NURS 307 ATI Real Life RN Nursing Care of Children Well Child.pdf
Reasoning Scenario Performance related to Outcomes:
Body
... [Show More] Function Strong Satisfactory Needs Improvement
Cardiac Output and Tissue Perfusion 100%
Cognition and Sensation 100%
Ingestion, Digestion, Absorption & Elimination 100%
Mobility 100%
Regulation and Metabolism 100%
NCLEX RN Strong Satisfactory Needs Improvement
Safety and Infection Control RN 2010 100%
Health Promotion and Maintenance RN 2010 100%
Psychosocial Integrity RN 2010 100%
Basic Care and Comfort RN 2010 100%
Pharmacological and Parenteral Therapies RN 2010 100%
Reduction of Risk Potential RN 2010 100%
QSEN Strong Satisfactory Needs Improvement
Safety 100%
Patient-Centered Care 100%
Informatics 100%
Decision Log:
Optimal Decision
Scenario The provider has not seen Kellen since his 6-week checkup.
Question Nurse Denise discusses Kellen’s immunization status, and Ms. Ralston appears upset. Which of the following responses by Denise is appropriate?
Selected Option “You appear upset. Can we discuss your thoughts regarding immunizations?”
Rationale This response acknowledges the client is upset and seeks clarification of her perceptions of immunizations.
Optimal Decision
Scenario Nurse Denise is taking Kellen’s vital signs.
Question Nurse Denise auscultates Kellen’s heart. Which of the following heart rates is within the expected range for Kellen?
Selected Option 89/min
Rationale A heart rate of 89/min is within the expected reference range for a 24-month-old child.
Optimal Decision
Scenario Nurse Denise discusses Kellen’s developmental milestones and gross motor skills.
Question Nurse Denise is preparing to assess Kellen’s gross motor development. Which of the following gross motor skills should Kellen accomplish? (Select all that apply.)
Selected Ordering Kick a ball forward
Walk up and down stairs with two feet on each step Use a wide stance when running
Rationale At age 2, toddlers should kick a ball forward without overbalancing, go up and down stairs alone with two feet on each step, and run reasonably well with a wide stance. At age 2, toddlers are not coordinated enough to balance on one foot or jump off the bottom step. These gross motor skills occur between the ages of 3 and 4.
Optimal Decision
Scenario Nurse Denise completes an assessment of Kellen’s gross motor skills and is preparing to assess Kellen’s fine motor skills.
Question Nurse Denise is preparing to assess Kellen’s fine motor development. Which of the following fine motor skills should Denise include in the assessment plan? (Select all that apply.)
Selected Ordering Stack six or seven blocks Unscrew lids on a container Turn each page of a book
Place small objects in a narrow-necked container
Rationale At age 2, toddlers can stack six or seven blocks, unscrew lids on a container, turn each page of a book, and place small objects in a narrow-necked container. At age 2, toddlers are not coordinated enough to draw a circle with eyes and nose. These fine motor skills occur at age 3.
Optimal Decision
Scenario The nurse assesses Kellen’s language development.
Question Nurse Denise assesses Kellen’s language development. Which of the following audio clips represents typical language development for a 24-month-old child? (Click to play the audio file.)
Selected Option “I love you.”
Rationale By 24 months of age, a child should be speaking two- to three-word phrases.
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Optimal Decision
Scenario Nurse Denise educates Ms. Ralston prior to administering the measles, mumps, rubella (MMR) and varicella vaccines.
Question Nurse Denise is teaching Ms. Ralston about immunizations. Which of the following information should Denise include about measles, mumps, rubella (MMR) and varicella vaccines? (Select all that apply.)
Selected Ordering Mild illness is not a reason to delay vaccination with the MMR and varicella vaccines.MMR and varicella vaccines should be administered subcutaneously.The client who has an egg allergy can receive the MMR and varicella vaccines.
Rationale Vaccination should not be delayed because of the presence of mild respiratory tract illness or other acute illness with or without fever. The nurse should administer the MMR and varicella vaccines subcutaneously. An allergy to eggs is not a contraindication to administration of the MMR and varicella vaccines; however, a gelatin allergy is a contraindication to receiving the vaccines. There is no causal link between MMR and varicella vaccines and autism.
Optimal Decision
Scenario Nurse Denise calculates the ibuprofen dosage for Kellen.
Question Nurse Denise is calculating Kellen’s dose of ibuprofen (Advil). Available is a liquid preparation that contains 100 mg/5 mL. The label indicates to administer 10 mg/kg/dose. Kellen weighs 27.5 lb. How many mL should Denise tell Ms.
Ralston to administer? (Round the answer to the nearest tenth.)
Selected Option 6.3
Rationale Ratio and Proportion
STEP 1: What is the unit of measurement to calculate? kg STEP 2: Set up an equation and solve for X.
2.2 lb/1 kg = Client's weight in lb/X kg
2.2 lb/1 kg = 27.5 lb/X kg X = 12.5
STEP 3: Round if necessary.
STEP 4: Reassess to determine if the equivalent makes sense. If 1 kg = 2.2 lb, it makes sense that 27.5 lb = 12.5 kg.
STEP 5: What is the unit of measurement to calculate? mg/dose STEP 6: Set up an equation and solve for X.
mg x kg/dose = X
10 mg x 12.5 = 125 mg/dose STEP 7: Round if necessary.
STEP 8: Reassess to determine if the equivalent makes sense. If 10 mg/kg/dose is prescribed and the client weighs 12.5 kg, it makes sense that the client should receive 125 mg/dose.
STEP 9: What is the unit of measurement to calculate? mL
STEP 10: What is the dose needed? Dose needed = Desired. 125 mg STEP 11: What is the dose available? Dose available = Have. 100 mg STEP 12: Should the nurse convert the units of measurement? No STEP 13: What is the quantity of the dose available? 5 mL
STEP 14: Set up an equation and solve for X. Have/Quantity = Desired/X
100 mg/5 mL = 125 mg/X mL X = 6.25 mL
STEP 15: Round if necessary. 6.25 = 6.3 mL
STEP 16: Reassess to determine if the equivalent makes sense. If there is 100 mg/5 mL and the prescribed dose is 125 mg, it makes sense to administer 6.3 mL. The nurse should administer ibuprofen 6.3 mL orally.
Optimal Decision
Scenario Nurse Denise is discussing immunizations with Chloe and her father.
Question Nurse Denise is discussing immunizations with Chloe and her father. Which of the following vaccinations should Denise anticipate administering to Chloe today? (Select all that apply.)
Selected Ordering Hepatitis A (Hep A) Meningococcal
Tetanus, diphtheria, acellular pertussis (Tdap) Human Papilloma Virus (HPV)
Rationale According to the Centers for Disease Control and Prevention guidelines, this client is missing the Tdap booster, HPV series, Hep A, series and meningococcal immunization. The DTaP series has been completed, and the rotavirus is not initiated 15 weeks or older.
Optimal Decision
Scenario Nurse Denise calculates and plots Chloe’s body mass index (BMI).
Question Nurse Denise calculates Chloe’s body mass index (BMI) using this formula: weight (kg) divided by stature (cm) divided by stature (cm) multiplied by 10,000 or weight (lb) divided by stature (in) divided by stature (in) multiplied by 703.
Select the area of the chart where Denise should plot Chloe’s BMI. (Selectable areas, or “Hot Spots,” can be found by moving your cursor over the artwork until the cursor changes appearance, usually into a hand. Click only on the Hot Spot that corresponds to your answer.)
Selected Option BMI is plotted as 30.
Rationale The calculated BMI of 30 is correct. Weight in pounds (height in inches x height in inches) x 703 = BMI 200 / (68 x 68) x 703 = 30.4 = 30
Optimal Decision
Scenario Nurse Denise discusses weight loss ideas with Chloe.
Question Nurse Denise prepares to discuss weight loss ideas with Chloe. Which of the following should Denise recommend Chloe integrate on a daily basis?
Selected Option Be physically active for at least 60 min.
Rationale In addition to calorie reduction, the nurse should recommend physical activity for at least 60 min per day.
Optimal Decision
Scenario Beth, the nurse practitioner, and Chloe are discussing her dysmenorrhea.
Question Nurse Practitioner Beth, is educating Chloe about the use of ibuprofen (Advil) to minimize dysmenorrhea. Which of the following should Beth include in the teaching?
Selected Option Notify the provider immediately if you experience dark tarry stools.
Rationale Although research studies show ibuprofen produces less gastric bleeding compared with aspirin, the client should contact the nurse or another health care provider if this occurs.
Scenario Nurse practitioner Beth, is completing a physical exam of Chloe and considers additional topics to discuss.
Question Nurse practitioner Beth, is completing a physical exam of Chloe and considers additional topics to discuss. List three topics Beth should include in her discussion with Chloe. (Fill in the blank and click on the Submit button when you finish.)
Selected Option -Periods. -Exercise. -Sexual activity. -Drugs. [Show Less]