ATI/RN Nursing Care of Children Proctored 2019 Exams(A & B included),Retake,Fundamentals,Study & Revision Guides.Helpful Compilation towards your Midterm,Retake & Final Exams 2019 -2024

NURSING CARE OF CHILDREN A
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.
A nurse is teaching the parent of an infant who has a Pavlik harness for the treatment of developmental
dysplasia of the hip. The nurse should identify that which of the following statements by the parent
indicates an understanding of the teaching?
“I will place my infant’s diapers under the harness straps.”
A nurse is planning care for a school-age child who is in the oliguric phase of acute kidney injury (AKI)
and has a sodium level of 129 mEq/L. Which of the following interventions should the nurse include in
the plan?
Initiate seizure precautions for the child.
A nurse is assessing a school-age child immediately following a perforated appendix repair. Which of the
following findings should the nurse expect?
Absence of peristalsis
A nurse is preparing an adolescent for a lumbar puncture. Which of the following actions should the
nurse take?
Apply topical analgesic cream to the site 1 hr prior to the procedure.
A nurse is caring for a school-age child who is receiving cefazolin via intermittent IV bolus. The child
suddenly develops diffuse flushing of the skin and angioedema. After discontinuing the medication
infusion, which of the following medications should the nurse administer first?
Epinephrine
A nurse is teaching the parent of a preschooler about ways to prevent acute asthma attacks. Which of
the following statements by the parent indicates an understanding of the teaching?
“I should keep my child indoors when I mow the yard.”
ATI MED SURG PROCTORED STUDY GUIDE
NURSING CARE OF CHILDREN
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A nurse is proving dietary teaching to the parent of a school-age child who has celiac disease. The nurse
should recommend that the parent offer which of the following foods to the child?
White rice
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%
A nurse is preparing to collect a sample from a toddler for a sickle-turbidity test. Which of the following
actions should the nurse plan to take?
Perform a finger stick.
A nurse is assessing a school-age child who has meningitis. Which of the following findings is the priority
for the nurse to report to the provider?
Petechiae on the lower extremities
A nurse is assessing an infant who has a ventricular septal defect. Which of the following findings should
the nurse expect?
Loud, harsh murmur
A nurse is creating a plan of care for an infant who has an epidural hematoma from a head injury. Which
of the following interventions should the nurse include in the plan?
Implement seizure precautions for the infant.
A nurse is caring for an adolescent who received a kidney transplant. Which of the following findings
should the nurse identify as an indication the adolescent is rejecting the kidney?
Serum creatinine 3.0 mg/dL
A nurse in an emergency department is performing an admission assessment on a 2 week-old male
newborn. Which of the following findings is the priority for the nurse to report to the provider?
Substernal retractions

A hospice nurse is caring for a preschooler who has a terminal illness. The father tells the nurse that he
cannot cope anymore and has decided to move out of the house. Which of the following statements
should the nurse make?
“Let’s talk about some of the ways you have handled previous stressors in your life.”
A nurse in an emergency department is caring for an adolescent who has severe abdominal pain due to
appendicitis. Which of the following locations should the nurse identify as McBurney’s point?
A. The nurse should identify this area of the client’s abdomen as McBurney’s point. This area of the
right lower quadrant located about two-thirds of the way between the umbilicus and the client’s
anterosuperior iliac spine is the area where a client who has appendicitis is most likely to report pain
and tenderness.
A nurse is reviewing the laboratory report of a 7 year-old child who is receiving chemotherapy. Which of
the following lab values should the nurse report to the provider?
Hgb 8.5 g/dL
A nurse is caring for a 15 year-old client who is married and is scheduled for a surgical procedure. The
client asks, “who should sign my surgical consent?” Which of the following responses should the nurse
make?
“You can sign the consent form because you are married.”
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.
A nurse is caring for an infant who has respiratory syncytial virus (RSV). Which of the following actions
should the nurse implement for infection control?
Have a designated stethoscope in the infant’s room.
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 0.05mg/kg IV

VATI Nursing Care of Children 2019

A nurse is teaching an adolescent how to use a peak expiratory flow meter.
o I will record the highest reading of the three attempts
A nurse in a pediatric clinic is providing teaching to the parent of an infant who has gastroesophageal
reflux.
o I will add rice cereal to my baby’s feeding
A nurse is planning care for a client who has cerebral palsy and is experiencing muscle spasms.
o Baclofen
A nurse is planning care for an infant who has RSV and a respiratory rate of 46/min
o Initiate contact precautions
A nurse is creating a of care for a school-age child who is postoperative following a tonsillectomy.
o Apply an ice collar to the child’s neck
A nurse is providing discharge teaching to a group of guardians of infants about home safety
o Keep your infant restrained when they are in a highchair.
A nurse is teaching the parents of an infant how to administer antibiotic eardrops
o Massage the anterior area of the ear following administration
A nurse is preparing to obtain a blood sample for an Hgb from a child who has hemophilia.
o Obtain the sample using venipuncture
A nurse is providing discharge teaching to the parents of a school-age child who has epilepsy and a new
prescription for phenytoin extended release capsules.
o Encourage the child to brush their teeth after each meal
A nurse is caring for a child who has terminal leukemia
o Your child will lose movement in their legs
A nurse is caring for a 6-month old infant who has acute vomiting and diarrhea.
o Tachypnea
A nurse is caring for an infant who has returned to the pediatric unit following surgical repair following a
cleft lip.
o Monitor temporal artery temperature
A nurse is assessing an infant who has Tetralogy of Fallot. Select all that apply
o A heart murmur
o Cyanotic spells
A nurse is assessing a child who has full thickness burns of the legs
o Injured skin is cream to black in color
A nurse is planning care for a newly admitted child who has autism spectrum disorder.
o Establish a reward system for the child
A nurse is teaching a female adolescent who report frequent urinary tract infections
o Void at least every 3-4 hrs
A nurse is providing discharge teaching to the parent of a school-age child who has juvenile idiopathic
arthritis.
o I will have my child wear splints during the night
A nurse is assessing a 4-month infant at a well-child visit.
o The infant has an absent grasp reflex
A nurse is reviewing the admission laboratory report of a school-age child who has glomerulonephritis.
o BUN 32
A nurse is admitting a child who has pertussis.
o Droplet
A nurse is assessing a 9-month old infant who has gastroenteritis.
o Absence of tears when they cry
A nurse is teaching a group of new parents about expected language development
o 18 months
A nurse is caring for an infant who has pyloric stenosis and a new prescription for 0.9% sodium chloride.
o Check the infant’s serum creatinine
A nurse in the emergency department is caring for a preschool-age child who has hemophilia A and an
MVA Select all
o Administer factor VIII
o Assess for changes in LOC
A nurse is teaching the parent of a school-age child who has cystic fibrosis about home care.
o I will give my child stool softeners for constipation
A nurse is teaching about injury prevention to the parent of a toddler.
o Place a throw rug under the crib

ATI PROCTORED NURSING CARE OF CHILDREN 2019 EXAM ( A)
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.
A nurse is teaching the parent of an infant who has a Pavlik harness for the treatment of developmental
dysplasia of the hip. The nurse should identify that which of the following statements by the parent
indicates an understanding of the teaching?
“I will place my infant’s diapers under the harness straps.”
A nurse is planning care for a school-age child who is in the oliguric phase of acute kidney injury (AKI)
and has a sodium level of 129 mEq/L. Which of the following interventions should the nurse include in
the plan?
Initiate seizure precautions for the child.
A nurse is assessing a school-age child immediately following a perforated appendix repair. Which of the
following findings should the nurse expect?
Absence of peristalsis
A nurse is preparing an adolescent for a lumbar puncture. Which of the following actions should the
nurse take?
Apply topical analgesic cream to the site 1 hr prior to the procedure.
A nurse is caring for a school-age child who is receiving cefazolin via intermittent IV bolus. The child
suddenly develops diffuse flushing of the skin and angioedema. After discontinuing the medication
infusion, which of the following medications should the nurse administer first?
Epinephrine
A nurse is teaching the parent of a preschooler about ways to prevent acute asthma attacks. Which of
the following statements by the parent indicates an understanding of the teaching?
“I should keep my child indoors when I mow the yard.”

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ATI PN Nursing Care of Children Practice B 2019
A nurse is reinforcing teaching with the parents of preschoolers regarding the use of
booster seats in a motor vehicle. Which of the following instructions should the nurse
include in the teaching?

Secure the child in the booster seat using the motor vehicle’s shoulder-lap seat belt
— booster seats do not have built in straps
A nurse is contributing to the plan of care for a child who is in Buck’s traction. Which of the
following interventions should the nurse include in the plan?
Maintain the leg in an extended position—this position decreases the risk for
further injury to the extremity and minimizes the occurrence of muscle spasms.
A guardian calls the clinic nurse after his child has developed symptoms of varicella and asks
when his child will no longer be contagious. Which of the following responses should the nurse
make?
Six days after lesions appear if they are crusted—as long as they are crusted over.
A nurse is caring for a toddler who has otitis media and a temperature of 102.4 F. Which of the
following actions should the nurse take first?
Administer an antipyretic—to decrease the toddler’s body temperature
A nurse is caring for an adolescent who has acne and a new prescription for isotretinoin. For
which of the following adverse effects should the nurse monitor?
Depression—experience mental status changes, such as suicidal thoughts,
aggression, emotional lability, and depression.
A nurse is contributing to the plan of care for a 10 month old infant who is postoperative
following a cleft palate repair. Which of the following actions should the nurse include in the
plan of care?
Place the infant in side-lying position—promote healing and prevent injury to
the surgical site.
A nurse is reinforcing teaching about sudden infant death syndrome (SIDS) with the parent of a
1 month old infant. Which of the following statements by the parent indicates an
understanding of the teaching?
I will allow my baby to have a pacifier while sleeping—decreases the risk for SIDS.
A nurse is collecting data from an infant during a well-child visit. Which of the following sites
should the nurse use when obtaining the infant’s heart rate?
Apical—to obtain the infant’s heart rate and count it for a full minute, because it gives
a reliable rate and rhythm and provides accurate baseline assessment—the apical
heart rate is auscultated at the fourth intercostal space lateral to the midclavicular line.

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A nurse is reinforcing teaching with the guardians of a school-age child who has frequent
nosebleeds. Which of the following instructions should the nurse include?

Apply pressure to the child’s nose—for a least 10 min to decrease bleeding—also
instruct the guardians to tilt the child’s head forward, because this position
prevents aspiration of the blood.
During a well-child visit, the parent of a toddler expresses concern to the nurse that the toddler
takes several hours to fall asleep at night. Which of the following recommendations should the
nurse make?
Provide the toddler with a favorite toy at bedtime—help the toddler to feel more
secure and facilitate sleep.
A nurse is caring for a toddler who has terminal cancer and is receiving hospice care. The
child’s parent tells the nurse, “I’m a bad parent, and I can’t deal with this.” Which of the
following responses should the nurse make?
Tell me more about what you are feeling—use open-ended statements that will allow
the parent to share his feelings and emotions. During times of grief, the parent needs to
express his emotions. The use of open ended statement relays the message that it is
safe to do so with the nurse.
A nurse is reinforcing teaching with the family of an adolescent client who was recently
diagnosed with celiac disease. Which of the following foods should the nurse recommend?
Yellow corn—unable to process gluten, a protein found in wheat, barley, rye and oats
— client’s diet is restricted to foods that are free of gluten, such as corn, rice and
millet.
A nurse is collecting data from a child during a well child visit. The nurse should recognize that
which of the following findings places the child at a higher risk for abuse?
The child was born at 30 weeks of gestation—children who are born prematurely are at
greater risk for abuse because of the potential for impaired bonding during early
infancy.
A nurse is reinforcing dietary teaching with the parent of a 2 year old toddler. Which of the
following should the nurse include in the teaching?
An appropriate serving size is 1 tablespoon of food per year of age—serving size for a
2 year old toddler is 1 tbsp of food per year of age.
A nurse is reviewing the plan of care for a child who has cystic fibrosis. Which of the
following is the priority goal for this child?
The child will maintain an effective breathing pattern—manifestations of cystic fibrosis,
such as chronic cough, pulmonary infection and bronchiolar obstruction lead to
severely impaired ventilation and gas exchange, which causes long-term pulmonary
complications. Therefore, when utilizing the airway, breathing, circulation approach to
client care, maintaining an effective breathing pattern is the priority goal for the child
who has cystic fibrosis.

lOMoARcPSD|3920845
ATI RN Proctored Nursing Care of Children 2019 B – Study Guide
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.

lOMoARcPSD|3920845
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

lOMoARcPSD|3920845
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

ATI Care of Children Proctored Exam 2 Revision Guide

A nurse is caring for a 4 year old child who has superficial partial thickness burns over 50% of his
body. When planning for the nutritional needs of the child, which of the following actions
should the nurse plan to take?
Supplement the childs feeding with enteral feedings.
A nurse is caring for a child who has vesicular rash. The parents of the child asks the nurse
what illness can cause this rash for 6 days. The nurse should expect that the child has which of
the following conditions?
varicella
A nurse is caring for a child who has been in Bucks traction for 2 days. Which of the
following actions should the nurse take to prevent complications?
Check for pulses in the affected leg every 4 hours.
A nurse is caring for a child who is in the emergency department after ingesting a bottle
of acetaminophen. Which of the following medications should the nurse plan to
administer?
Acetylcysteine
A nurse is preparing to administer an intramuscular injection to a 2month old infant. In which
of the following sites should the nurse plan to administer injection?

Vastus lateralis

A nurse is teaching the parents of an infant who has congenital hypothyroidism. Which of
the following statements should the nurse make?
Your child will need to take thyroid hormone replacement for her entire life.
A nurse is teaching a group of parents of toddlers about G&D. A parent asks “why does my
childs abd stick out?” Which of the following statements should the nurse make?
Toddlers do not have well developed abdominal muscles.
A nurse is caring for a 10 year old child who should reduce his fat intake. Which of the
following menu choices should the nurse suggest?
Baked chicken sandwich on whole wheat bun.
A nurse is assessing an adolescent who has sustained a broken tibia. Following the application
of cast, adolescent reports pain and tingling.
Assess for manifestations of circulatory impairment
Preparing to administer diphenhydramine 5mg/kg/day PO divide equally every 8 hours to a
child who weighs 50lb.
15 mL
A nurse is caring for child who adheres to vegi diet and has superficial partial thickness burns.
The nurse should recommend which food choice having highest protein content?
1/2 cup of peanut butter with apple slices
A nurse is caring for a 4 yo who has pneumonia. The childs mother left 2 hr ago and he
is currently experiencing separation anxiety of despair.
Inactive and thumb sucking
A nurse is caring for an 8 year old who has sickle cell anemia. Which of the following
actions should the nurse take?
Give the child flavored popsicles.
A nurse is teaching the parents of a child who has cerebral palsy. Which of the
following statements should the nurse make?
Will need botulinum toxin A to help with muscle spasticity.
A nurse is planning care for a 6 year old child who is reciving chemo. The child has platelet
count of 20,000. Which intervention should the nurse include in the plan of care?
Encourage quiet play

Page 1 of 27
ATI RN Nursing Care of Children Online Practice 2019 A
Teaching the parents of a school-aged child who has a new diagnosis of osteomyelitis of the tibia. The
nurse should identify that which of the following statements by the parents indicates an
understanding of the teaching?
my child will have a cast until healing is complete.
My child will receive antibiotics for several weeks.
My child can return to playing sports once he is discharged.
My child needs to be in contact isolation.
Answer: b
The nurse should instruct the parent that the child will receive antibiotic therapy for at least 4
weeks. Surgery might be indicated if the antibiotics are not successful.
A – incorrect
Weight bearing must be avoided with osteomyelitis. Therefore, the child is placed in a
comfortable position with the limb supported. There is no indication for a cast.
C- incorrect
Weight bearing should be avoided to prevent complications and minimize pain. Therefore, it
will be several weeks to months before the child can play contact sports.
D- incorrect
Contact isolation is NOT necessary, because osteomyelitis is not a communicable illness.
A nurse is auscultating the lungs of an adolescent who has asthma. The nurse should identify the
sound as which of the following? Click the audio button to listen.
A- Biots respiration
B- Chaney Stokes respiration
C- tackypnea
D – Bradypnea
Answer- c
The nurse should identify the sound heard during auscultation as tachypnea, which is a rapid,
regular breathing pattern. This breathing pattern often occurs with anxiety, fever, metabolic
acidosis, or severe anemia.
A- Biot’s respirations are periods of apnea alternating with two or three shallow breaths.
B- Cheyne-Stokes respirations are periods of apnea alternating with periods of
hyperventilation.
D- Bradypnea is a slow, regular breathing pattern.
A nurse in an emergency department is caring for a school-age child who is experiencing an
anaphylactic reaction. Which of the following is the priority action by the nurse?
A- Elevate the head of the child’s bed
B- insert a large-bore IV catheter for the child
C- determine the allergen that caused the child’s reaction
D- administer IM epinephrine to the child
Answer- d

Page 2 of 27
When using the urgent vs nonurgent approach to client care, the nurse determines that the
priority action is administering IM epinephrine to the child. During an anaphylactic reaction,
histamine release causes bronchoconstriction and vasodilation. This is an emergency because
ultimately it causes decreased blood return to the heart.
A- Elevating the head of the child’s bed is important to facilitate breathing and circulation.
However, it is not the priority action the nurse should take.
B- Inserting a large bore IV catheter is important to facilitate administration of IV fluids and
medications. However, it is not the priority action the nurse should take.
C- Determining the allergen that caused the child’s reaction is important to prevent any
additional episodes of anaphylaxis. However, it is not the priority action the nurse should take.
The nurse is preparing to administer an immunization to a four-year-old child. Which of the
following actions should the nurse plan to take?
A- Place the child in a prone position for the immunization
B- request that the child’s caregiver leave the room during the immunization
C- administer the immunization using a 24 gauge needle
D- inject the immunization slowly after aspirating for 3 seconds
Answer – c
The nurse should administer an immunization for a 4-year-old child using a 24-gauge needle to
minimize the amount of pain experienced by the toddler.
A- The nurse should place the child in an upright sitting position for the immunization because
this decreases the child’s fear and anxiety.
B- The nurse should allow the caregiver to stay near the child during the immunization to
provide a sense of security and reduce the child’s anxiety level.
D- The nurse should inject the immunization rapidly and avoid aspiration. These
actions decrease the risk of needle displacement and lower the child’s fear and anxiety
level by decreasing the amount of time it takes to administer the immunization.
A nurse is reviewing the laboratory report of an infant who is receiving treatment for severe
dehydration. The nurse should identify which of the following laboratory values indicates
effectiveness of the current treatment?
A- Potassium 2.9 mEq/L
B- sodium 140
C- urine specific gravity 1.035
D- BUN 25 mg
Answer- b
The nurse should identify that a sodium level of 140 mEq/L is within the expected
reference range and indicates the current treatment regimen the infant is receiving for
dehydration is effective.
A- A potassium level of 2.9 mEq/L is below the expected reference range and
indicates hypokalemia.

Page 3 of 27
C- A urine specific gravity of 1.035 is above the expected reference range and indicates
concentrated urine.
D- A BUN level of 25 mg/dL is above the expected reference range and indicates the kidneys are
not excreting BUN as they should be.
The nurse is providing teaching about Social Development to the parents of a preschooler.
Which of the following play activities should the nurse recommend for the child?
A- Play pat-a-cake
B- using a push pull toy
C- creating a scrapbook
D- playing dress-up
Answer – d
The nurse should instruct the parents that at the preschool age, play should focus on social,
mental, and physical development. Therefore, playing dress-up is a recommended play
activity for this child.
A- Playing pat-a-cake is a recommended play activity for an infant.
B- Using a push pull toy is a recommended play activity for a toddler.
C- Creating a scrapbook is a recommended play activity for a school-age child.
A nurse is teaching the parents of a newborn about ways to prevent sudden infant death
syndrome SIDS. Which of the following instructions should the nurse include?
A- Place the infant in a prone position to sleep.
B- Allow the infant to sleep on a large pillow.
C- User soft mattress in the infant’s crib.
D- Give the infant a pacifier at bedtime.
Answer- d
The nurse should inform the parent that protective factors against SIDS include breastfeeding
and the use of a pacifier when the infant is sleeping.
A- The nurse should instruct the parent to place the infant in a supine position to sleep. Prone
and side-lying positions are risk factors for SIDS.
B- Placing the infant on a large pillow to sleep can increase the risk of suffocation, asphyxiation,
and SIDS.
C- The nurse should instruct the parent to use a firm mattress and avoid the use of waterbeds,
beanbags, or soft mattresses when placing the infant to bed. The use of a soft mattress in the
infant’s crib is a risk factor for SIDS and can lead to asphyxiation.

RN Nursing Care of Children Online Practice 2019 B

A nurse is planning care for a newly admitted school-age child who has
generalized seizure disorder. Which of the following interventions should the
nurse plan to include?
Ensure the oxygen source is functioning in the childs room
A nurse is providing dietary teaching to the guardian of a school-age child who
has cystic fibrosis. Which of the following statements should the nurse make?
“You should offer your child high-protein meals and snacks throughout the day.”
A nurse is providing discharge teaching to the parents of a 6-month-old infant
who is postoperative following hypospadias repair with a stent placement. Which
of the following instructions should the nurse include in the teaching?
“Allow the stent to drain into your infants diaper.”
A nurse is caring for a school-age child who has primary nephrotic syndrome and
is taking prednisone. Following 1 week of treatment, which of the following
manifestations indicates to the nurse that the medication is effective?
Decreased edema
A nurse is receiving change-of-shift report for four children. Which of the
following children should the nurse assess first?
A toddler who has a concussion and an episode of forceful vomiting.
A nurse is providing discharge teaching to the guardians of a toddler who had
lower leg cast applied 24 hr ago. The nurse should instruct the guardians to report
which of the following finding to the provider?
Restricted ability to move the toes.
A nurse in an emergency department is auscultating the lungs of an adolescent
who is experiencing dyspnea. The nurse should identify the sound as which of the
following?
Wheezes
A nurse is caring for a preschooler who has congestive heart failure. The nurse
observes wide QRS complexes and peaked T waves on the cardiac monitor.
Which of the following prescriptions should the nurse clarify with the provider?
Potassium Chloride
A nurse is planning an educational program for school-age children and their
parents about bicycle safety. Which of the following information should the nurse
plan to include?
The child should be able to stand on the balls of their feet when sitting on the
bike.
A nurse is monitoring the oxygen saturation level of an infant using pulse
oximetry. The nurse should secure the sensor to which of the following areas on
the infant?
Great Toe
A nurse is an emergency department is caring for a school-age child who has
epiglottitis. Which of the following actions should the nurse take?
Monitor the childs oxygen saturation
A nurse in an emergency department is caring for a school-age child who has
sustained a minor superficial burn from fireworks on their forearm. Which of the
following actions should the nurse take?
Apply an antimicrobial ointment to the affected area.
A nurse in a providers office is caring for a school-age child who has varicella.
The parents asks the nurse when their child will no longer be contagious. Which
of the following responses should the nurse make?
“When your childs lesions are crusted, usually 6 days after they appear.”
A nurse is providing discharge teaching to the parent of a school-age child who
has moderate persistant asthma. Which of the following instructions should the
nurse include?
“Pulmonary function tests will be performed every 12 to 24 months to evaluate
how your child is responding to therapy.”
A nurse is admitting an infant who has intussusception. Which of the following
findings should the nurse expect? (Select all that apply.)
-Vomiting
-Lethargy
A nurse is reviewing the laboratory results of a school-age child who is 1 week
postoperative following an open fracture repair. Which of the following findings
should the nurse identify as an indication of a potential complication?

ATI Nursing Care of Children
Remediation
The nurse is developing a teaching plan for the upcoming discharge of a child who has a
resolving sickle cell crisis. While developing the plan the nurse knows it is imperative to
include what information?
o Increasing fluid intake and being well hydrated will help prevent cell stasis in the small
vessels. Restricting fluids causes stasis of red blood cells and promotes obstruction and
increases the chance of sickling with hypoxia and pain to the part that is involved. Clients
with sickle cell disease should stay away from others who have infections. When the
spleen of a client who has sickle cell disease has become fibrotic and nonfunctional, the
client is more susceptible to infections. Clients with sickle cell disease should not avoid
physical activity as long as the client stays well hydrated.
What does FLACC stand for?
o It stands for face, legs, activity, crying and consolability. The FLACC pain scale was
developed to help medical observers to assess the level of pain in children who are too
young to cooperate verbally.
How old does a child need to be to use the FLACC Scale for pain?
o This scale is used for children between the ages of 2 months and 7 years of age.
What is the form of evaluation when using the FLACC Scale?
o When looking at their face- assessing for smiling, grimacing, frowning, withdrawn,
quivering chin, clenched jaw etc. When assessing legs- the positioning of their legs, if
they’re relaxed, uneasy, restless, tense etc. Their activity is rated by assessing if they’re
lying quietly, moving easily, squirming, tense, shifting back and forth, or rigid. Crying is
determined by the types of cries such as moans or whimpers, occasional complaints,
screaming or sobbing. Consolability is determined by if they’re content and relaxed or
reassured by occasional touching hugging or being talked to or if they’re difficult to
console or comfort.
A nurse is caring for a client newly prescribed cefazolin who has hereditary glomerulopathy.
What are three (3) adverse effects of this class of medication? Is the administration of
cefazolin safe for this client?
o Loss of appetite
o Increased blood glucose level/hyperglycemia, decreased blood glucose level/hypoglycemia
o Anorexia
o No the administration of cefazolin would not be safe for this client

Ati Nursing
Care of
Children EXAM
1 REVIEW
1.-A nurse is caring for a 4-year-old child who refuses to take his medications
because of the bad taste. Which of the following strategies should the nurse
use to elicit the child’s cooperation? Hide the medication in apple slices. Hide
the medication in ice cream or juice.
2.-A nurse is caring for a 4-year-old child who refuses to take his medications
because of the bad taste. Which of the following strategies should the nurse
use to elicit the child’s cooperation? Offer the child an ice pop prior to
administering the medication.
3.-A nurse is planning care for a four-year-old child who has been admitted to
the hospital. Which of the following toys should the nurse plan to provide the
child? Modeling clay. A Plastic stethoscope.
4-The mother of a 4-year-old child tells a nurse that her child is reluctant to
go to bed at night. Which of the following responses should the nurse make?
Keep a night light on in your child’s room. Allow your child an additional 30
minutes of play time before bed.
5 -A parent expresses concern to a nurse about his 5-year-old child
stuttering. Which of the following statements should the nurse make? Look
directly at your son when he is speaking
6 -A nurse is caring for a 4-year-old child who had an incident of bedwetting
during hospitalization. The child’s parents express concern about the
incident. Which of the following responses should the nurse make? “Children
who are hospitalized often regress. The toileting skills will return when your
child is feeling better.” It’s very
7 -A nurse is caring for an 8-month-old child who starts to cry when his
parents leave. The nurse should make which of the following statements to
the parents? “You should expect your child to be upset when you leave.”
8 -A father of a toddler asks a nurse at a well-child clinic what to do when
the child kicks and screams during temper tantrums. Which of the following
responses should the nurse make? “You should ignore your toddler’s temper

tantrums.” (The parent should ignore the toddler’s attention-seeking
behavior, so the child realizes that expressing himself in this method is not
effective way to communicate)

ATI NURSING CARE OF CHILDREN PROCTORED EXAM A 2019

A nurse is planning care for a school-age child who is in the oliguric phase of acute kidney
injury (AKI) and has a sodium level of 129 mEq/L. Which of the following interventions
should the nurse include in the plan?
a. Initiate seizure precautions for the child.
A nurse is assessing a school-age child immediately following a perforated appendix repair.
Which of the following findings should the nurse expect?
a. Absence of peristalsis
A nurse is preparing an adolescent for a lumbar puncture. Which of the following actions
should the nurse take?
a. Apply topical analgesic cream to the site 1 hr prior to the procedure.
A nurse is caring for a school-age child who is receiving cefazolin via intermittent IV bolus.
The child suddenly develops diffuse flushing of the skin and angioedema. After
discontinuing the medication infusion, which of the following medications should the nurse
administer first?
a. Epinephrine
A nurse is teaching the parent of a preschooler about ways to prevent acute asthma attacks.
Which of the following statements by the parent indicates an understanding of the teaching?
a. “I should keep my child indoors when I mow the yard.”
A nurse is proving dietary teaching to the parent of a school-age child who has celiac disease.
The nurse should recommend that the parent offer which of the following foods to the child?
a. White rice
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?
a. Hematocrit 28%
A nurse is preparing to collect a sample from a toddler for a sickle-turbidity test. Which
of the following actions should the nurse plan to take?
a. Perform a finger stick.
A nurse is assessing a school-age child who has meningitis. Which of the following findings
is the priority for the nurse to report to the provider?
a. Petechiae on the lower extremities
A nurse is assessing an infant who has a ventricular septal defect. Which of the following
findings should the nurse expect?
a. Loud, harsh murmur
A nurse is creating a plan of care for an infant who has an epidural hematoma from a
head injury. Which of the following interventions should the nurse include in the plan?
a. Implement seizure precautions for the infant.
A nurse is caring for an adolescent who received a kidney transplant. Which of the following
findings should the nurse identify as an indication the adolescent is rejecting the kidney?
a. Serum creatinine 3.0 mg/dL
A nurse in an emergency department is performing an admission assessment on a 2-week-old
male newborn. Which of the following findings is the priority for the nurse to report to the
provider?
a. Substernal retractions

lOMoARcPSD|3920845
Care of the Child ATI 2019
Chapter 1
Parenting styles:
 Dictatorial or authoritarian
o Super strict parents, it’s their way or the highway
o Parents try to control their child’s behaviors through unquestioned rules
or expectations
o Ex. the child is never allowed to watch tv on a school night
 Permissive
o Very laid back, allow children to set their rules
o Parents exert very little control over their child’s behaviors; consult the
child when making decisions
o Ex. the child assists in deciding whether or not they can watch tv on a
school night
 Democratic or authoritative
o Right in the middle, not too strict but also not too permissive
o Parents direct the child’s behaviors by setting rules and explain the
reason behind them
o Parents negatively reinforce deviations from the rules and may do so by
taking privileges away
o Ex. the child can watch tv for 1 hour on school nights as long as their
homework is done
 Passive parents
o Do not care what is going on, don’t even consult with the children.
Uninvolved, indifferent or emotionally removed
Chapter 2
Physical Assessment Findings
 Pediatric vital signs differ from an adult’s, except for blood pressure.
 Temperature of a one year old is 99.9 degrees
 Not until 5 years old when they begin to have a normal temperature of 98.6
 Pulse rate for an infant is 80-180 with respirations of 30-35
 Infant bp systolic is between 65-80 and their diastolic is between 40 & 50
 The fontanels*
o Should be flat and soft
o Posterior: closes between 6 & 8 weeks
o Anterior closes between 12 & 18 months
 Infant can have 6-8 teeth by one year of age
 There will be 20 deciduous teeth and 32 permeant teeth

lOMoARcPSD|3920845
 Reflexes*
o Moro reflex: present from birth to four months. Allowing the head
and trunk of the infant to fall backwards. The arms and legs
symmetrically extend and abduct, and fingers form a C shape.
o Rooting: stroking the infant’s cheek or edge of mouth causes the infant
to turn their head to that side and suck. Birth to 4 months.
o Palmar grasp: placing an object in the infant’s palm and the infant grasps
the object. Birth to 3 months.
o Plantar: by touching the sole of the infant’s foot the toes curl downward.
Birth to 8 months.
o Startle: by making a loud noise the infant abducts arms and hands remained
clenched. Birth to 4 months.
o Tonic neck: by turning the infants head to one side the infant will extend
the arm and leg on that side and flex the opposite side. Birth to 3-4
months.
o Babinski: by stroking the outer edge of the sole up toward the toes the
infant will fan its toes upward and out. Birth to 1 year.
o Stepping: by holding the infant upright with its feet touching the surface
the infant will make stepping movements. Birth to 4 weeks.
 Cranial nerves
o 1 is olfactory
o 2 is optic
o 3 oculomotor
o 4 trochlear: ability of eye to look down and in
o 5 trigeminal: have child close eye and they will detect you touching their
face
o 6 abducens: the ability to look laterally with the eyes
o 7 facial: symmetry facial movements
o 8 vestibulocochlear/acoustic: checking hearing
o 9 glossopharyngeal: checking for intact gag reflex
o 10 vagus: checking for swallowing
o 11 spinal accessory: can move shoulders symmetrically
o 12 hypoglossal: tongue is midline and can move in all directions
Ooh ooh ooh to touch and feel very good velvet such heaven
Some say marry money but my brother says big brains matter
most
Chapter 3
Physical Development:
 Doubles by 6 months; triples by 1 year*

lOMoARcPSD|3920845
 2.5 cm (1 in) per month for the first 6 months
 Length increases by 50% by 12 months of age
 First teeth erupt between 6-10 months
Age Gross motor Fine motor
1 month Demonstrates head lag Strong grasp
2 months Lifts head up when prone Holds hands in an open
position, grasp reflex
fading
3 months Raises head and shoulders
when prone, slight head
lag
No longer has a grasp
reflex, keeps hands open
loosely.
4 months Rolls from back to side Grasps with both hands
5 months Rolls from front to back Uses palmar grasp
6 months Rolls from back to front Holds bottle
7 months Bears full weight on feet.
Sits leaning forward on
both hands
Moves objects from
hand to hand
8 months Sits unsupported Begins using pincer grip
9 months Pulls to standing position.
Creeps on hands and
knees
Has crude pincer grip.
Dominant hand preference
evident
10 months Changes from prone to
sitting position
Grasps rattle by its hand
11 months Cruises or walks while
holding on to something.
Walks with one hand held.
Places objects into a
container. Neat pincer
grasp.
12 months Sits down from a standing
position without assistance
Tries to build a twoblock tower w/o success.
Can
turn pages in a book.
Cognitive Development: Piaget
 From birth to 24 months they are in the sensorimotor stage
 Object permanence occurs around 9 months of age.
Language Development:
 Should be able to say 3-5 words by age 1 and they know the concept of no.
Erickson:
 From birth to 1 year is trust vs. mistrust.
 Is the caretaker meeting the needs of the infant?
 Separations anxiety occurs around 4-8 months of age
 Stranger fear occurs around 6-8 months of age

lOMoARcPSD|3920845
Toys:
 Rattles, blocks, brightly colored toys, playing patty cake, reading books, mirrors,
and playing with balls.
Immunizations:
 Birth: hep B
 2 months: 2
nd hep B, IPV (inactivated polio), RV (rotavirus), PCV (pneumococcal),
DTaP, Hib (haemophilus influenza type B)
 4 months: all of the above minus the hep B
 6 months: all including hep B
 Should also get flu between 6 months and 1 year
Nutrition:
 Breastmilk for the first 6 months
 No solids until 4 to 6 months, iron fortified rice cereal
 Do not need juice or water during first year of life**
 Introduce new foods one at a time over a 4 to 7 day period to observe for allergies
 Never leave unattended in bathtub
 Stay in rear facing cars seat until two years of age
 Crib slats should be no more than 6 cm apart, keep pillows out of crib
 On back to sleep*
Chapter 4:
 Quadruple weight by 30 months of age
 Grow 3 inches per year
 Head and chest circumference should be equal around 2 years of age
Age Gross Motor Fine Motor
15 months Walks without help. Creeps
up stairs
Uses a cup. Builds a tower
of 2 blocks
18 months Runs clumsily, falls
often, throws ball
overhead, jumps in
place with both
feet. Pushes and pulls toys
Manages a spoon.
Turns pages in a book
two or three at a time,
build a
tower of 3-4 blocks

ATI NURSING CARE OF CHILDREN 1 PROCTORED EXAM
2019 (STUDY GUIDE)

A nurse in the emergency department is caring for a 2-year-old child who was found by his parents crying and
holding a container of toilet bowl cleaner. The child’s lips are edematous and inflamed, and he isdrooling. Which
of the following is the priority action by the nurse?
a. Remove the child’s contaminated clothing.
b. Check the child’s respiratory status.
c. Administer an antidote to the child.
d. Establish IV access for the child.
Rationale: The nurse should apply the ABC priority-setting framework when answering this item. This
framework emphasizes the basic core of human functioning: having an open airway, being able to breathe in
adequate amounts of oxygen, and circulating oxygen to the body’s organs via the blood. An alteration in any of
these can indicate a threat to life, and is therefore the nurse’s priority concern. When applying the ABC priority
setting framework, airway is always the highest priority because the airway must be clear and openfor oxygen
exchange to occur. Breathing is the second highest priority in the ABC priority setting framework because
adequate ventilatory effort is essential in order for oxygen exchange to occur.
Circulation is the third highest priority in the ABC priority setting framework because delivery of oxygen tocritical
organs only occurs if the heart and blood vessels are capable of efficiently carrying oxygen to them.The nurse
observes that the child’s lips are edematous and inflamed and that he is drooling. These findingsindicate that the
child might have swelling of the oral cavity and pharynx, which can result in a compromised airway.
A nurse is teaching a parent of a 12-month old child about development during the toddleryears. Whichof the
following statements should the nurse include?
a. “Your child should be referring to himself using the appropriate pronoun by 18 months of age.”
b. “A toddler’s interest in looking at pictures occurs at 20 months of age.”
c. “A toddler should have daytime control of his bowel and bladder by 24 months of age.”
d. “Your child should be able to scribble spontaneously using a crayon at the age of 15
months.”
Rationale: The nurse should teach the parent that at the age of 15 months, the toddler should be able to scribble
spontaneously, and at the age of 18 months, the toddler should be able to make strokes imitatively.
A nurse is caring for a toddler and is preparing to administer 0.9%sodium chloride 100 mL IV to infuse over 4
hr. The drop factor of the manual IV tubing is 60 gtt/mL. The nurse should set the manual IV infusionto deliver
how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use
a trailing zero.)
25 gtt
Rationale: 100ml/4 hr x 60gtt/1mlx 1 hr/60min= 6000/240= 25 gtt
Ratio and Proportion
STEP 1: What is the unit of measurement to calculate? gtt/min
STEP 2: What is the volume needed? 100 mL
STEP 3: What is the total infusion time? 4 hr
STEP 4: Should the nurse convert the units of measurement? Yes (min does not equal hr)1
hr/60 min = 4 hr/X min
X = 240 min
STEP 5: Set up an equation and solve for X.
Volume (mL)/Time (min) = drop factor (gtt/mL) = X100
mL/240 min x 60 gtt/mL = X gtt/min
X = 25

STEP 6: Round if necessary.
STEP 7: Reassess to determine whether the amount to administer makes sense. If the prescriptionreads
100 ml of 0.9% sodium chloride IV to infuse over 4 hr, it makes sense to administer 25 gtt/min. The
nurse should set the manual IV infusion to deliver0.9% sodium chloride IV at 25 gtt/min.
Dimensional Analysis
STEP 1: What is the unit of measurement to calculate? gtt/min
STEP 2: What is the volume needed? 100 mL
STEP 3: What is the total infusion time? 4 hr
STEP 4: Should the nurse convert the units of measurement? Yes (min does not equal hr)STEP
5: Set up an equation and solve for X.
X = Quantity / 1 mL x Conversion (hr) / Conversion (min) x Volume (mL) / Time (hr)
X gtt/min = 60 gtt/1 mL x 1 hr/ 60 min x 100 mL/4 hrX =
25
STEP 6: Round if necessary.
STEP 7: Reassess to determine whether the amount to administer makes sense. If the prescriptionreads
100 ml of 0.9% sodium chloride IV to infuse over 4 hr, it makes sense to administer 25 gtt/min. The
nurse should set the manual IV infusion to deliver 0.9%sodium chloride IV at 25 gtt/min

RN VATI Nursing Care of Children 2019 Assessment

“Your child will be exposed to a moderate amount of radiation during the
procedure.” MY ANSWER
An MRI produces radiofrequency emissions from nonradioactive elements; therefore, there is no
exposure to radiation involved during this procedure.
“Your child might experience pain during the procedure.”
An MRI does not cause pain, as it is a noninvasive procedure that emits radiofrequencies to
produce an image.
“This is considered an invasive procedure.”
An MRI is a noninvasive procedure, unless an IV is prescribed when contrast is used. No
contrast is indicated for this child, so no IV is needed.
“You can remain in the room with your child during the procedure.”
The parent may remain in the room with the child to provide comfort and reassurance during
the procedure.
Nausea
The nurse should identify that nausea is an early sign of increased intracranial pressure in a child.
Papilledema
The nurse should identify that papilledema is a late sign of increased intracranial pressure in a
child.
Dilated pupils
The nurse should identify that dilated pupils along with a decreased pupillary response are late
signs of increased intracranial pressure in a child.
Bradycardia
MY ANSWER
The nurse should identify that bradycardia is a late sign of increased intracranial pressure in a
child.
Initiate contact precautions.
The nurse should initiate contact, droplet, and standard precautions for RSV because exposure to
contaminated secretions can transmit the virus. RSV can live on objects for several hours and on
hands for 30 min.
Perform chest percussion and postural drainage.
The nurse should perform periodic suctioning of the nose or nasopharynx to clear nasal
secretions. Chest percussion and postural drainage are not routinely recommended for an infant
who has RSV.
Encourage clear liquids by
mouth. MY ANSWER
The nurse should not encourage clear liquids by mouth, because the infant has tachypnea. Oral
fluids are contraindicated in the presence of tachypnea due to the risk for aspiration.
Administer IV antibiotics.
The nurse should not plan to administer IV antibiotics, because RSV is a viral infection.
Antibiotics may be prescribed if a secondary bacterial infection occurs.
Warm extremities
Heart failure involves an inability of the heart to pump effectively, limiting perfusion to major
organs and the extremities. The nurse should expect a child who has heart failure to exhibit
pale, cool extremities.
Frequent headaches
The child who has heart failure can exhibit neurologic manifestations, such as increased
restlessness or irritability as a result of hypoxia and impaired cardiac function; however, frequent
headaches are not an expected manifestation associated with heart failure.
Distended neck veins
The child who has heart failure will exhibit manifestations of increased blood volume, such as
distended neck veins. This occurs because the hormone ADH is excreted, which holds onto
sodium and water in response to decreased cardiac output and renal perfusion.
Weight loss
MY ANSWER
The child who has heart failure will exhibit weight gain as a result of sodium and water retention.
As the heart failure progresses, dependent and periorbital edema, ascites, and pulmonary
effusions result.
The infant falls to a sitting position while learning how to walk.
The infant falling to a sitting position while learning how to walk is not a manifestation of
hemophilia, as this is an expected part of growth and development.
The infant bleeds slightly when scratched by a cat.
Bleeding slightly when a minor scratch occurs is not a manifestation of hemophilia; however, if
the bleeding is not easily controlled, the parent should notify the provider.
The infant’s skinned knee drains serosanguineous fluid.
MY ANSWER
The drainage of serosanguineous fluid from a skinned knee is not a manifestation of
hemophilia. This is an expected finding after a skin injury and does not warrant evaluation.
The infant’s knees are reddened and edematous.
The nurse should identify that the infant might be experiencing hemarthrosis if redness, edema,
and warmth of the joints are noted. Bleeding into the joints is the most frequent form of
internal bleeding in children who have hemophilia.
“I should eat extra food on busy days when I am more active” is correct. The nurse should
instruct the child to increase her intake of allowable foods when she is more active. Exercise
lowers blood glucose levels during and after activity. Food intake should be adjusted to
compensate for the release of insulin into the circulatory system and prevent episodes of
hypoglycemia. The recommended increase of carbohydrates is 10 to 15 g per hour of moderate
play or activity.
“I should wait 2 hours after eating before playing with my friends” is incorrect. The child should
play or exercise within 2 hr of eating because exercise requires her to have more carbohydrates
in her system. Waiting 2 hr after eating before play or exercise increases the likelihood of a
hypoglycemic episode. A carbohydrate snack will most likely be needed during prolonged play or

exercise and another a few hours after the activity.
“I should increase my intake of sugar-free fluids when I am sick” is correct. The nurse should
instruct the child to increase her intake of sugar-free fluids when she is sick. Fluids flush out
ketones to prevent dehydration. The nurse should recommend sugar-free liquids, such as water,
broth, and tea to the child. The child should continue with her usual intake at mealtimes and
follow her recommended meal plan as much as possible.
“I should eat a snack 30 minutes before my baseball game starts” is correct. The nurse should
instruct the child to eat a recommended snack 30 min prior to a planned activity, such as a
baseball game. If the game is prolonged, she should have a snack every 45 min to an hour. If for
some reason the child cannot tolerate the extra food, the next intervention is to decrease the
child’s insulin dose before baseball games.
“I should have a 16 ounce sports drink if I start feeling weak or shaky” is incorrect. The child
should consume 8 oz of a sports drink if she feels hypoglycemic, rather than 16 oz. Clinical
manifestations of hypoglycemia include dizziness, headache, irritability, weakness, shakiness,
and confusion. An 8-oz sports drink contains 15 g of carbohydrate. If the child consumes 16 oz, it
would contain a minimum of 30 g of carbohydrate and most likely cause the child to become
hyperglycemic and require a dose of insulin.

“Your child’s skin will appear
flushed.” MY ANSWER
The nurse should inform the parents that their child will have pale skin near the end of his life.
The skin is cool to the touch and might appear grayish-blue as death nears. Mottling might
occur in the extremities and move toward the body core because of a decrease in cardiac
output and perfusion to the extremities.
“Your child will lose movement in his legs.”
The nurse should inform the parents that their child will lose movement of the lower
extremities. This progressive loss of movement will move up the body as death nears.
“Your child will first lose his ability to hear.”
The nurse should inform the parents that the sense of hearing is the last sense to fail as death
nears. Loss of sensation develops before hearing loss, and the child might become more
sensitive to light.
“Your child’s blood pressure will start to increase.”
The nurse should inform the parents that their child will experience decreased cardiac output,
leading to a drop in blood pressure and decreased pulses.
Koplik spots
The nurse should not expect a child who has viral meningitis to have Koplik spots. Koplik spots
are small red spots with a white center that are found on the oral mucosa in children who have
measles.
Decreased protein in the cerebrospinal fluid
The nurse should expect a child who has viral meningitis to exhibit either a normal or slightly
elevated protein level in the cerebrospinal fluid due to increased permeability of the blood-brain
barrier.

ATI RN Proctored Nursing Care of Children
Form B Exam 2019

A nurse is providing education to the parent of a child who has cystic fibrosis
and has a prolapsed rectum. The nurse should teach that which of the
following is a cause of this complication:
Bulky stools
A pre-schooler is admitted to the emergency department with full thickness
third degree burn over 45% of his body. Which of the following actions should
the nurse take first:
Administer IV solutions
A nurse is providing teaching to a parent of a pre-schooler who has Tinea
Capitis. Which of the following should the nurse include in the teaching:
Leave the shampoo on the scalp for 5 to 10 minutes
A nurse is caring for a child who has sickle cell anemia. Which of the following
signs of acute chest syndrome should the nurse report to the primary care
provide immediately:
Congestive cough
A nurse is assessing a 3month old infant for suspected intussusception. Which
of the following findings should the nurse expect:
Jelly-like stool
A nurse is planning a teaching session for parents regarding infant
development. Which of the following parent activities regarding play should
the nurse include in the teaching:
Give the infant a large piece puzzle
A school-aged child with sickle cell anemia has been admitted in vasoocclusive crisis. Which of the following assessment findings should the nurse
recognize as an emergency?
Fever of 38.30 C (1010 F)
A nurse in an emergency department is assessing a child who was in a motor
vehicle accident. Which of the following assessment findings require
immediate intervention:
Dilated and fixed pupils
A nurse is assessing a child who has sustained a head injury. During the
assessment, the nurse observes clear drainage leaking from the child’s nose.
Which of the following actions should the nurse take?
Testthe nasal secretions for glucose
A nurse at a provider’s office is preparing a newborn for a routine heel
puncture. Which of the following actions should the nurse take?
Prepare concentrated sucrose for oral administration
A nurse is caring for a child who has rheumatic fever. Which of the following is
an indication that the child has developed carditis?
Chest pain
A parent calls the clinic asking for pinworm testing information, the nurse
should advise the parent to perform the test at which of the following times?
Immediately after the child awakes in the morning
A nurse is educating the parents of an infant who has mild gastroesophageal
reflux. Which dietary adjustment should the nurse recommend?
Thicken feedings with rice cereal
A nurse is teaching an adolescent client about managing asthma and using a
peak respiratory flow meter. Which of the following by the client
demonstrates an understanding of the teaching:
I will continue to take my medication when my peak flow meter is
in the green zone
A nurse is instructing the parent of an infant who has clubfeet and has cast
applied. Which of the following statements by the parent indicates a need for
further teaching:
My baby will need to have surgery at 18 months if his toes aren’t
fixed
A nurse assesses an infant that is admitted for acute gastroenteritis. Which of
the following is the priority finding?
Capillary refill of 5 seconds
A nurse is planning to teach a nutrition class for preschoolers. Which of the
following is an appropriate instructional strategy? (Select all that apply.)
Limit the teaching session to 45 minutes
Use simple language
Incorporate games into the lesson
Provide concrete examples
A nurse is caring for a toddler who has a fever, high-pitched cry, irritability and
vomiting. Which of the following is an appropriate action for the nurse to
take?
Place the toddler in a cold water bath

lOMoARcPSD|3920845
ATI RN PROCTORED: Nursing Care of Children 2 2019 Exam – STUDY GUIDE

A nurse in an emergency department is caring for a 4-year-old child who has burns to the neck and face following a house fire. Which of the
following actions should the nurse take first?
A. Cover the child’s wounds with a clean, dry cloth.
B. Establish IV access for the child with a large-bore catheter.
C. Provide reassurance to the child’s
parents. D. Determine the child’s breathing
pattern.
Determine the child’s breathing pattern.
The nurse should apply the ABC priority setting framework. This framework emphasizes the basic core of human functioning: having an open
airway, being able to breathe in adequate amounts of oxygen, and circulating oxygen to the body’s organs via the blood. An alteration in any of
these can indicate a threat to life, and is therefore the nurse’s priority concern. When applying the ABC priority setting framework, airway is always
the highest priority because the airway must be clear and open for oxygen exchange to occur. Breathing is the second highest priority in the ABC
priority setting framework because adequate ventilatory effort is essential in order for oxygen exchange to occur. Determining the child’s breathing
pattern is the first action the nurse should take. Circulation is the third highest priority in the ABC priority setting framework because delivery of
oxygen to critical organs only occurs if the heart and blood vessels are capable of efficiently carrying oxygen to them.
A nurse is providing teaching to the parent of a 2-year-old toddler about nutrition. Which of the following statements by the parent indicates an
understanding of the teaching?
A. “My child should consume 1,000 calories per day.”
B. “My child should have 4 ounces of protein per day.”
C. “I should give my child 32 ounces (4 cups) of milk per day.”
D. “I should feed my child 4 ounces (1/2 cup) of vegetables per
day.” “My child should consume 1,000 calories per day.”
Toddlers who are 2 years old should consume 1,000 calories daily.
A nurse is providing discharge teaching to the parent of a school-age child who has leukemia and is receiving chemotherapy. Which of the
following statements by the parent indicates an understanding of the teaching?
A. “I will take my child’s rectal temperature daily.”
B. “I will make sure my child gets his MMR vaccine this
week.” C. “I will inspect my child’s mouth every day for
sores.”
D. “I will allow my child to ride his bicycle
tomorrow.” “I will inspect my child’s mouth every day
for sores.”
A child who has leukemia is at an increased risk for mucositis; therefore, the parent should inspect the child’s mouth daily for lesions or ulcerations.
A nurse is preparing to obtain an antistreptolysin O (ASO) titer from a child who has acute glomerulonephritis. The child’s parent asks the nurse to
explain the purpose of the test. Which of the following responses should the nurse make?
A. “The test determines the level of antibiotics in your child’s blood.”
B. “The test tells us if your child ever had the measles.”
C. “The test verifies the amount of albumin in your child’s
blood.” D. “The test shows us if your child had a recent strep
infection.”

lOMoARcPSD|3920845
“The test shows us if your child had a recent strep infection.”

ATI RN Nursing Care of the Child with an Alteration
in Urinary Elimination / GU Disorder

A newborn is diagnosed with hypospadias and the parents want him to be circumcised. What
would be the best response by the nurse?
The foreskin is needed for repair.
A child’s foreskin is not removed since it is needed to help repair a hypospadias. Once the
hypospadias is repaired, a circumcision can be performed at the same time. Meatal stenosis has to
do with the urethral opening diameter, not the placement.
A child is having their urine checked for a routine well visit. When analyzing the results, what
would positive leukocytes indicate?
This may indicate a urinary tract infection.
Positive leukocytes may indicate a urinary tract infection. The urine would also need to be cultured to
determine the type and amount of bacteria growth.
The nurse is working with a child with altered genitourinary status. Which intervention
would be included in the plan of care with excess fluid volume?
Weigh the child twice a day on the same scale.
A child with a renal problem needs to be weighed on the same scale for accurate weights. The frequency is important to ensure the child is not retaining fluid.
In caring for a child with nephrotic syndrome, which interventions will be included in the child’s
plan of care?
Weighing on the same scale each day
The child with nephrotic syndrome is weighed every day using the same scale to accurately monitor
the child’s fluid gain and loss.
The first method of choice for obtaining a urine specimen from a 3-year-old child with a
possible urinary tract infection is:
obtaining a clean catch voided urine.
In the cooperative, toilet-trained child, a clean midstream urine may be used successfully to obtain a
“clean catch” voided urine. If a culture is needed,the child may be catheterized, but this is usually
avoided if possible. A suprapubic aspiration also may be done to obtain a sterile specimen. In the
toilet-trained child, using a cotton ball to collect the urine would not be appropriate.
Urinary tract infections are usually successfully treated by what means?
Administering antibiotics
UTIs may be treated with antibiotics (usually sulfamethoxazole or ampicillin) at home. Fluids are
encouraged, but they do not treat the infection.Bladder irrigations and diuretics are not used in the
treatment of urinary tract infections.
The nurse is collecting data on a 2-year-old child admitted with a diagnosis of urinary tract
infection. When interviewing the caregivers,which question would be most important for
the nurse to ask?
“Has your child complained of pain?”
Gather information about the current illness: when the fever started and its course thus far, signs of

pain or discomfort on voiding, recent change in feeding pattern, presence of vomiting or diarrhea,
irritability, lethargy, abdominal pain, unusual odor to urine, chronic diaper rash, and signs of febrile
convulsions. Toilet training and bathing habits would be of importance, but they are not the most
important to ask. Temperatures in other children in the family would not be related to this child’s
current situation.

A child in kidney failure has had a kidney transplantation. You would prepare the child for which of
the following to occur postoperatively?
Infection-control precautions that may cause him to be lonely
Children may be isolated following a transplant to help them resist infection during the time their
immune system response is lowered to help them avoid transplant rejection.
Which nursing diagnosis would be the priority when caring for a child in renal failure following
a kidney transplant?
Risk for infection related to immunocompromised state
Children are administered anti-immune therapies to lower immune system response and help prevent rejection following a transplant; this leaves them susceptible to infection.
10.The nurse is providing discharge teaching to an adolescent who has been treated for pelvic
inflammatory disease (PID). What would the nurse include as a preventive measure?
Insisting that sexual partners use condoms
PID is a sexually transmitted infection; use of condoms prevents PID. Using a vaginal douche routinely leads to bacterial overgrowth and increases the risk for PID. Sexual partners should also
receive treatment with antibiotics. Oral contraceptives prevent pregnancy, not PID.
An adolescent comes to the clinic reporting vaginal discharge.When assessing the vaginal
discharge, what would lead the nurse to suspect that the adolescent has candidiasis?
Thick, white cheese-like discharge
With candidiasis, the vaginal discharge is thick,white, and cheese-like. A frothy, gray-green discharge is noted with trichomoniasis. A milky, gray discharge with a fishy odor suggests gardnerella.
A yellow-green vaginal discharge suggests gonorrhea.
The mother of 6-month-old girl is concerned about her daughter getting a urinary tract infection.
What should the nurse mention to the mother to help prevent this condition?
Report any abnormally colored urine to the child’s primary care provider.
Several important interventions can help prevent urinary and renal disease in children. The first intervention is to educate parents and caregivers about wiping from front to back (not back to front)
when changing diapers of female infants. Remind parents of simple ways to prevent UTI, such as
not allowing children to bathe with bubble bath. Teach parents to recognize that abnormally colored
urine (red, black, or cloudy) should not be dismissed as this could be the beginning of a UTI or
kidney disease. Educating parents about the importance of giving the full course of antibiotics
prescribed for UTIs can help prevent return reinfection; giving the full course of antibiotics after a
streptococcal infection can help prevent acute glomerulonephritis.
The nurse is teaching the parent of a child with chronic renal failure on high-potassium foods that
should be restricted. Which foods will the nurse include in this teaching? (Select all that apply.)
bananas,carrots, nuts, and milk.
Foods that are high in potassium include bananas,carrots, nuts, and milk. Broccoli, wheat, bran,
chicken, fish, and green beans are not high in potassium and do not need to be restricted.

Ati Nursing Care of Children Proctored 2022 –
Study Guide

A nurse is caring for a 6-year-old child who is experiencing encopresis. Which of the following
actions should the nurse take?
Determine if there are any recent stressors in the child’s environment
A nurse is caring for a child who has an exacerbation of cystic fibrosis. Which of the following
laboratory findings should the nurse report to the provider immediately?
Oxygen saturation 85%
A nurse is a pediatric clinic is caring for a 3-year-old child who has a blood lead level of
3 mcg/dL. When teaching the toddler’s parent about the correlation of nutrition with lead
poisoning,which of the following pieces of information is appropriate for the nurse to include?
Ensure the child’s dietary intake of calcium and iron is adequate
A nurse is caring for a child who has sickle cell anemia and is experiencing a vaso-occlusive
crisis. Which of the following actions should the nurse take?
Administer ibuprofen
A nurse at a pediatric clinic is assessing a 5-month-old infant during a well child visit.
Which of the following findings should the nurse report to the provider?
Head lagging when the infant is pulled from a lying to a sitting position
A nurse is providing teaching to the guardians of an infant who has failure to thrive (FTT).
Which of the following pieces of information should the nurse include in the teaching?
Add fortified rice cereal to the infants formula
A nurse is an emergency department is caring for a 4-year-old child who has burns to the neck
and face following a house fire. Which of the following actions should the nurse take first?
Determine the child’s breathing pattern
A nurse is teaching to a group of parents of adolescents about developmental needs. Which of
the following statements by a parent should the nurse investigate further?
“My child spends 4 hours per day using online chat rooms.”
9.A nurse is providing discharge teaching to paents whose infant had a ventriculoperitoneal
shunt placement for the treatment of hydrocephalus. Which of the following statements by
the parents indicates an understanding of the teaching?
“We will notify the doctor right away if he has a fever.”
A nurse is performing a nutritional screening for a 12-year-old client who weighs 41 kg (90 lb)
and has a height of 1.5 m (60 in). Which of the following values is the client’s body mass index
(BMI)
18.2 – to calculate the clients BMI, the nurse should divide the clients weight in kilograms by
the square of the clients height in meters. Therefore, 41 kg divided by the square of 1.5 m gives a
correct BMI of 18.2
A nurse is teaching the parents of an infant about treatment option for profound sensorineural
hearing loss. The nurse should include which of the following pieces of information about the
function of cochlear implants?
The provide direct stimulation of auditory nerve fiber
A nurse is instructing a group of parents and guardians about child development. Which
of the following recommendations should the nurse make to promote the developmental task
of industry in the school-age child?
Assign the child several small chores
A nurse is providing teaching to the guardian of an adolescent. The guardian reports that
the adolescent sleeps about 10 hour on weekend nights. Which of the following responses
should the nurse provide?
“Adolescents need more sleep due to rapid growth.”
A nurse is caring for a child who is in skeletal traction. Which of the following actions is the
nurse’s priority?
Encourage the child to use an incentive spirometer
A nurse is assessing the gross motor skills of a 4-year-old preschooler. The nurse should
expect the preschooler to perform which of the following activities?
Hopping on 1 foot
A nurse is caring for a school-aged child who begins to have a tonic-clinic seizure when leaving the bathroom. Which of the following actions should the nurse take first?
Ease the child to the floor in Sims’ position
A nurse is assessing a 4-year-old child. The nurse should expect the child to be able to perform which of the following activities?
Fastening buttons on a shirt
A nurse is reviewing the laboratory report of a 2-year-old child who has diarrhea and has been
vomiting for 24 hr. Which of the following findings should the nurse report to the provider?
Potassium 2.5 mEq/L
A nurse is evaluating the outcome of surgery for an infant who had a bile duct obstruction
which of the following findings should indicate to the nurse that the surgery was successful?
The color of the infants stool is yellowish-brown
A nurse is teaching an adolescent client who has type 1 diabetes mellitus about managing
hypoglycemia. Which of the following statements should the nurse include in the teaching?
“You should drink 4 ox of orange juice if you experience hypoglycemia’’
A nurse is assessing the fine motor skills development of a 4-year-old child. The nurse should

expect the child to be able to perform which of the following activities?
Copying a square

A nurse is teaching the parents of a 4-month-old infant who has gastroesophageal reflex. Which
of the following statements by a parent indicates an understanding of the teaching?
“I will add 1 teaspoon of rice cereal per ounce to my baby’s formula”
A nurse is caring for a 15-month-old client who requires droplet precautions. Which of the
following actions should the nurse take?
Wear a mask when assisting the toddler with meals
A nurse is providing teaching to a 12-year-old client who is recovering from an acute episode
of hemophilia A. Which of the following statements should the nurse include in the teaching?
“You will be able to participate in physical exercise”
A nurse is caring for a child who has episaxis.Which of the following actions should the nurse
take?
Apply continuous pressure to the lower part of the childs nose
A nurse is teaching a parent of an infant who has a colostomy. Which of the following statements
by the parent indicates an understanding of the teaching
” I need to apply paste to the back of the wafer on my child’s appliance’’
A nurse is preparing to assess a 2-year-old toddler. Which of the following behaviors should the
nurse expect during the examinations
The child prefers to sit on the parent’s lap during the examination
A nurse is caring for a child who has acute glomerulonephritis. Which of the following actions
should the nurse take?
Check the child’s blood pressure every 4 hr
A nurse is providing teaching about poisoning prevention top a group of parents with toddlers.
Which of the following statements should the nurse make?
“Put all cleaning supplies in a locked cabinet”
A nurse is assessing an infant w ho has acute gastroenteritis. Which of the following findings
should the nurse identify as the priority?
Capillary refill 5 seconds

Above 4 seconds is s/s severe dehydration

An 18-month-old infant has pneumocystiscarinii pneumonia. Results of enzyme-linked

ATI RN Care of Children Proctored 2019 Exam – Study Guide

A nurse is assessing a school-age child who has heart failure and is
taking furosemide.
Which of the following findings should the nurse identify as an indication that
the medication is
effective?
a. An increase in venous pressure
b. a decrease in peripheral edema
c. a decrease in cardiac output
d. an increase in potassium levels
A nurse is assessing an infant who has acute otitis media. Which of the
following findings
should the nurse expect (select all that apply)
a. Increased appetite
b. enlarged subclavian lymph node
c. Crying
d. Restlessness
e. fever
a nurse is providing teaching to the parents of an infant who is to undergo
pilocarpine
lontophoresis Testing for Cystic Fibrosis. Which of the following statements
should the nurse
include in the teaching?
a. We will measure the amount of protein in your baby’s urine over 24 hour
period
b. The test will measure the amount of water in your baby’s sweat
c. a nurse will insert an IV prior to the test
d. your baby will need to fast for 8 hours prior to the test
A nurse in an urgent care clinic is prioritizing care for children. Which
of the following children should the nurse assess first?
a. A toddler who has nephrotic syndrome and facial edema
b. a preschool-age child who has a muffled voice and no spontaneous cough
c. a preschool-age child who has diabetes mellitus and a blood glucose of

200 mg/dL
d. an adolescent who has Crohn’s disease and recent weight loss of 5kg
mg (11 lb)
5 .A nurse is providing teaching to the parents of a toddler who is to undergo
a sweat chloride test. Which of the following statements should the nurse
include?
a. The purpose of the test is to determine if your child has Crohn’s disease
b. the technician will use a device to produce an electrical current during
the test
c. during the test, your child will be in a room that is
cold d. your child sweat will be collected over 24 hours

A nurse in the emergency department is caring for an adolescent who is
requesting testing for STI. Which of the following action is appropriate for
the nurse to take?
a. Request verbal consent from the social worker
b. contact the client’s parents to obtain phone consent
c. postpone the testing until the client’s parents are present
d. obtain written consent from the client
A nurse in the emergency department is assessing the toddler who has
hyperpyrexia severe dyspnea and drooling which of the following actions
should the nurse take first?
a. obtain a blood culture from the toddler
b. administering antibiotic to the toddler
c. insert an IV catheter for the toddler
d. prepare the toddler for nasotracheal intubation
A nurse is providing teaching to a 10 year old child with scheduled for an
arterial cardiac catheterization. Which of the following information should
the nurse include in the teaching?
a. You will have your dressing removed 12 hours after the procedure
b. you will need to keep your legs straight for 8 hours following the
procedure
c. you will be on a clear liquid diet for 24 hours following the procedure
d. you will be on bed rest for 2 days after the procedure
9.
A nurse is caring for a preschooler who is post-operative following a
tonsillectomy. The child

is now ready to resume oral intake which of the following dietary choices
should the nurse offer
the child?
a. sugar-free Cherry gelatin
b. vanilla ice cream
c. chocolate milk
d. lime flavored ice pop

A nurse is caring for an infant who has Patent ductus arteriosus. The
nurse should identify
that the defect is a switch of the following locations of the heart. ( you will
find hot spots to select
in the artwork below. Select only the hot spot that corresponds to your
answer)Answer: B
A nurse is caring for a 10 month old child was brought to the emergency
department by his parents following a head injury. Which of the following
actions should the nurse take first?
a. Inspect for fluid leaking from the ears (thinking about CSF leakage severe
trauma =
urgent, after respiratory status is confirmed)
b. assess respiratory status
c. check pupil reactions
d. examine the scalp for lacerations
A charge nurse is planning care for an infant who has failure to thrive.
Which of the following
actions should the nurse include in the plan of care?
a. Assign consistent nursing Staff Care for the infant
b. Keep infant in a visually stimulating environment
c. use half-strength formula when feeding the
infant
d. give the infant fruit juice between feedings
A nurse is providing teaching about home care to the parent of a child
who has scabies. Which of the following instruction should the nurse include
in the teaching?
a. Wash your clients hair with shampoo containing Ketoconazole
b. soak Combs and brushes in boiling water for 10 minutes
c. apply petroleum jelly to the affected areas
d. treat everyone who came into close contact with a child

1.A nurse is reinforcing teaching about home safety with the parent of a toddler. Which of
the following parent statements indicates an understanding of the teaching?

The nurse should instruct the parent to place a screen in front of a fireplace or
other heating appliances to prevent burns
2.A nurse is reinforcing teaching with the parent of a child who has hemophilia and is
experiencing acute hemarthosis. Which of the following instructions should the nurse include
in the teaching?
The nurse should reinforce with the parent to keep the child’s affected joints
elevated and immobilized to minimize bleeding. After the acute episode, the child
should begin active range-of-motion exercise.
3.A nurse is collecting data about the dietary habits of an adolescent client. The nurse should
identify that which of the following findings puts the client at risk for nutritional deficits?
The nurse should identify that adolescents are often at risk for developing poor
eating habits. Skipping dinner twice each week puts this client at risk for nutritional
deficits.
4.A nurse is assisting with the care of a child who has tonic-clonic seizures. Which of the
following actions should the nurse take?
The nurse should have a suction canister and tubing available in the child’s room to
keep the child’s airway patent during a seizure.
5.A nurse is reinforcing home safety instructions with the parents of a toddler. Which of the
following parent statements indicates an understanding of the teaching?
The nurse should instruct the parents to turn pot handles toward the back of the
stove to prevent the toddler from pulling a pot off the stove, resulting in a burn.
6.A nurse in a pediatric clinic is collecting data from an infant who recently started taking
digoxin. Which of the following manifestations should the nurse identify as an indication of
digoxin toxicity and report to the provider?
The nurse should identify that vomiting, especially unrelated to feedings, is
a manifestation of digoxin toxicity and should be reported to the provider.
7.A nurse is caring for a school-age girl who is being treated for frequent, severe urinary
tract infections (UTIs). The nurse should recognize that which of the following
statements by the parent indicates a possible cause of the UTIs?
My daughter has bowel movements every 4 to 5 days—the nurse should recognize
that this frequency indicates the child is constipated. Therefore, large stool masses
might prevent complete emptying of the bladder and lead to urinary stasis and
infection.
8.A nurse is caring for a school-age child who has been admitted to facility in sickle cell crisis.
The nurse is measuring the child’s oral intake for the shift. The child consumed 4 oz of juice at
breakfast. For lunch, the child consumed 6 oz of milk, 6 oz of gelatin, and drank 7 oz of water.
What is the child’s oral intake for this shit of milliliters. (Round to the nearest whole

number.)

ATI Nursing Care of Children Final Exam Guide Latest 2022
1.Providing education to a parent whose child has had a colostomy, which is an appropriate method to
determine understanding:
observe the parents while they perform the procedure
2.Educating the parent of a 9 month old infant recently diagnosed with cerebral palsy. Which statement by
the parent indicates teaching effective:
I am hopeful that the early schooling will increase my child’s ability for self-care
3.Caring for a child who Isin Buck’s traction. Which is appropriate intervention to prevent complications:
Provide small meals with high fiber
4.Providing diabetic teaching to a 12 year old who appears apprehensive during teaching, which actions
should the nurse recognize as appropriate in this situation:
Teach the child to do her own fingersticks
5.Pediatric unit caring for four client who all have assessments ordered in the morning, which values
should the nurse report immediately:
Sickle cell anemia and a urine specific gravity of 1.030
6.Caring for a 3 year old who is scheduled for a nephrectomy, when preparing preoperatively, which
action is appropriate:
Explain the procedure to the child in simple sentences just before administereingthe preoperative
sedation
7.Caring for a child receiving chemotherapy with anorexia and nausea. Which intervention is most
appropriate for the child experiencing these symptoms:
allow the client to eat whatever the client wants,at any time
8.Parent of a toddler asks the nurse why the toddler’s abdomen protrudes, which statement is an
appropriate response:
The muscles of the abdomen are weak, and therefore, the abdomen protrudes
9.Caring for a child who will be receiving PE tubesin the morning, nurse isteaching parents how to care
for tubes upon discharge, which statement indicatesteaching was understand:
I will keep water out ofmy child’s ears
10.Caring for a child who has cellulitis and a rectal temperature of 102.2 F (39 C). The child has an order
foracetaminophen (Tylenol 280 mg by mouth) label reads 160mg/5ml. what is the correct dose:
8.8 mL
11.Caring for a child who is a vegetarian and has sustained superficial partial-thickness burns on her
legs,which diet choices would be appropriate:
Peanut butter and jelly sandwich

12.Performing a yearly physical on an adolescent. Adolescent’s parents ask about developmental needs,
which statement by the parents should the nurse investigate further:
He spends several hours a day onthe internet
13.Caring for a child who has a superficial partial-thickness burns over 50% of his body. Planning for
nutritional needs, which should the nurse recognize as an appropriate intervention:
Perform dressingchanges at least 1 hr before or after meals
14.Caring for a child who has cystic fibrosis, which assessments should the nurse recognize as a priority
toreport to the primary care provider:
inability to clear secretions
15.Preparing a 7 year old for a tonsillectomy, which nursing actions would be appropriate in this
preparation:
Schedule the child for a preoperative visit to the hospital
16.Caring for a child who hastetralogy of Fallot preoperatively, which laboratory value should the nurse
expect to find:
Hematocrit of 58%
17.School nurse is assisting a child who has been stung by a bee. Childs hand is swelling and the nurse
notesthat the child has allergies to insect stings. Which manifestations should the nurse recognize with
anaphylaxis: Select all:
Nausea, urticaria (hives), stridor
18.Caring for a child who is undergoing a bone marrow aspiration, which response by the child
shouldindicate the nurse that teaching has been effective:
Ill have to lie on my belly while its done
19.Preparing to administer an injection to a 2 month old. Which is appropriate site:
Vastus lateralis
20.Caring for a toddler who has asthma, parents concerned about the toddlers reaction to the
hospitalization, which nursing action should the nurse perform to decrease the stress experienced by the
toddler:
encourage rooming-in
21.School nurse assessing a child who returned to school following a cases of mononucleosis. Child has a
note from primary care provider excusing him from gym class.
Most appropriate reason for this excuse:sustaining abdominal trauma
22.Caring for a 10 year old who is obese, Which menu choices are most appropriate:
a glass ofskim milk,baked fish sandwhich on whole wheat roll with lettuce, and a medium apple

ATI RN Nursing Care of Children (B) 2019 Exam -Retake Guide

A nurse is planning care for a newly admitted school-age child who has
generalized seizure disorder. Which of the following interventions should
the nurse plan to include?
Ensure the oxygen source is functioning in the childs room
A nurse is providing dietary teaching to the guardian of a school-age child
who has cystic fibrosis. Which of the following statements should the nurse
make?
“You should offer your child high-protein meals and snacks throughout the day.”
A nurse is providing discharge teaching to the parents of a 6-month-old infant
who is postoperative following hypospadias repair with a stent placement.
Which of the following instructions should the nurse include in the teaching?
“Allow the stent to drain into your infants diaper.”
A nurse is caring for a school-age child who has primary nephrotic syndrome and
is taking prednisone. Following 1 week of treatment, which of the following
manifestations indicates to the nurse that the medication is effective?
Decreased edema
A nurse is receiving change-of-shift report for four children. Which of
the following children should the nurse assess first?
A toddler who has a concussion and an episode of forceful vomiting.
A nurse is providing discharge teaching to the guardians of a toddler who had
lower leg cast applied 24 hr ago. The nurse should instruct the guardians to
report which of the following finding to the provider?
Restricted ability to move the toes.
A nurse in an emergency department is auscultating the lungs of an adolescent
who is experiencing dyspnea. The nurse should identify the sound as which of
the following?
Wheezes
A nurse is caring for a preschooler who has congestive heart failure. The nurse
observes wide QRS complexes and peaked T waves on the cardiac monitor.
Which of the following prescriptions should the nurse clarify with the provider?
Potassium Chloride
A nurse is planning an educational program for school-age children and their
parents about bicycle safety. Which of the following information should the
nurse plan to include?
The child should be able to stand on the balls of their feet when sitting on the
bike.
A nurse is monitoring the oxygen saturation level of an infant using pulse
oximetry. The nurse should secure the sensor to which of the following areas
on the infant?
Great Toe
A nurse is an emergency department is caring for a school-age child who has
epiglottitis. Which of the following actions should the nurse take?
Monitor the child’s oxygen saturation
A nurse in an emergency department is caring for a school-age child who has
sustained a minor superficial burn from fireworks on their forearm. Which of
the following actions should the nurse take?
Apply an antimicrobial ointment to the affected area.
A nurse in a providers office is caring for a school-age child who has varicella.
The parents asks the nurse when their child will no longer be contagious.
Which of the following responses should the nurse make?
“When your childs lesions are crusted, usually 6 days after they appear.”
A nurse is providing discharge teaching to the parent of a school-age child who
has moderate persistant asthma. Which of the following instructions should the
nurse include?
“Pulmonary function tests will be performed every 12 to 24 months to evaluate
how your child is responding to therapy.”
A nurse is admitting an infant who has intussusception. Which of the following
findings should the nurse expect? (Select all that apply.)
-Vomiting
-Lethargy
A nurse is reviewing the laboratory results of a school-age child who is 1 week
postoperative following an open fracture repair. Which of the following
findings should the nurse identify as an indication of a potential complication?

ATI RN Nursing Care of Children (A) 2019 Exam 2019 – Revision Guide
1.A nurse is creating a plan of care for an infant who has an epidural hematoma with askull fracture.
Which of the following actions should the nurse include in the plan?
Implement seizure precautions for the infant.
The nurse should implement seizure precautions for an infant who has an epidural hematoma as a safety
measure.
2.A nurse is providing teaching about car seat use to the mother of a 6-month-old infant.
Which of the following statements by the mother indicates an understanding of the
teaching?
“I should secure the car seat using lower anchors and tethers instead of the seat belt.”
Lower anchors and tethers, or the LATCH child safety seat system, should be used to secure an infant’s
car seat in the vehicle. This system provides anchors between the front cushion and the back-rest for the
car seat. Therefore, if this system is available, the seatbelt does not have to be used.
3.Planning care for a toddler who has a serum lead leverl of 4 mcg/dL. Appropriate action to
take?
Schedule the toddler for a yearly rescreening.
The nurse should schedule the toddler for a lead level rescreening in 1 year and educate the family on
ways to prevent exposure.
Chelation therpay is required for lead level of 45, or can be intiated with lead levels above 10
4.Assessing a school-age child immediately postop following a perforated appendix
repair. Expected findings?
Absence of peristalsis
The nurse should expect absence of peristalsis in the immediate postoperative period, until the bowel
resumes functioning.
5.Preparing an adolescent for lumbar puncture. Appropriate action?
Apply topical analgesic cream to the site 1 hr prior to the procedure.
The nurse should apply a topical analgesic to the lumbar site 60 min prior to the procedure to decrease
the adolescent’s pain while the lumbar needle is inserted.
6.Providing anticipatory guidance to the mother of a toddler. Expected behavior
characteristics of the toddler to be included in the teaching?
Expresses likes and dislikes
The nurse should teach the mother that her toddler will begin to express her likes and dislikes. This is the
time in life when a toddler is developing autonomy and self-concept. She will try to assert herself and
frequently refuse to comply. The parent should allow the child to have some control but also set limits in
order for her to learn from her behavior and learn to control her actions.
7.Providing teaching to the parents of a preschooler who has heart failure and who isbeginning
to take digoxin twice daily. Appropriate instructions to include?
“Brush the child’s teeth after giving the medication.”
The nurse should instruct the parents to brush the child’s teeth after administering digoxin to prevent
tooth decay caused by the medication, which comes as a sweetened liquid to enhance the taste.

8.A nurse in a provider’s office is preparing to administer immunizations to a toddler
during a well-child visit. Which of the following actions should the nurse plan to take?
Withhold the influenza vaccine
Exhibit 1: Tuberculin skin test, Measles, mumps, rubella vaccine, live attenuated influenza vaccine, varicela
vaccine
Exhibit 2: rr 24/min, HR 115/min, temp 37.4/99.3F,
Exhibit 3: age 12 months 9 days, 71.1 cm. Iodine allergy, Hx of asthma
The live attenuated influenza vaccine is contraindicated in a child who has asthma.
9.A school nurse is assessing a school-age child’s BP while he is seated in a chair. Thechild
starts to experience a tonic-clonic seizure. Appropriate action to take first?
Assist the child to a side-lying position on the floor
The greatest risk to this child is aspiration, occlusion of the airway, and bodily injury from falling out of the
chair. The nurse should ease the child down to floor in a side-lying position immediately. This position
enables the child’s secretions to drain from the mouth, preventing aspiration, and maintaining a patent
airway.
10.A nurse in an ED is performing a physical assessment on a 2-wk-old male infant.
Manifestation that is the priority to report to the provider?
Substernal retractions
When using the airway, breathing, circulation approach to client care, the nurse should determine that
the priority finding to report to the provider is substernal retractions. This finding indicates the infant is
experiencing acute respiratory distress and increased respiratory effort, which could quickly progress to
respiratory failure.
11.A nurse is providing teaching to the family of a school-age child who has juvenile
idiopathic arthritis. Instructions to be included in the teaching?
“Encourage the child to perform independent self-care”
The nurse should teach the family the importance of encouraging the child to perform independent
self-care. This will minimize the child’s pain while maximizing mobility. Encouraging and praising the
child’s efforts for independence will also increase his self-esteem
12.A nurse is caring for a hospitalized preschooler. The child’s mother is going home for a
few hrs while another relative stays with the child. Statement that the nurse should make
to explain to the child when her mother will return?
“Your mommy will be back after you eat.”
Preschoolers make sense of time best when they can associate it with an expected daily routine, such as
meals and bedtime. Therefore, the child comprehends time best when it is explained to them in relation
to an event they are familiar with, such as eating.
13.A nurse is assessing the pain lvl of a 3-yr-old toddler. Appropriate pain assessment
scale to use?
FACES pain rating scale.
The nurse should use the FACES pain rating scale for pediatric clients who are 3 years old and older. This
scale allows the toddler to point to the face that depicts the current level of pain. The nurse can then
determine the need for pain management.

lOMoARcPSD|392 084 5
ATI RN Proctored Nursing Care of Children Exam A 2019
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 mealsfor the child.
A nurse is teaching the parent of an infant who has a Pavlik harness for the treatment of developmental
dysplasia of the hip. The nurse should identify that which of the following statements by the parent
indicates an understanding of the teaching?
“I will place my infant’s diapers under the harnessstraps.”
A nurse is planning care for a school-age child who is in the oliguric phase of acute kidney injury (AKI)
and has a sodium level of 129 mEq/L. Which of the following interventions should the nurse include in
the plan?
Initiate seizure precautionsfor the child.
A nurse is assessing a school-age child immediately following a perforated appendix repair. Which of the
following findings should the nurse expect?
Absence of peristalsis
A nurse is preparing an adolescent for a lumbar puncture. Which of the following actions should the
nurse take?
Apply topical analgesic cream to the site 1 hr prior to the procedure.
A nurse is caring for a school-age child who is receiving cefazolin via intermittent IV bolus. The child
suddenly develops diffuse flushing of the skin and angioedema. After discontinuing the medication
infusion, which of the following medications should the nurse administer first?
Epinephrine
A nurse is teaching the parent of a preschooler about ways to prevent acute asthma attacks. Which of
the following statements by the parent indicates an understanding of the teaching?
“I should keep my child indoors when I mow the yard.”

lOMoARcPSD|392 084 5
A nurse is proving dietary teaching to the parent of a school-age child who has celiac disease. The nurse
should recommend that the parent offer which of the following foods to the child?
White rice
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%
A nurse is preparing to collect a sample from a toddler for a sickle-turbidity test. Which of the following
actions should the nurse plan to take?
Perform a fingerstick.
A nurse is assessing a school-age child who has meningitis. Which of the following findings is the priority
for the nurse to report to the provider?
Petechiae on the lower extremities
A nurse is assessing an infant who has a ventricular septal defect. Which of the following findings should
the nurse expect?
Loud, harsh murmur
A nurse is creating a plan of care for an infant who has an epidural hematoma from a head injury. Which
of the following interventions should the nurse include in the plan?
Implementseizure precautionsfor the infant.
A nurse is caring for an adolescent who received a kidney transplant. Which of the following findings
should the nurse identify as an indication the adolescent is rejecting the kidney?
Serum creatinine 3.0 mg/dL
A nurse in an emergency department is performing an admission assessment on a 2 week-old male
newborn. Which of the following findings is the priority for the nurse to report to the provider?
Substernalretractions

ATI RN Proctored Nursing Care of Children B 2019
A nurse is planning care for a newly admitted schole-age child who has generalized seizure disorder.
Which of the following interventions should the nurse plan to include?
Ensure the oxygen source is functioning in the childs room: The nurse should recognize that
maintaining the child’s airway is important during a seizure. The nurse should ensure that the oxygen
source is functioning because the child might require supplemental oxygen following a seizure.
A nurse is providing dietary teaching to the guardian of a school-age child who has cystic fibrosis. Which
of the following statements should the nurse make?
“You should offer your child high-protein meals and snacks throughout the day.” The nurse should
instruct the guardian to provide a diet that is well-balanced and high in protein and calories. Children
who have cystic fibrosis require a higher percentage of the recommended dietary allowances of all
nutrients to meet their energy requirements. Children who have good nutritional intake have improved
lung function and decreased risk of infection.
A nurse is providing discharge teaching to the parents of a 6-month-old infant who is postoperative
following hypospadias repair with a stent placement. Which of the following instructions should the
nurse include in the teaching?
“Allow the stent to drain into your infants diaper.” The nurse should instruct the parents to ensure that
the stent drains directly into the infant’s diaper to prevent kinking or twisting that can interfere with
urine flow.
A nurse is caring for a school-age child who has primary nephrotic syndrome and is taking prednisone.
Following 1 week of treatment, which of the following manifestations indicates to the nurse that the
medication is effective?
Decreased edema: A child who has nephrotic syndrome can experience edema due to the increased
glomerular permeability, which increases protein loss. Prednisone decreases glomerular permeability,
which causes fluid to shift from the extracellular spaces, resulting in decreased edema.
A nurse is receiving change-of-shift report for four children. Which of the following children should the
nurse assess first?

A toddler who has a concussion and an episode of forceful vomiting.: When using the urgent vs.
nonurgent approach to client care, the nurse should assess this child first. An episode of forceful
vomiting is an indication of increased intracranial pressure in a toddler who has a concussion.
A nurse is providing discharge teaching to the guardians of a toddler who had lower leg cast applied 24
hr ago. The nurse should instruct the guardians to report which of the following finding to the provider?
Restricted ability to move the toes.: The nurse should inform the guardians that a restricted ability of
the toddler to move their toes is an indication of neurovascular compromise and requires immediate
notification of the provider. Permanent muscle and tissue damage can occur in just a few hours.
A nurse in an emergency department is auscultating the lungs of an adolescent who is experiencing
dyspnea. The nurse should identify the sound as which of the following?
Wheezes: The nurse should identify the sound during auscultation as wheezes, which are high-pitched,
musical or whistling-like sounds heard primarily on expiration as air passes through and vibrates
narrowed airways.
A nurse is caring for a preschooler who has congestive heart failure. The nurse observes wide QRS
complexes and peaked T waves on the cardiac monitor. Which of the following prescriptions should the
nurse clarify with the provider?
Potassium Chloride: The nurse should identify that a child who has congestive heart failure can develop
electrolyte imbalances, such as hyperkalemia or hypokalemia. The nurse should identify that the child is
exhibiting manifestations of hyperkalemia and contact the provider about the administration of
potassium chloride, which can increase the severity of hyperkalemia.
A nurse is planning an educational program for school-age children and their parents about bicycle
safety. Which of the following information should the nurse plan to include?
The child should be able to stand on the balls of their feet when sitting on the bike.: To decrease the
risk for injury, parents should ensure that the bike is the correct size for the child. When seated on the
bike, the child should be able to stand with the ball of each foot touching the ground and should be able
to stand with each foot flat on the ground when straddling the bike’s center bar.
A nurse is monitoring the oxygen saturation level of an infant using pulse oximetry. The nurse should
secure the sensor to which of the following areas on the infant?
Great Toe. The nurse should secure the sensor to the great toe of the infant and then place a snugfitting sock on the foot to hold the sensor in place. The nurse should also check the skin under the
sensor site frequently for temperature, color, and the presence of a pulse.

ATI RN NURSING CARE OF CHILDREN
PROCTORED EXAM
STUDY GUIDE 2022-2023

ATI RN Nursing Care of Children
Page 1 of 31
Teaching the parents of a school-aged child who has a new diagnosis of osteomyelitis of the tibia. The
nurse should identify that which of the following statements by the parents indicates an
understanding of the teaching?
my child will have a cast until healing is complete.
My child will receive antibiotics for several weeks.
My child can return to playing sports once he is discharged.
My child needs to be in contact isolation.
Answer: b
The nurse should instruct the parent that the child will receive antibiotic therapy for at least 4
weeks. Surgery might be indicated if the antibiotics are not successful.
A – incorrect
Weight bearing must be avoided with osteomyelitis. Therefore, the child is placed in a
comfortable position with the limb supported. There is no indication for a cast.
C- incorrect
Weight bearing should be avoided to prevent complications and minimize pain. Therefore, it
will be several weeks to months before the child can play contact sports.
D- incorrect
Contact isolation is NOT necessary, because osteomyelitis is not a communicable illness.
A nurse is auscultating the lungs of an adolescent who has asthma. The nurse should identify the
sound as which of the following? Click the audio button to listen.
A- Biots respiration
B- Chaney Stokes respiration
C- tackypnea
D – Bradypnea
Answer- c
The nurse should identify the sound heard during auscultation as tachypnea, which is a rapid,
regular breathing pattern. This breathing pattern often occurs with anxiety, fever, metabolic
acidosis, or severe anemia.
A- Biot’s respirations are periods of apnea alternating with two or three shallow breaths.
B- Cheyne-Stokes respirations are periods of apnea alternating with periods of
hyperventilation.
D- Bradypnea is a slow, regular breathing pattern.
A nurse in an emergency department is caring for a school-age child who is experiencing an
anaphylactic reaction. Which of the following is the priority action by the nurse?
A- Elevate the head of the child’s bed
B- insert a large-bore IV catheter for the child
C- determine the allergen that caused the child’s reaction
D- administer IM epinephrine to the child
Answer- d

ATI RN Nursing Care of Children
Page 2 of 31
When using the urgent vs nonurgent approach to client care, the nurse determines that the
priority action is administering IM epinephrine to the child. During an anaphylactic reaction,
histamine release causes bronchoconstriction and vasodilation. This is an emergency because
ultimately it causes decreased blood return to the heart.
A- Elevating the head of the child’s bed is important to facilitate breathing and circulation.
However, it is not the priority action the nurse should take.
B- Inserting a large bore IV catheter is important to facilitate administration of IV fluids and
medications. However, it is not the priority action the nurse should take.
C- Determining the allergen that caused the child’s reaction is important to prevent any
additional episodes of anaphylaxis. However, it is not the priority action the nurse should take.
The nurse is preparing to administer an immunization to a four-year-old child. Which of the
following actions should the nurse plan to take?
A- Place the child in a prone position for the immunization
B- request that the child’s caregiver leave the room during the immunization
C- administer the immunization using a 24 gauge needle
D- inject the immunization slowly after aspirating for 3 seconds
Answer – c
The nurse should administer an immunization for a 4-year-old child using a 24-gauge needle to
minimize the amount of pain experienced by the toddler.
A- The nurse should place the child in an upright sitting position for the immunization because
this decreases the child’s fear and anxiety.
B- The nurse should allow the caregiver to stay near the child during the immunization to
provide a sense of security and reduce the child’s anxiety level.
D- The nurse should inject the immunization rapidly and avoid aspiration. These actions
decrease the risk of needle displacement and lower the child’s fear and anxiety level by
decreasing the amount of time it takes to administer the immunization.
A nurse is reviewing the laboratory report of an infant who is receiving treatment for severe
dehydration. The nurse should identify which of the following laboratory values indicates
effectiveness of the current treatment?
A- Potassium 2.9 mEq/L
B- sodium 140
C- urine specific gravity 1.035
D- BUN 25 mg
Answer- b
The nurse should identify that a sodium level of 140 mEq/L is within the expected
reference range and indicates the current treatment regimen the infant is receiving for
dehydration is effective.
A- A potassium level of 2.9 mEq/L is below the expected reference range and indicates
hypokalemia.

ATI RN Nursing Care of Children
Page 3 of 31
C- A urine specific gravity of 1.035 is above the expected reference range and indicates
concentrated urine.
D- A BUN level of 25 mg/dL is above the expected reference range and indicates the kidneys are
not excreting BUN as they should be.
The nurse is providing teaching about Social Development to the parents of a preschooler.
Which of the following play activities should the nurse recommend for the child?
A- Play pat-a-cake
B- using a push pull toy
C- creating a scrapbook
D- playing dress-up
Answer – d
The nurse should instruct the parents that at the preschool age, play should focus on social,
mental, and physical development. Therefore, playing dress-up is a recommended play activity
for this child.
A- Playing pat-a-cake is a recommended play activity for an infant.
B- Using a push pull toy is a recommended play activity for a toddler.
C- Creating a scrapbook is a recommended play activity for a school-age child.
A nurse is teaching the parents of a newborn about ways to prevent sudden infant death
syndrome SIDS. Which of the following instructions should the nurse include?
A- Place the infant in a prone position to sleep.
B- Allow the infant to sleep on a large pillow.
C- User soft mattress in the infant’s crib.
D- Give the infant a pacifier at bedtime.
Answer- d
The nurse should inform the parent that protective factors against SIDS include breastfeeding
and the use of a pacifier when the infant is sleeping.
A- The nurse should instruct the parent to place the infant in a supine position to sleep. Prone
and side-lying positions are risk factors for SIDS.
B- Placing the infant on a large pillow to sleep can increase the risk of suffocation, asphyxiation,
and SIDS.
C- The nurse should instruct the parent to use a firm mattress and avoid the use of waterbeds,
beanbags, or soft mattresses when placing the infant to bed. The use of a soft mattress in the
infant’s crib is a risk factor for SIDS and can lead to asphyxiation.

lOMoARcPSD|3920845
ATI RN Nursing Care of Children Proctored Exam 2019
Retake Guide – 70 Q’s & A’s

A nurse is providing education about dietary modifications to the parent of a school age
child who
has glomerulonephritis. Which of the following information should the nurse include in
the teaching?
A. Increase the child calcium intake
B. Decrease the Child’s sodium intake
C. Increase the child’s intake of carbohydrates
D. Decrease the child’s fat intake
B. Decrease the Child’s sodium intake
A nurse is providing teaching to the parents of a school-age child newly diagnosed with a
seizure
disorder. The nurse should teach the parents to take which of the following actions during
a seizure?
A. Minimize movement of the limbs
B. Insert a tongue blade between the teeth
C. Clear the area of hard object
D. Place the child in a prone position
C. Clear the area of hard object
A nurse is assessing an adolescent who has type 1 diabetes mellitus. Which of the
following findings is the nurse’s priority?
A. HbA1C 11.5%
B. cholesterol 189 mg/dL
C. Preprandial blood glucose 124 mg/dL
D. Glycosuria
A. HbA1C 11.5%
A nurse is providing anticipatory guidance to a parent of a 1- month-old infant. The
nurse should include that it is recommended to start this series of which of the following
immunization first?
A. Varicella
B. measles, mumps, rubella
C. Inactivated poliovirus
D. Hepatitis A tetra
C. Inactivated poliovirus
A nurse is reviewing the laboratory report of a toddler who has hemolytic uremic
syndrome. Which of the following findings should the nurse expect?
A. Creatinine 0.3 mg/dL – normal
B. Hbg 18 g/dL -this is elevated, Hbg should be decreased
C. Urine casts absent – urine should be positive for casts, blood and protein
D. BUN 28 mg/dL
D. BUN 28 mg/dL

lOMoARcPSD|3920845

A nurse is caring for a school-age child who is experiencing a sickle cell crisis. Which of
the following actions should the nurse take? (ATI pg. 126)
A. Administer furosemide IV twice per day.
B. Apply warm compresses to the affected areas
C. Decrease the child’s fluid intake
D. Initiate contact precautions.
B. Apply warm compresses to the affected areas
A nurse is assessing a 6-month-old infant who has respiratory syncytial virus. The nurse
should immediately report which of the following finding to the provider?
A. Rhinorrhea – Expected
B. Tachypnea
C. Pharyngitis – Expected
D. Coughing (and sneezing) – Expected
B. Tachypnea
A nurse is planning to teach an adolescent who is lactose intolerant about dietary
guidelines. Which of the following instructions should the nurse include in the
teaching?
A. You can drink milk on an empty stomach.
B. You should consume flavored yogurt instead of plain yogurt.
C. You can tolerate plain milk better than chocolate milk.
D. You can replace milk with nondairy source of calcium
D. You can replace milk with nondairy source of calcium
A nurse on a pediatric intensive care unit is caring for a toddler who weighs 12 kg
(26.5 Ib) and is postoperative following open heart surgery. Which of the following
findings should the nurse report to
the provider?
A. Skin temperature 36C (96.8 F)
B. Pedal and posterior tibial pulses of 2+
C. Urine output of 15 mL in the last 2 hr – urine output should = 1mL/kg/hr =>24mL
D. Drainage from the chest tube of 22 mL in the last hour
C. Urine output of 15 mL in the last 2 hr – urine output should = 1mL/kg/hr =>24mL
A nurse is providing dietary teaching to a parent of a 10-month-old infant who
has phenylketonuria. Which of the following responses by the parent indicate an
understanding of the teaching?
A. My daughter can’t drink orange juice – has nothing to do with anything
B. I will steam carrots and cut them into small pieces for her.”
C. I should ensure that my daughter eats one ounce of meat every day.” – avoid
high protein
D. I will switch her to whole milk now that she is old enough.” – avoid high protein
B. I will steam carrots and cut them into small pieces for her.”

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