RN ATI NURSING CARE OF CHILDREN 2019 A EXAM WITH NGN
(WITH RATIONALE)
A nurse is preparing to collect a sample from a toddler for a sickle-turbidity
... [Show More] test. Which of the
following actions should the nurse plan to take?
- Perform a finger stick
RATIONALE: The nurse should perform a finger stick on a toddler as a component of the sickleturbidity test. If the test is positive, hemoglobin electrophoresis is required to distinguish
between children who have the genetic trait & children who have the disease.
A nurse is reviewing the lumbar puncture results of a school-aged child who is suspected of
having bacterial meningitis. Which of the following findings should the nurse identify as an
indication of bacterial meningitis?
Increased protein concentration
RATIONALE: The nurse should identify that an increased protein concentration in the spinal fluid is
a finding that can indicate bacterial meningitis.
A nurse is preparing to administer an immunization to a 4-year-old child. Which of the following
actions should the nurse plan to take?
- Administer the immunization using a 24-gauge needle
RATIONALE: The nurse should administer an immunization for a 4-year-old child using a 22- to 25-
gauge needle to minimize the amount of pain the child experiences.
A nurse is providing teaching to the parent of an infant who has diaper dermatitis. The nurse
should instruct the parent to apply which of the following to the affected area?
- Zinc oxide
RATIONALE: Diaper dermatitis is a common inflammatory skin disorder caused by contact with an
irritant such as urine, feces, soap, or friction, & takes the form of scaling, blisters, or papules
with erythema. Providing a protective barrier, such as zinc oxide, against the irritants allows the
skin to heal.
A nurse is creating a plan of care for a school-age child who has heart disease and has developed
heart failure. Which of the following interventions should the nurse include in the plan?
- Provide small, frequent meals for the child
RATIONALE: The metabolic rate of a child who has heart failure is high because of poor cardiac
function. Therefore, the nurse should provide small, frequent meals for the child because it helps
to conserve energy.
A nurse is assessing a 4-year-old child at a well-child visit. Which of the following developmental
milestones should the nurse expect to observe?
- Cuts an outlined shape using scissors
RATIONALE: The nurse should recognize that an expected developmental milestone of a 4-year-old
child is using scissors to cut out a shape.
A nurse is assessing a toddler who has gastroenteritis & is exhibiting manifestations of
dehydration. Which of the following findings is the nurse's priority?
- Tachypnea
RATIONALE: When using the airway, breathing, & circulation approach to client care, the nurse's
priority finding is the toddler's tachypnea. Tachypnea is a result of the kidneys being unable to
excrete hydrogen ions & produce bicarbonate, which lead to metabolic acidosis.
A nurse is receiving change-of-shift report for four children. Which of the following children
should the nurse see first?
- - A school-age child who has sickle cell anemia & reports decreased vision in the left eye
RATIONALE: When using the urgent vs. nonurgent approach to client care, the nurse should
determine the priority finding is a report of decreased vision in the left eye. This finding indicates
that the child is experiencing a vaso-occlusive crisis & should be reported to the provider
immediately. Therefore, the nurse should see this child first.
A school nurse is preparing to administer atomoxetine 1.2 mg/kg/day PO to a school-age child
who weighs 75 lbs. Available is atomoxetine 40 mg/capsule. How many capsules should the nurse
administer per day? - - 1 capsule
RATIONALE:
75 lb x 1 kg/2.2 lb x 1.2mg/1 kg x 1 capsule/40 mg
=
1 capsule
A nurse is teaching a school-age child who has a new diagnosis of type 1 diabetes mellitus. Which
of the following statements by the child indicates an understanding of the teaching?
- - "I will give myself a shot of regular insulin 30 minutes before I eat breakfast."
RATIONALE: The child should administer regular insulin 30 minutes before meals so that the onset
coincides with food intake.
A nurse in an emergency department is caring for a school-age child who has appendicitis and
rates their abdominal pain as 7 on a scale of 0 to 10. Which of the following actions should the
nurse take?
- Give morphine 0.05 mg/kg IV
RATIONALE: A pain level of 7 on a scale of 0 to 10 is considered severe. The nurse should
administer a analgesic medication for pain relief.
A nurse is interviewing the parent of an 18-month-old toddler during a well-child visit. The nurse
should identify that which of the following findings indicates a need to assess the toddler for
hearing loss?
- The toddler has a vocabulary of 25 words
- The toddler developed a mild rash following a recent varicella immunization
- The toddler's Moro reflex is absent
- The toddler received tobramycin during a hospitalization 2 weeks ago. - - The toddler received
tobramycin during a hospitalization 2 weeks ago.
RATIONALE: The nurse should identify tobramycin as an aminoglycoside, which is an ototoxic
medication that can cause mild to moderate hearing loss, and should assess the toddler for a
hearing impairment.
A nurse is reviewing the laboratory report of a school-age child who is experiencing fatigue.
Which of the following findings should the nurse recognize as an indication of anemia?
- Hematocrit 28%
RATIONALE: The nurse should recognize that this hematocrit level is below the expected reference
range of 32% to 44% for a school-age child. The child can exhibit fatigue, lightheadedness,
tachycardia, dyspnea, and pallor due to the decreased oxygen-carrying supply.
A nurse is providing discharge teaching to the parent of a child who is 1 week postoperative
following a cleft palate repair. For which of the following members of the interprofessional team
should the nurse initiate a referral?
- Occupational therapist
- Speech therapist
- Respiratory therapist
- Physical therapist - - Speech therapist
RATIONALE: The nurse should initiate a referral for a speech therapist for a child who is
postoperative following a cleft palate repair. A child who has a cleft palate will require speech
therapy immediately following the repair to support speech development and future articulatio [Show Less]