ATI NUR 4355 Fall 2025 Final Exam
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Free ATI NUR 4355 Fall 2025 Final Exam Questions
The nurse caring for a toddler is diagnosed with congenital hypothyroidism. Which of the following developmental delays should the nurse recognize as the priority concern if the condition is left untreated?
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Delayed motor skills
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Delayed social interactions
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Delayed language development
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Delayed cognitive abilities
Explanation
Explanation
Congenital hypothyroidism, if left untreated, can lead to irreversible intellectual disability due to insufficient thyroid hormone during critical periods of brain development. Thyroid hormone is essential for neuronal growth, myelination, and synapse formation in early life. Although motor, language, and social delays may also occur, impaired cognitive development is the most serious and permanent consequence, making it the highest priority concern.
Correct Answer Is:
D. Delayed cognitive abilitiesA nurse is reviewing the plan of care for a 1-year-old following cleft lip and cleft palate repair. Which of the following are developmental concerns for the infant?
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Potential delays in oral motor skills
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Potential delays in olfactory motor skills
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Potential delays in fine motor skills
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Potential delays in proprioceptive skills
Explanation
Explanation
Infants with repaired cleft lip and/or palate often experience challenges with oral motor development, including sucking, swallowing, and later speech articulation. These delays can affect feeding, language development, and overall oral coordination. Olfactory, fine motor, and proprioceptive skills are generally not directly impacted by cleft lip or palate repairs, although ongoing developmental surveillance is important. Early intervention with feeding therapy and speech therapy can help optimize oral motor function.
Correct Answer Is:
A. Potential delays in oral motor skillsWhy the other options are incorrect:
Olfactory, fine motor, and proprioceptive skills are generally not directly impacted by cleft lip or palate repairs, although ongoing developmental surveillance is important. Early intervention with feeding therapy and speech therapy can help optimize oral motor function.A nurse is providing education regarding dental visits to the caregivers of a child who has a history of recurrent infectious endocarditis. Which of the following statements made by the caregivers indicates an understanding of the education provided?
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“My child only needs to take antibiotics for dental visits if they actively have infectious endocarditis at the time of the visit.”
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“My child should take prophylactic antibiotics before dental visits or invasive oral procedures.”
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“My child should take antibiotics only after the dental visit.”
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“My child only needs to take prophylactic antibiotics if they had infectious endocarditis within the 6 months preceding a dental visit.”
Explanation
Explanation
Children with a history of infectious endocarditis are at increased risk for bacteremia during dental procedures. Current guidelines recommend prophylactic antibiotics prior to dental visits or invasive oral procedures to prevent recurrence. Antibiotics are given before—not after—the procedure. They are indicated regardless of whether the child currently has an active infection and are not limited to a specific time frame since the last infection.
Correct Answer Is:
B. “My child should take prophylactic antibiotics before dental visits or invasive oral procedures.”Why the other options are incorrect:
Antibiotics are given before—not after—the procedure. They are indicated regardless of whether the child currently has an active infection and are not limited to a specific time frame since the last infection.A nurse is providing care to a 5-year-old child who has been diagnosed with autism spectrum disorder. The child’s parents state they are feeling overwhelmed, stressed, and burnt out. Which of the following interventions should the nurse recommend for the parents to help them cope?
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Eye Movement Desensitization and Reprocessing (EMDR)
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Acceptance and Commitment Therapy (ACT)
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Cognitive-Behavioral Therapy (CBT)
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Play Therapy and Art Therapy
Explanation
Explanation
Cognitive-Behavioral Therapy is an evidence-based intervention that helps caregivers identify negative thought patterns, develop coping strategies, and manage stress more effectively. CBT is commonly recommended for parents of children with chronic conditions, including autism spectrum disorder, to address caregiver burnout, anxiety, and depression. It focuses on practical skills that improve emotional regulation, problem-solving, and resilience. EMDR is used for trauma, play therapy targets children, and ACT is less commonly used as a first-line approach for caregiver stress.
Correct Answer Is:
C. Cognitive-Behavioral Therapy (CBT)Why the other options are incorrect:
EMDR is used for trauma, play therapy targets children, and ACT is less commonly used as a first-line approach for caregiver stress.A nurse is teaching a newly licensed nurse about routes of medication administration for preschoolers. Which of the following nursing interventions should the nurse include in the teaching? (Select all that apply.)
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Using a medicine cup for oral medication administration
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Instructing the child to swallow sublingual medication
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Administering rectal medication into the client’s anus
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Selecting a suitable vein for intravenous medication administration
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Educating the client on proper inhalation technique for inhaled medication
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Applying topical or transdermal medication directly to the client’s open wound
Explanation
Explanation
C. Administering rectal medication into the client’s anus
Rectal administration is an appropriate route for preschoolers when oral medication is not tolerated due to vomiting or refusal. Suppositories must be inserted into the anus past the internal sphincter to ensure proper absorption and prevent expulsion, making correct technique essential for effectiveness and safety.
D. Selecting a suitable vein for intravenous medication administration
Preschoolers may require IV medications, and nurses must be skilled in selecting age-appropriate veins, such as those in the hand or forearm. Proper vein selection minimizes discomfort, reduces the risk of infiltration, and ensures safe and effective medication delivery.
E. Educating the client on proper inhalation technique for inhaled medication
Preschool-aged children can safely receive inhaled medications with appropriate instruction and the use of spacers or masks. Teaching correct inhalation technique improves medication delivery to the lungs and enhances treatment effectiveness, especially for conditions such as asthma.
Correct Answer Is:
C. Administering rectal medication into the client’s anusD. Selecting a suitable vein for intravenous medication administration
E. Educating the client on proper inhalation technique for inhaled medication
A nurse is guiding a newly hired nurse on teaching motor skill development in school-age children aged 6 to 12 years. Which statement by the newly hired nurse correctly reflects effective teaching for this age group?
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“Children are expected to count backwards from 20 to 1 by age 7.”
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School-age children demonstrate improved coordination and endurance, allowing participation in activities like running, jumping rope, and team sports.
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Physical development at this stage is minimal, and children do not typically engage in organized physical activities.
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“By age 6, most children can use tools such as a screwdriver or hammer.”
Explanation
Explanation
Between the ages of 6 and 12, children experience significant improvements in gross and fine motor coordination, balance, strength, and endurance. These developmental advances allow them to successfully participate in complex physical activities such as organized sports, running games, and skill-based tasks like jumping rope. Teaching for this age group should encourage physical activity and skill refinement, supporting both physical health and social development.
Correct Answer Is:
B. School-age children demonstrate improved coordination and endurance, allowing participation in activities like running, jumping rope, and team sports.The nurse is assessing a pediatric patient with a spinal cord injury. Which cue should the nurse recognize as a potential indication of spinal cord injury in this patient?
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Increased muscle tone
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Heightened reflex activity
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Loss of function and reflexes below the affected area of the spine
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Normal bowel function
Explanation
Explanation
Spinal cord injuries result in motor, sensory, and autonomic dysfunction below the level of the injury. Loss of function and absent reflexes (flaccid paralysis) are common in the acute phase. Increased muscle tone and heightened reflexes may occur later during the recovery phase (spasticity). Normal bowel function would not be expected if the injury affects autonomic control of the gastrointestinal tract. Recognizing loss of function promptly is essential for assessment and intervention.
Correct Answer Is:
C. Loss of function and reflexes below the affected area of the spineWhy the other options are incorrect:
Increased muscle tone and heightened reflexes may occur later during the recovery phase (spasticity). Normal bowel function would not be expected if the injury affects autonomic control of the gastrointestinal tract. Recognizing loss of function promptly is essential for assessment and intervention.Which of the following findings may lead a nurse to suspect spina bifida?
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High levels of cerebrospinal fluid (CSF)
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Increased intracranial pressure (ICP)
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Indications of infection
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Presence of a small dimple and a tuft of hair over the lower lumbar region.
Explanation
Explanation
Spina bifida is a neural tube defect that often presents with cutaneous markers over the spine. A small dimple, tuft of hair, hemangioma, or lipoma over the lower lumbar or sacral area can indicate an underlying spinal defect. Elevated CSF levels, increased ICP, and infection are not specific findings associated with spina bifida and do not typically present as early indicators of the condition.
Correct Answer Is:
D. Presence of a small dimple and a tuft of hair over the lower lumbar region.Why the other options are incorrect:
Elevated CSF levels, increased ICP, and infection are not specific findings associated with spina bifida and do not typically present as early indicators of the condition.A nurse is teaching a newly licensed nurse about assessing children's blood pressure. Which of the following statements made by the newly licensed nurse demonstrates an understanding of the teaching?
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“Routine blood pressure measurements should begin around 1 year of age.”
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“Cuffs are recommended to be 6 to 15 cm or 2 to 6 inches for school-aged children.”
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“Blood pressure measurement is taken over the brachial artery using a manual blood pressure cuff.”
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“The cuff should fit loosely around the child's arm.”
Explanation
Explanation
In children, blood pressure is most accurately measured over the brachial artery using a properly sized manual blood pressure cuff. The brachial artery provides a reliable site for auscultation of Korotkoff sounds, which are necessary for accurate systolic and diastolic readings. Manual measurement is preferred in pediatric clients because automated devices may be less accurate, especially in younger children or those with small arms.
Correct Answer Is:
C. “Blood pressure measurement is taken over the brachial artery using a manual blood pressure cuff.”Why the other options are incorrect:
Manual measurement is preferred in pediatric clients because automated devices may be less accurate, especially in younger children or those with small arms.A nurse is providing care to a 6-year-old client who has an ileostomy. Which of the following interventions should the nurse anticipate to support ostomy care?
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Assess the stoma site monthly to minimize disruption to the client's routine.
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Consult the stoma/ostomy team for guidance on treating irritated or broken skin around the stoma.
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Change the ostomy appliance daily regardless of the condition of the stoma site.
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Empty the ostomy's stool output only when the collection appliance is full to capacity.
Explanation
Explanation
Ostomy care in children requires specialized attention to prevent complications such as skin irritation, infection, or poor appliance fit. Consulting a stoma/ostomy care team ensures expert guidance for managing peristomal skin breakdown and maintaining proper hygiene. Monthly assessment is insufficient; stoma sites should be evaluated at each appliance change. The appliance should be changed as needed rather than daily regardless of condition, and stool output should be emptied regularly to prevent overfilling, leakage, or skin damage.
Correct Answer Is:
B. Consult the stoma/ostomy team for guidance on treating irritated or broken skin around the stoma.Why the other options are incorrect:
Monthly assessment is insufficient; stoma sites should be evaluated at each appliance change. The appliance should be changed as needed rather than daily regardless of condition, and stool output should be emptied regularly to prevent overfilling, leakage, or skin damage.How to Order
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