ATI Pediatrics Exam 5
Total Questions : 49
Showing 25 questions, Sign in for moreWhich reflex, if found in a 4-month-old infant, would cause the nurse to be concerned?
Explanation
A. The step reflex is an expected primitive reflex in infants, disappearing around 2 months of age.Therefore, if ounf in a 4 month old baby, the nurse should be concerned.
B. The plantar grasp reflex should be present in infants and typically disappears by 9 to 12 months of age.
C. Neck righting reflex is a normal response in infants, allowing them to orient their heads in relation to their body movements.
D. The Babinski reflex is typically present in infants but should disappear by around 12 months of age. If it persists beyond this age, it could indicate neurological concerns and warrant further evaluation. therefore, the reflex is normal in a 44 month old baby
The nurse is observing a 24-month-old boy in a daycare center. Which finding suggests delayed motor development?
Explanation
A. Inability to push a toy lawnmower might indicate strength or coordination issues but might not necessarily point to delayed motor development.
B. Having trouble undressing himself could relate to coordination or dexterity but doesn't directly reflect delayed motor development.
C. The inability to unscrew a jar lid suggests delayed fine motor skills, which could indicate delayed motor development at this age.
D. Falling when bending over might indicate balance or coordination concerns but might not solely indicate delayed motor development.
A nurse is obtaining vital signs from 2-month-old infant. The infant's heart rate is 190/min and his temperature is 40° C (104° F). The father asks the nurse why the infant's heart is beating so fast. Which of the following responses by the nurse is appropriate
Explanation
A. In the case of a fever, the body's response often includes an increase in heart rate to help distribute heat and manage the fever.
B. While the body might attempt to regulate temperature through various means, the increased heart rate is primarily due to the fever itself.
C. A heart rate of 190/min is higher than normal for a 2-month-old infant and is likely elevated due to the fever.
D. Heart rate tends to decrease during sleep but doesn't explain the elevated heart rate specifically in response to the fever.
The order is Solumedrol 3 mg/kg for a child weighing 20 kg. Solumedrol is available as 125 mg/2mL. How many ml(s) must the nurse administer? mL. Please record your exact answer. Record numbers only.
Explanation
- The dose of Solumedrol in mg is = 20 kg x 3 mg/kg = 60 mg.
- The concentration of Solumedrol is given as 125 mg/2mL
- Therefore 1 mL contains 125/2 = 62.5 mg of the drug.
If 62.5 mg =1ml
60mg= 60/62.5
= 0.96ml
A nurse is caring for a child who has otitis media. Which of the following assessment findings should the nurse expect?
Explanation
A. Clear drainage from the affected ear is not a typical finding in otitis media; instead, it might indicate other conditions such as a ruptured eardrum.
B. Otitis media commonly presents with erythema (redness) and edema (swelling) of the affected ear.
C. Pain when manipulating the affected ear lobe might be present but is not exclusive to otitis media.
D. Tugging on the affected ear lobe can be a sign of ear discomfort but isn't a specific indicator of otitis media.
A new mother tells the nurse that she is having difficulty breastfeeding her baby. When observing the mother, which actions prompt the nurse to provide teaching about proper breastfeeding techniques? Select all that apply.
Explanation
A. Stroking the nipple against the infant's face might confuse the baby and hinder the proper latch-on technique.
B. Supplementing feedings with water might interfere with the baby's intake of necessary nutrients from breast milk.
C. Feeding the infant every hour might not allow enough time for the baby to obtain the full benefits of feeding, potentially leading to inadequate milk intake.
D. Holding the breast in the "C position" is a proper technique for breastfeeding and doesn't require teaching.
E. Carefully washing breasts prior to feeding isn't necessary and might remove natural oils that aid breastfeeding.
A nurse is caring for a 17-year-old client who is experiencing a relapse of leukemia and is refusing treatment. The client's mother insists that the client receive treatment. Which of the following actions should the nurse take?
Explanation
A. Offering the client an antiemetic doesn't address the issue of refusal of treatment.
B. In this situation, the nurse should notify the provider of the conflict between the client's refusal of treatment and the parent's insistence, allowing for further assessment and intervention.
C. Administering a sedative to calm the client is not appropriate without further assessment and consent.
D. Initiating an IV per the parent's request doesn't address the ethical and legal complexities involved in a competent minor's refusal of treatment.
The nurse is conducting a well-child assessment for a 5-year-old boy in preparation for kindergarten. The boy's grandmother is his primary caregiver because the boy's mother has suffered from depression and substance abuse issues. The nurse understands that the child is at increased risk for which developmental problem?
Explanation
A. Speech and language delays could occur but might not be the primary developmental problem given the circumstances.
B. Fine motor skills delays could also occur but might not be the primary developmental problem considering the caregiver's situation.
C. Stuttering might arise but might not be the primary developmental problem given the context of the caregiving environment.
D. Children in environments affected by parental depression and substance abuse may face challenges in developing social and emotional readiness for school due to inconsistent caregiving and potential emotional stressors.
A nurse is speaking with the mother of a 6-year-old child. Which of the following statements by the mother should concern the nurse?
Explanation
A. Acting bossy with friends might not necessarily raise immediate concerns regarding health or development.
B. The statement indicating the child has to squint to see the board might suggest a potential vision problem, which should be further evaluated to ensure proper eye health and vision correction if necessary.
C. Losing baby teeth around age 6 is a normal developmental process.
D. Playing board games and cheating is a common behavior in children but doesn't raise immediate health or developmental concerns.
Ceclor oral suspension 375 mg g. 8h, is ordered for a patient on discharge. The pharmacy gives the patient Ceclor 125 mg/5 ml oral suspension. How many teaspoons will the nurse instruct the patient to take per dose? Record numbers only.
Explanation
Dose ordered / Dose available = Amount to give
Dose ordered = 375 mg, Dose available = 125 mg/5 ml, Amount to give = x ml
Plug in the values and solve for x: 375 / 125 = x / 5
Simplify and cross-multiply: 3 = x / 5, x = 15
The amount to give is 15 ml, which is equivalent to 3 teaspoons (1 teaspoon = 5 ml)
The nurse will instruct the patient to take 3 teaspoons per dose
A nurse is assessing a 15-month-old toddler. Which of the following findings should the nurse report to the provider?
Explanation
A. At 15 months, toddlers should typically be able to stand upright without support. The inability to do so might indicate a developmental delay or a motor skill issue.
B. Inability to jump with both feet might be within the range of normal development at 15 months, as jumping skills tend to develop later.
C. Building a tower of six to seven cubes might be challenging for some toddlers at this age due to fine motor skills still developing, so it might not necessarily raise concern.
D. Turning a doorknob involves more complex fine motor skills and might not be expected at this age, so it's not as critical an indicator of developmental delay.
A nurse is caring for a 4-year-old child who is resistant to taking medication. Which of the following strategies should the nurse use to elicit the child's cooperation?
Explanation
A. Offering the child a choice empowers them and provides a sense of control. It might increase cooperation as it involves the child in the decision-making process.
B. Threatening with a shot is coercive and can cause fear and anxiety, negatively impacting cooperation and trust.
C. Hiding medication in food without the child's knowledge might breach trust once discovered and doesn't address the child's autonomy.
D. Misrepresenting medication as candy can be dangerous and erode trust between the child and the healthcare provider.
A nurse is assessing a 3-month-old infant. Which of the following findings should the nurse report to the provider?
Explanation
A. At 3 months, infants might not consistently bring objects to their mouths, and this skill might still be developing, so it might not be a cause for immediate concern.
B. By 3 months, most infants should be able to raise their head when placed in a prone position; failure to do so might indicate a developmental delay.
C. Picking up objects with fingers is a skill that typically develops closer to 6 to 9 months; thus, it's not expected at 3 months.
D. Sitting without support usually begins around 6 to 7 months, so it's not an expected skill at 3 months and wouldn't necessarily be concerning yet.
A nurse is performing a pre-college physical assessment on an adolescent. Which of the following immunizations should the nurse anticipate administering?
Explanation
A. The influenza vaccine is typically recommended annually but might not be specifically administered during a pre-college physical unless it's flu season.
B. Meningococcal vaccine is often required for college admission due to the risk of meningitis outbreaks in communal living settings like college dormitories.
C. BCG vaccine is primarily used in countries with a higher prevalence of tuberculosis and is not routinely administered in most places for college entry.
D. Pneumococcal vaccine might be recommended for certain health conditions or specific circumstances but is not typically administered routinely during pre-college physicals.
A nurse reports an incident of suspected child abuse. One of the parents of the child becomes upset and demands to know the reason for the nurse's action. Which of the following responses by the nurse is appropriate?
Explanation
A. Nurses are mandated reporters, required by law to report suspected cases of child abuse or neglect to the appropriate authorities.
B. While maintaining confidentiality is important, in cases of suspected abuse, legal obligations override the need for confidentiality.
C. Involving the provider might not be immediate or necessary for explaining the situation, as the priority is reporting and ensuring the child's safety.
D. Directly reporting to authorities or involving supervisors is the responsibility of the nurse when faced with suspected child abuse.
A nurse is caring for a toddler who is having difficulty sleeping during hospitalization. Which of the following actions should the nurse take to promote sleep?
Explanation
A. Turning off the room light might aid sleep, but providing specific bedtime rituals is more effective in establishing a sleep routine and signaling to the toddler that it's time to rest.
B. While addressing fears is important, it might not immediately resolve the toddler's difficulty sleeping; establishing bedtime rituals helps create a calming environment.
C. Evening play exercises might energize the toddler rather than promoting sleep, so they might not be conducive to improving sleep during hospitalization.
D. Bedtime rituals, like a soothing bath, reading a book, or soft music, can create a predictable routine that signals to the toddler it's time to wind down and sleep.
During a health check-up without his parents, a 17-year-old tells the nurse he is gay. Which approach should the nurse take?
Explanation
A. Stating that being gay puts someone in an "at-risk" category can be stigmatizing and might not address the teenager's concerns or questions.
B. While discussing safe sex might be important, it assumes that being gay automatically implies a need for this conversation, which might not be the case.
C. Dismissing the teenager's statement by denying his sexual orientation can be harmful, dismissive, and invalidate the individual's feelings and identity.
D. Encouraging open communication and asking the teenager to share his thoughts fosters a supportive environment, allowing the nurse to understand the teenager's perspective and concerns.
During a well-child check-up, the parents of a 9-year-old boy tell the nurse that their son's friends told him that soccer is a stupid game, and now he wants to play baseball. Which comment by the nurse best explains the effects of peer groups?
Explanation
A. This statement assumes without addressing the effects of peer influence on the child's behavior.
B. Acceptance and validation by peers, particularly those of the same gender, often hold significant importance during middle childhood, influencing interests and activities.
C. While camaraderie among children playing different sports is positive, it doesn't address the primary concern about peer influence on the child's choice.
D. Assuming the child's best friends will continue playing soccer doesn't explain the influence peers have on a child's preferences and decisions.
The nurse is conducting a well-child examination of a 5-year-old girl, who was 40 inches tall at her last examination at age 4. Which height measurement would be within the normal range of growth expected for a preschooler?
Explanation
A. 45 inches is significantly higher than the expected height increase for a 5-year-old based on the previous measurement; this would be an unusually high growth rate.
B. 47 inches is a substantial increase and would be considered outside the typical range of growth for a 5-year-old compared to the previous measurement.
C. 41 inches is within a reasonable range of growth, considering the child's height at the previous examination was 40 inches at age 4.
D. 43 inches is closer to the higher end of the range but might be slightly higher than expected growth within a year for most children in this age group.
A nurse in a pediatric clinic is talking with the mother of a preschool-age child. The mother tells the nurse that her son is a "picky eater." Which of the following instructions should the nurse include in the teaching?
Explanation
A. Acknowledging that food consumption might not significantly decrease helps manage the mother's expectations regarding her "picky eater" child and reduces potential stress around mealtime.
B. Adding fruit juice might contribute to increased sugar intake and may not necessarily address the nutritional concerns associated with picky eating.
C. Forcing a child to remain at the table after meals could create negative associations with mealtime and food, potentially exacerbating picky eating behavior.
D. Emphasizing quantity over quality doesn't address the nutritional concerns related to picky eating and might encourage unhealthy eating habits.
A nurse is caring for a client who is scheduled to have a magnetic resonance imaging (MRI) scan. The client asks the nurse what to expect during the procedure. Which of the following statements should the nurse make?
Explanation
A. MRI scans can vary in duration and may take longer than 30 minutes, depending on the specific procedure and imaging requirements.
B. Movement can distort the images in an MRI scan, so it's crucial for the client to lie as still as possible during the procedure.
C. The contrast dye used in MRIs does not typically contain iodine and is not known to cause skin itching.
D. MRI scanners generate loud noises during operation, and patients are often provided with earplugs or headphones to minimize discomfort from the noise.
The nurse has determined that an 8-year-old girl is at risk for being overweight. Which intervention should the nurse include in the care plan?
Explanation
A. Discussing the influence of peers on the child's diet can help identify potential social factors contributing to unhealthy eating habits and enable strategies to counteract them.
B. While involving the parents in the care plan is important, asking who they want to work with might not directly address the child's risk of being overweight.
C. Determining the need for additional caloric intake might not be the primary concern for a child at risk for being overweight; rather, it's about healthy eating habits and portion control.
D. Interviewing the parents about their eating habits could be beneficial for understanding the family's overall approach to nutrition but may not directly address the child's weight risk and potential interventions.
A nurse is providing health promotion teaching to the parents of a toddler. Which of the following information should the nurse include in the teaching? (Select all that apply.)
Explanation
A. While establishing trust is important in caregiving, it might not be the primary focus in health promotion teaching for toddlers.
B. Managing tantrums is valuable information for parents of toddlers to help them understand and address challenging behavior effectively.
C. Dental care is crucial in toddlers to promote good oral hygiene and prevent dental issues.
D. Encouraging cooperative play helps toddlers develop social skills and interact positively with others.
E. The need for increased caloric intake is not typically a significant focus in health promotion teaching for toddlers unless specific dietary concerns are present.
The nurse is providing discharge teaching regarding formula preparation for a new mother. Which guideline would the nurse include in the teaching plan?
Explanation
A. Adding cereal to formula in a bottle or sweetening with honey can pose choking hazards and introduce unnecessary risks or adverse reactions.
B. Washing bottles and nipples properly is essential, but this guideline doesn't specifically address formula preparation.
C. Storing ready-to-feed formula in the refrigerator is a valid guideline, but it's not related to formula preparation.
D. Microwaving formula can create uneven heating and hot spots, potentially burning the baby's mouth; this is not a recommended method for warming formula.
The nurse is caring for a 7-month-old girl during a well-child visit. Which intervention is most appropriate for this child?
Explanation
A. Advising about increased caloric needs might not be the primary focus unless specific growth concerns are present.
B. At 7 months, while introducing table foods might be on the horizon, it's not the most immediate concern during this well-child visit.
C. Discussing the type of sippy cup to use is pertinent as the infant is approaching an age where the introduction of a sippy cup becomes relevant for transitioning from a bottle.
D. Describing the tongue extrusion reflex might be more relevant for younger infants just starting on solids, typically around 4 to 6 months, rather than at 7 months.
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