ATI NUR 4355 Fall 2025 Final Exam
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Free ATI NUR 4355 Fall 2025 Final Exam Questions
A nurse is caring for a newborn diagnosed with a cleft lip. The nurse understands that the cause of the cleft lip is most often related to which of the following factors?
- A. “It is caused primarily by a combination of genetic factors and maternal environmental exposures during early pregnancy, such as smoking, certain medications, and infections.”
- B. “A cleft lip is due to an abnormal autoimmune response.”
- C. “Intrauterine hypoxia causing tissue necrosis of the lip during the third trimester.”
- D. “Postnatal trauma to the upper lip during delivery.”
Explanation
Explanation
Cleft lip is a congenital malformation that occurs during the early embryonic period, typically between the fourth and seventh weeks of gestation, when the lip fails to fuse properly. The etiology is multifactorial, involving both genetic predisposition and environmental influences, such as maternal smoking, certain medications (e.g., anticonvulsants), and infections during pregnancy. It is not caused by autoimmune responses, intrauterine hypoxia in the third trimester, or trauma during delivery.
Correct Answer Is:
A. “It is caused primarily by a combination of genetic factors and maternal environmental exposures during early pregnancy, such as smoking, certain medications, and infections.”Why the other options are incorrect:
It is not caused by autoimmune responses, intrauterine hypoxia in the third trimester, or trauma during delivery.A nurse reviewing the medical record of a child who has autism spectrum disorder (ASD) notes the child has missed several appointments. When the nurse calls the parent, they state that visits to the healthcare provider’s office are difficult because of the loud environment, bright lights, and overstimulation, which leads to meltdowns. Which of the following actions should the nurse take to facilitate compliance with appointments? (Select all that apply.)
- A. Ensure the healthcare staff are staff that the child is familiar with.
- B. Schedule the child’s appointment at a less busy time of day.
- C. Place the child in a room further away from other clients.
- D. Dim the lights in the child’s room.
- E. Schedule the child’s appointment for after-hours so no other clients are there.
Explanation
Explanation
A. Ensure the healthcare staff are staff that the child is familiar with.
Children with ASD often have difficulty with unfamiliar people and changes in routine. Seeing familiar staff can reduce anxiety, increase predictability, and improve cooperation during healthcare visits, making appointments less stressful and more successful.
B. Schedule the child’s appointment at a less busy time of day.
Less busy appointment times reduce noise, crowding, and overall stimulation. This helps prevent sensory overload, which is a common trigger for distress and meltdowns in children with ASD.
C. Place the child in a room further away from other clients.
Separating the child from high-traffic areas decreases exposure to loud sounds, conversations, and movement. A quieter environment supports emotional regulation and helps the child tolerate the visit more comfortably.
D. Dim the lights in the child’s room.
Bright lighting can be overwhelming for children with sensory sensitivities. Dimming the lights helps reduce visual overstimulation and promotes a calmer, more supportive environment during the appointment.
Correct Answer Is:
A. Ensure the healthcare staff are staff that the child is familiar with.B. Schedule the child’s appointment at a less busy time of day.
C. Place the child in a room further away from other clients.
D. Dim the lights in the child’s room.
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?
- A. Eye Movement Desensitization and Reprocessing (EMDR)
- B. Acceptance and Commitment Therapy (ACT)
- C. Cognitive-Behavioral Therapy (CBT)
- D. 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 assessing children's blood pressure. Which of the following statements made by the newly licensed nurse demonstrates an understanding of the teaching?
- A. “Routine blood pressure measurements should begin around 1 year of age.”
- B. “Cuffs are recommended to be 6 to 15 cm or 2 to 6 inches for school-aged children.”
- C. “Blood pressure measurement is taken over the brachial artery using a manual blood pressure cuff.”
- D. “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 teaching to the parent of a 3-year-old who has not yet been to a dentist. Which of the following information should the nurse include in the teaching? (Select all that apply.)
- A. Regular appointments with a dentist provide preventative education and oral care.
- B. Dentist visits should not be regular until all teeth are present.
- C. Dental visits should occur every 6 months.
- D. Regular, routine dental visits are effective and more cost-efficient than emergency dental treatment.
- E. Teeth brushing should be supervised.
Explanation
Explanation
A. Regular appointments with a dentist provide preventative education and oral care.
Early dental visits help identify problems such as early childhood caries and allow parents to receive guidance on proper oral hygiene, fluoride use, and nutrition. Preventive care supports long-term oral health beginning in early childhood.
C. Dental visits should occur every 6 months.
Routine dental visits every six months are recommended for children to monitor tooth development, reinforce oral hygiene practices, and prevent dental disease. Regular visits promote familiarity with dental care and reduce anxiety.
D. Regular, routine dental visits are effective and more cost-efficient than emergency dental treatment.
Preventive dental care helps avoid advanced dental problems that require costly and invasive emergency treatment. Early detection and routine care improve outcomes and reduce overall healthcare costs.
E. Teeth brushing should be supervised.
At 3 years of age, children lack the fine motor skills needed for effective brushing. Parental supervision ensures proper technique, appropriate toothpaste use, and adequate cleaning to prevent cavities.
Correct Answer Is:
A. Regular appointments with a dentist provide preventative education and oral care.C. Dental visits should occur every 6 months.
D. Regular, routine dental visits are effective and more cost-efficient than emergency dental treatment.
E. Teeth brushing should be supervised.
A nurse is educating the parents of a 2-year-old child diagnosed with atopic dermatitis about managing pruritus and preventing skin irritation. Which parental action best supports prevention of worsening symptoms?
- A. Constantly reminding the child to stop scratching to prevent skin damage.
- B. Applying topical moisturizers regularly to maintain skin hydration.
- C. Administering oral antibiotics to prevent secondary infections from scratching.
- D. Preparing hot baths for the child to soothe the itching skin.
Explanation
Explanation
Regular application of emollients and moisturizers helps maintain skin barrier function, reduces dryness, and minimizes pruritus in atopic dermatitis. This preventive approach decreases the risk of scratching and subsequent skin damage. Constantly telling a child to stop scratching is ineffective, oral antibiotics are only indicated for confirmed secondary infections, and hot baths can worsen skin dryness and irritation.
Correct Answer Is:
B. Applying topical moisturizers regularly to maintain skin hydration.Why the other options are incorrect:
Constantly telling a child to stop scratching is ineffective, oral antibiotics are only indicated for confirmed secondary infections, and hot baths can worsen skin dryness and irritation.A nurse is providing teaching to the parents of a 6-year-old child who is suspected to have attention deficit hyperactivity disorder (ADHD). Which of the following statements should the nurse make to describe the diagnostic process for ADHD?
- A. “Blood tests and scans are typically used to confirm the diagnosis of ADHD.”
- B. “We can use a computer-based test to definitively diagnose your child with ADHD.”
- C. “Clinical manifestations of ADHD must be observed for at least three months to be considered for diagnosis.”
- D. “Diagnosis of ADHD primarily relies on the results of comprehensive diagnostic studies.”
Explanation
Explanation
ADHD is diagnosed based on persistent patterns of inattention, hyperactivity, and impulsivity that interfere with functioning, typically observed for at least six months in more than one setting. While there are rating scales and behavioral assessments, there is no definitive lab test or scan for ADHD. Clinical observation over time, gathering information from parents, teachers, and caregivers, and using standardized tools are the primary components of diagnosis.
Correct Answer Is:
C. “Clinical manifestations of ADHD must be observed for at least three months to be considered for diagnosis.”A nurse is caring for a child who has been diagnosed with malignant neuroblastoma. Which of the following findings should the nurse expect?
- A. The tumor originated in the adrenal glands.
- B. The tumor has not spread to other areas of the child’s body.
- C. The tumor came from malformation of astrocyte glial brain cells.
- D. The tumor is located in the lower back of the brain in the midline posterior fossa.
Explanation
Explanation
Neuroblastoma is a malignant tumor that arises from neural crest cells of the sympathetic nervous system. It most commonly originates in the adrenal medulla, although it can also develop along sympathetic chain ganglia. Malignant neuroblastoma frequently metastasizes to bone, bone marrow, liver, and lymph nodes. The other options describe features of different pediatric tumors, such as astrocytomas or medulloblastomas.
Correct Answer Is:
A. The tumor originated in the adrenal glands.Why the other options are incorrect:
Malignant neuroblastoma frequently metastasizes to bone, bone marrow, liver, and lymph nodes. The other options describe features of different pediatric tumors, such as astrocytomas or medulloblastomas.A nurse is caring for a 12-year-old client diagnosed with systemic lupus erythematosus (SLE). The nurse should recognize which of the following as a common manifestation of SLE?
- A. Presence of proteinuria and elevated blood urea nitrogen (BUN) levels
- B. Increased energy
- C. Weight gain
- D. Mania
Explanation
Explanation
Renal involvement is a common and serious manifestation of systemic lupus erythematosus, especially in pediatric clients. Lupus nephritis occurs when immune complexes damage the glomeruli, leading to proteinuria, hematuria, and impaired kidney function. Elevated BUN levels indicate decreased renal filtration and worsening kidney involvement. Early recognition is critical because untreated renal disease can progress to chronic kidney failure and significantly affect long-term outcomes.
Correct Answer Is:
A. Presence of proteinuria and elevated blood urea nitrogen (BUN) levelsWhy the other options are incorrect:
Early recognition is critical because untreated renal disease can progress to chronic kidney failure and significantly affect long-term outcomes.A nurse is assessing a pediatric client who is exhibiting manifestations of rhabdomyosarcoma. In which area of the body should the nurse expect to find a tumor?
- A. Spine
- B. Head
- C. Ribs
- D. Upper leg
Explanation
Explanation
Rhabdomyosarcoma is a malignant tumor of skeletal muscle commonly seen in children. It most frequently occurs in the head and neck region, including the orbit, nasopharynx, and paranasal sinuses. While it can develop in other sites, such as the genitourinary tract or extremities, the head is a classic and common location for initial tumors. Tumors in the spine, ribs, or upper leg are less typical presentations in pediatric cases.
Correct Answer Is:
B. HeadWhy the other options are incorrect:
Tumors in the spine, ribs, or upper leg are less typical presentations in pediatric cases.How to Order
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