NURSING 212/ N212 ATI RN Nursing Care of Children Online Practice 2016 B.
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NURSING 212
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NURSING 212
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?
a. Identifies right from left hand
b. Uses a utensil to spread butter
c. Cuts a shape using scissors
d. Draws a stick figure with seven body parts
...
nursing 212 n212 ati rn nursing care of children online practice 2016 b
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N212 ATI RN Nursing Care of Children Online Practice 2016 B.
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?
a. Identifies right from left hand
b. Uses a utensil to spread butter
c. Cuts a shape using scissors
d. Draws a stick figure with seven body parts
c. Cuts a shape using scissors
A- Identifying the right from left hand is an expected developmental milestone of a 6-year-old
child.
B- Using a utensil to spread butter is an expected developmental milestone of a 6-year-old
child. D- Drawing a stick figure with seven body parts is an expected developmental milestone
of a 5- year-old child.
A school nurse is preparing to administer atomoxetine 1.2 mg/kg/day PO to a school-age child
who weighs 75lb. Available is atomexetine 40 mg/capsule. How many capsules should the
nurse administer per day?
1
A nurse in the emergency department is assessing a toddler who has Kawasaki disease. Which
of the following findings should the nurse expect? (select all that apply.)
a. Increased temperature
b. Gingival hyperplasia
c. Xerophthalmia
d. Bradycardia
e. Cervical lymphadenopathy
Answer- a,c,e
Increased temperature is correct. Kawasaki disease is an acute illness associated with a fever
lasting more than 4 days that is unresponsive to antipyretics or antibiotics.
Gingival hyperplasia is incorrect. Children who have Kawasaki disease develop a strawberry
tongue, cracked lips, and edema of the oral mucosa and pharynx. A child who is receiving
phenytoin therapy can develop gingival hyperplasia.
Xerophthalmia is correct. Ophthalmic manifestations of Kawasaki disease include reddening of
the conjunctiva and dryness of the eyes, or xerophthalmia.
Bradycardia is incorrect. Kawasaki disease is an infection that affects the vascular system,
including the heart. The nurse should expect the child to be tachycardic with a gallop rhythm.
Long term effects of Kawasaki disease include the development of coronary artery aneurysms or
myocardial infarction.
Cervical lymphadenopathy is correct. The child who has Kawasaki disease may develop
enlarged cervical nodes on one side of the neck that are nontender and greater than 1.5 cm in
size.
,N212 ATI RN Nursing Care of Children Online Practice 2016 B.
A nurse is teaching a school-age child who has a new diagnosis of type 1 diabetes MELITIS.
The nurse should identify which of the following statements by the child as understanding
the teaching?
a. I will puncture the pad of my finger when I am testing my blood glucose."
b. "I will give myself a shot of regular insulin 30 minutes before I eat breakfast."
c. "I will eat a snack of 5 grams of carbohydrates if my blood glucose is low."
d. "I will decrease the amount of fluids I drink when I am sick."
Answer- b. "I will give myself a shot of regular insulin 30 minutes before I eat breakfast."
The child should administer regular insulin 30 min before meals so that the onset coincides
with food intake.
A- The child should avoid puncturing the pads of the fingers because they have fewer blood
vessels and more nerve fibers. Instead, the child should puncture the skin to either side of the
finger pad to promote blood flow and decrease pain.
C- The child should eat a snack of 15 g of carbohydrates, such as 120 mL (4 oz) of fruit juice or
66 g (1/2 cup) of ice cream, to rapidly increase a mild hypoglycemic reaction.
D- During acute illness the child is prone to hyperglycemia and ketonuria and is at risk for
dehydration. Therefore, the child's fluid intake should increase rather than decrease.
A school nurse is assessing an adolescent who has scoliosis. Which of the following findings
should the nurse expect?
a. Increase in anterior convexity of the lumbar spine
b. Increased curvature of the thoracic spine
c. Lateral flexion of the neck
d. A unilateral rib hump
Answer- d. A unilateral rib hump
When assessing an adolescent for scoliosis, the school nurse should expect to see a unilateral
rib hump with hip flexion. This results from a lateral S- or C-shaped curvature to the thoracic
spine resulting in asymmetry of the ribs, shoulders, hips, or pelvis. Scoliosis can be the result of
a neuromuscular or connective tissue disorder, or it can be congenital in nature.
A- An increased anterior convexity of the lumbar spine is a manifestation of lordosis. An
expected finding in toddlers, lordosis can indicate a complication of a disease process, such as
flexion contractures, congenital dislocation of the hip, or obesity, when seen in older children.
B- An increased curvature of the thoracic spine is a manifestation of kyphosis. Kyphosis can be
a manifestation of a congenital condition or disease process such as rickets, or it can be
posture- related. In posture-related kyphosis, the adolescent presents with rounded shoulders
and a slouching posture.
C- Lateral flexion of the neck is an indication of torticollis as a result of contracture of the
sternocleidomastoid muscle. Torticollis can be congenital, the result of intrauterine fetal
, N212 ATI RN Nursing Care of Children Online Practice 2016 B.
posturing or abnormality of the cervical spine, or it can be acquired, due to such factors as a
traumatic lesion to the sternocleidomastoid muscle.
A nurse is reviewing the lumbar puncture results of a school-age child suspected of having
bacterial meningitis. Which of the following results should the nurse identify as a finding
associated with bacterial meningitis?
a. Decreased cerebrospinal fluid pressure
b. Decreased WBC count
c. Increased protein concentration
d. Increased glucose level
Answer- c. Increased protein concentration. The nurse should recognize that an
increased protein concentration in the spinal fluid is a finding associated with bacterial
meningitis. A- Increased cerebrospinal fluid pressure is a finding associated with bacterial
meningitis.
B- An increased WBC count in the spinal fluid is a finding associated with bacterial meningitis.
D- A decreased glucose level in the spinal fluid is a finding associated with bacterial
meningitis.
A nurse is planning care for a preschooler who has cystic fibrosis. Which of the following
interventions should the nurse include in the plan?
a. Administer pancreatic enzymes 2 hr after meals.
b. Decrease pancreatic enzymes if steatorrhea develops.
c. Limit fluid intake to 750 mL per day.
d. Increase fat content in the child's diet to 40% of total calories.
Answer - d. Increase fat content in the child's diet to 40% of total calories. A child who has cystic
fibrosis is unable to properly digest fats due to fibrosis of the pancreas and limited secretion of
pancreatic enzymes. The nurse should increase the child's fat intake to equal 40% of total caloric
intake.
A- The nurse should plan to administer pancreatic enzymes within 30 min of meals and snacks.
B- A child who has cystic fibrosis and develops steatorrhea, or fatty stools, needs to increase the
intake of pancreatic enzymes.
C- The nurse should encourage fluid intake, rather than restrict it, to prevent dehydration
caused by the loss of sodium and chloride through perspiration.
A nurse is assessing a toddler who has gastroenteritis and is exhibiting manifestations of
dehydration. Which of the following findings should the nurse address first?
a. Skin breakdown
b. Hypotension
c. Hyperpyrexia
d. Tachypnea
Answer- d. Tachypnea. When using the airway, breathing, circulation approach to client care,
the first finding the nurse should address is the toddler's tachypnea, which results when the
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