorrect because a flexed posture actually helps reduce heat loss by minimizing the surface area exposed to the environment. Choice D is incorrect because neonates have limited subcutaneous fat, which contributes to their susceptibility to heat loss.
5. A new parent, when asked by a nurse, explains that the 4-month-old infant has been nursing regularly every 3 to 4 hours and seems satisfied. However, the parent recently introduced solid food in the form of unbuttered popcorn to the infant as a supplement. What should be the primary nursing concern in this situation?
- A. Imbalanced nutrition, more than body requirements, related to introduction of a high-calorie food
- B. Risk for aspiration related to feeding the infant an inappropriate food
- C. Imbalanced nutrition, less than body requirements, related to introduction of a low-nutritive food
- D. Readiness for enhanced nutrition, related to the age of the infant
Correct answer: B
Rationale: The primary nursing concern in this situation is the risk for aspiration. Popcorn is a choking hazard for infants, as their airway is not fully developed to handle solid foods like popcorn. Choices A, C, and D are incorrect because the main focus should be on the immediate risk of aspiration due to the inappropriate solid food given to the infant, rather than on nutritional imbalances or readiness for enhanced nutrition.
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