ATI.CHILD CARE 1.0
1 A child diagnosed with asthma begins corticosteroid treatments. The nurse explains to the
parents that the purpose of
... [Show More] corticosteroid treatment is to produce which therapeutic effect?
Incorrect: Dilation of the bronchial airways is common in treating asthma. Albuterol is a
common medication.
Incorrect: Bronchospasms are usually reduced by B-2 agonists and bronchodilators.
Incorrect: Infections are treated by antibiotics but not indicated in the treatment of asthma unless
lung congestion is noted.
Correct: Corticosteroid usage is common for decreasing inflammation of the bronchial
airways.
Dilation of bronchial airways
Decrease bronchospasms
Prevention of infection
Anti-inflammatory effect
2 Which is the recommended treatment for moderate to severe lead poisoning?Incorrect: IV fluids are typically not used in the treatment of lead poisoning. IV fluids area
conservative treatment regimen and are not indicated for treatment of lead poisoning; a more
radical therapy is needed to remove the lead from the body.
Incorrect: Treatment with antiemetic is not effective in the treatment of lead toxicity because the
heavy metal is absorbed into the body. Lead ingestion usually occurs more than one time.
Correct: The heavy metal antagonist, edetate calcium disodium, is frequently the drug of
choice for the removal of the lead toxin from the body. Chelating agents inactivate the
toxicity of the lead and cause excretion through the urine. Others drugs may treat the
symptoms of toxicity rather than remove the lead from the body. Untreated lead toxicity
can lead to a wide array of neurobehavioral problems include: attention
deficithyperactivity disorder, reduced cognitive performance, irritability or lethargy,
aggressiveness, and hearing impairment. The most serious and irreversible side effect of
lead poisoning is encephalopathy, which is associated with lead levels > 100 mg/ dL.
Incorrect: Antibiotics have no effect on the removal of the toxin.
IV fluids
Antiemetics
Heavy metal antagonist
Antibiotics
3 Which treatment is a nursing priority when providing care for an infant diagnosed with
bacterial meningitis?
Incorrect: Cardiorespiratory monitoring is standard for care of the child with bacterial meningitis
as a means of establishing the baseline parameters for vital signs. The infant with meningitis
may have a low baseline heart rate, tachypnea or fever. This however, is not the priority nursing
intervention.
Incorrect: The initiation of IV fluids for hydration and nutrition is a primary concern for the care
of the infant with bacterial meningitis. However, the most important intervention is starting
antibiotic therapy.
Incorrect: Meningococcal meningitis is the only type of meningitis spread through air-born
droplets and therefore, respiratory precautions need to be initiated as soon as possible.
Respiratory isolation is important for the control of transmission of the disease after the child
receives the first doses of antibiotics.Correct: The first nursing priority is the implementation of antibiotic therapy, which
prohibits the microbial damage to the neurologic system through the cerebral spinal fluid.
Bacterial meningitis has a high rate of infant morbidity (illness) or mortality (death).
Immediate treatment with antibiotics can prevent: death, deafness, reduced cognitive
ability, attention deficit-hyperactive disorder, seizures and various other complications.
Initiate cardiorespiratory monitoring.
Initiate intravenous fluids.
Observe respiratory isolation.
Administer antibiotic therapy.
4 The dosage of a pediatric medication is 120mg/kg/day to be give t.i.d. The patient weighs 12
pounds. What is the correct dose for the nurse to administer?
Incorrect: The dose of 120 mg is half the indicated dose. The erred dosage represents a failure to
divide the total daily dose by the number of individual dosages required per day. The failure to
use the weight in the calculation is evident.
Incorrect: The dosage of 480 mg is an excessive dose for the child. The calculation error is likely
a failure to convert pounds to kilograms.
Correct: The patient weighs twelve pounds. This weight converts to kilograms by dividing
12 by 2.2 (1 kg. = 2.2 lb.). In this example, the child's weight converts to 5.4 kg. The daily
dose of 120 mg is given t.i.d: each individual dose is 40 mg/kg. Then multiply the weight in
kilograms by the individual dose (40mg). The individual dose is 218 mg.
Incorrect: The dose of 650 mg is too large of a dose. The weight of the child when converting
from pounds to kilograms is 5.45 kg. The dose is ordered to be given t.i.d.. Therefore, the daily
dose of 120 mg/kg/day is divided by 3 to yield an individual dose of 40 mg/kg/dose. The error is
this dosage was likely a failure to divide the total daily dose by the number of doses required per
day.
120 mg
480 mg
218 mg
651 mg
5 In a child diagnosed with Tetralogy of Fallot, which of the following is a compensatory
mechanism to decrease venous return to the heart?Correct: Squatting is a compensatory mechanism that decreases venous return
(deoxygenated blood) to the heart. The clinical sign is commonly seen in young children
with Tetralogy of Fallot (a type of cyanotic heart disease). The signs associated with
cyanotic heart disease include hypoxia, poor growth, low tolerance for physical exertion,
cardiomegaly, murmur and acute, intermittent blue spells that occur after crying or
feeding (tet spells).
Incorrect: Clubbing is found in children with chronic respiratory disease and cyanotic heart
disease. However, this finding is rare in young children.
Incorrect: Shortness of breath, retractions and increased respiratory effort occur with lung
dysfunction. Generally, the child with impaired oxygenation due to a cardiac lesion does not
exhibit signs of respiratory distress.
Incorrect: Polycythemia is common in children with hypoxia due to respiratory or cardiac
dysfunction. This compensatory mechanism increases the oxygen-. carrying capacity in the
body. The effect is not related to the venous return of unoxygenated blood to the heart.
Squatting
Clubbing
Shortness of breath
Polycythemia
6 A 1-year-old receives routine health maintenance care at the pediatric clinic. The child receives
an MMR immunization. The mother asks the nurse, "When will my child get the next dose of
MMR vaccine?" Which is the correct response by the nurse?
Incorrect: The DPT vaccine is routinely given in six months.
Incorrect: An additional dose of MMR vaccine is needed in the middle school years to maintain
full immunity from the diseases.
Incorrect: The first dose of Hepatitis B vaccine (HBV) is given in the hospital prior to discharge
home. A follow-up HBV is given in 1-2 months and followed up in 6-12 months following the
second does. The schedule does not coordinate with the routine immunization schedule for
MMR.
Correct: A second MMR, often called a booster, will be needed when the child enters
middle school at age eleven or twelve years of age.
In six months with the next DPTNo further vaccination needed
With the Hepatitis B series
After the child is 10 years of age
7 Which is a major difference in the clinical manifestation of adolescents with anorexia nervosa
compared to bulimia?
Incorrect: Binge eating is a common manifestation of both disorders.
Incorrect: Purging can be associated with both disorders.
Correct: The major difference between adolescents with anorexia nervosa and adolescents
with bulimia is body image distortion. Clients with anorexia see themselves as being
overweight no matter how underweight they become. Clients with bulimia see their weight
realistically but have psychological problems that manifest in an eating disorder.
Incorrect: Decreased self-esteem is often a catalyst of both disorders.
Binge eating
Purging
Body image distortion
Decreased self esteem
8 Which is the most common factor associated with non-organic failure to thrive?
Incorrect: A cool, drafty sleeping area is not a comfortable environment for sleep, but is
unrelated as a cause of failure to thrive.
Correct: The most significant factor associated with non-organic failure to thrive is
typically a disturbance in the mother/child relationship. A situation involving dysfunctional
family relationships is often complex; characterized by marital discord, economic
pressures, and parental immaturity with a low stress tolerance.
Incorrect: Lack of interest in the surroundings is a symptom of failure to thrive but not an
etiologic factor.
Incorrect: The financial hardship related to the expense of infant formula is not usually a primary
cause of non-organic failure to thrive. The Women's Infant and Children program (WIC)
provides infant formula at a low or no cost with eligibility. Therefore, the disorder is not likelyto be related to obtaining adequate nutrition but instead related to the ability of the infant to
consume, digest, and utilize the nutritive source.
A cool, drafty area for sleeping
Disturbance of mother/child relationship
Lack of interest in the surroundings
Financial hardship causing poor nutritional care
9 An adolescent recovering from substance abuse is diagnosed with hepatitis B. Which nursing
instruction should be included when planning the client's care?
Incorrect: During periods of acute hepatitis, the client needs plenty of rest.
Correct: The mode of the transmission in hepatitis B is via the parenteral route through
blood products, intravenous injection and maternal-fetal trans placental transmission. It is
extremely important for the nurse to educate the family about the relationship between
intravenous exposure and the transmission of the disease.
Incorrect: Fluid intake is not limited in the treatment of hepatitis B.
Incorrect: Eating a diet high in fat is contraindicated because of the liver involvement.
Increase exercise.
Avoid sharing needles.
Limit fluid intake.
Eat a diet high in fat.
10 Changes in the growth and development of the preschooler are characterized by:
Incorrect: Continued rapid physical growth is not common for this developmental level.
Incorrect: Major changes in weight, height and head circumference have usually already taken
place prior to this developmental level.
Correct: Physical growth slows in the preschool years. Preschoolers enjoy social contacts.
Preschoolers are gaining control of their muscles and participate in vigorous activities with
other children.Incorrect: Improvement in motor ability is rapid at this developmental level as the children are
gaining control of their muscles.
Preschoolers' gait resembles that of an adult.
Rapid physical growth and a persistent curiosity.
Major changes in weight, height and head circumference.
A slowing of physical growth and expansion of social contacts.
A slow improvement in motor ability. [Show Less]