ATI Ped Unit 1 Assessment Fall

Correct Answer: C. Allen figures

The Allen figures chart is the most appropriate tool for determining visual acuity in a 4-year-old child. This chart uses familiar pictures (such as a house, apple, and boat) rather than letters or numbers, making it easier for young children to understand and identify the symbols, allowing for an accurate assessment of visual acuity.

Why the Other Options Are Incorrect:

A. Snellen

The Snellen chart is typically used for children who are at least 6 years old. It uses letters or numbers to assess visual acuity, which would be difficult for a 4-year-old child to recognize and identify. Therefore, it's not suitable for children this young.

B. Ishihara

The Ishihara chart is specifically designed for testing color vision, not overall visual acuity. It presents colored plates with numbers or shapes that can only be seen correctly if the child has normal color vision. This chart is not used for assessing visual acuity.

D. CVTME

The CVTME chart is not a standard tool for vision screening in children. It may refer to a type of chart used for more specific or specialized testing, but it is not widely used for determining visual acuity in young children.

Summary:

For a 4-year-old child, the Allen figures chart is the most appropriate tool to assess visual acuity. It uses familiar pictures that young children can recognize, allowing for an accurate assessment of their vision.

The correct goals of the National Children's Study include:

B. Provide information for families to eradicate unhealthy diets, dental caries, and childhood obesity.

D. Significantly reduce violence, substance abuse, and mental health disorders among the nation's children.

The National Children's Study was designed to follow children over time to better understand how various environmental, biological, and behavioral factors affect their health, development, and well-being. It includes a broad focus on health promotion and disease prevention in children.

B. Provide information for families to eradicate unhealthy diets, dental caries, and childhood obesity:

One of the key objectives of the study was to investigate the various risk factors leading to childhood obesity and other related health issues, such as poor nutrition and dental problems. The study provided valuable data to inform families and communities about healthier lifestyles.

D. Significantly reduce violence, substance abuse, and mental health disorders among the nation's children:

The study also aimed to understand how early life experiences, community environment, and genetic factors contribute to mental health issues, violence, and substance abuse. By understanding these factors, the study sought to guide interventions to reduce these problems in children.

Why the other options are incorrect:

A. Ensure that every child is immunized at the appropriate age:

While immunization is important for children's health, the National Children's Study did not specifically set the goal of ensuring every child is immunized at the appropriate age. However, the study may have included immunization data as part of a broader health evaluation.

C. Enlist the help of school lunch programs to reach the goal of vegetables and fruits as 30% of each lunch:

The study did not specifically focus on influencing school lunch programs to meet a 30% target for fruits and vegetables. Although nutrition is an important aspect of children's health, the National Children's Study's focus was broader, encompassing a variety of factors that affect childhood health.

E. Decrease tardiness and truancy and increase the high school graduation rate in each state over the next 5 years:

The National Children's Study did not specifically set goals around tardiness, truancy, or high school graduation rates. While education may have been an indirect factor in studying children's development, the focus was primarily on health-related outcomes.

Conclusion:

The National Children's Study aimed to collect data to improve children's health and well-being by studying factors like nutrition, mental health, and the environment. The goals related to health education and reducing violence and substance abuse were key aspects of the study's objectives.

Correct Answer:

a.) Self-image is not dependent on others' opinions

d.) Has mood swings

e.) Not willing to compromise with others

Explanation:

Based on Kya's comments, the following psychological characteristics are applicable to the adolescent:

a.) Self-image is not dependent on others' opinions

Adolescents, like Kya, often experience a developmental phase where they seek independence and form a self-identity. They may feel strongly about their personal choices, such as their exercise and eating habits, and resist others' opinions or criticisms. Kya's statement that she "doesn't need anyone's advice or opinion" indicates her focus on her own self-image and an emerging need for autonomy.

d.) Has mood swings

Adolescence is a time of significant hormonal changes and emotional development, which can lead to mood swings. Kya’s anger when discussing her parents and friends' concerns about her behavior is an example of emotional reactivity, which is common in adolescents. The emotional volatility and increased sensitivity to external opinions often lead to mood swings during this developmental stage.

e.) Not willing to compromise with others

Adolescents often exhibit a strong desire for independence and may be less willing to compromise. Kya's response to her parents and friends' attempts to intervene in her exercise and eating habits reflects a reluctance to compromise or accept others' suggestions. This is typical of the adolescent stage, where the desire for control over one's life is heightened.

Why the Other Options Are Wrong:

b.) Impulsive

While adolescents can be impulsive, Kya’s behavior does not necessarily indicate impulsivity. She is actively choosing to run and avoid red meat, and although this may be extreme, it seems to be a deliberate decision rather than a spur-of-the-moment action. Impulsivity in adolescents often involves more spontaneous, less thought-out behaviors, such as engaging in risky activities or making quick, unplanned decisions.

c.) Knows right from wrong

While adolescents generally have an improved ability to distinguish right from wrong, this is not always fully developed during the adolescent years. Kya’s strict exercise regimen and avoidance of red meat, despite her low BMI and potential health risks, suggest that she may be prioritizing her personal beliefs about health over objective medical advice. This indicates that her judgment regarding what is “right” may be influenced by distorted thinking patterns, which are common in eating disorders.

Summary:

Kya's comments indicate typical psychological characteristics of adolescents, such as a focus on self-image and independence, mood swings, and a reluctance to compromise. These behaviors are common during adolescence, which is a time of identity formation and emotional turbulence. Her rigid approach to exercise and eating, as well as her resistance to others' opinions, reflects typical adolescent tendencies to assert control and independence, even when it may be detrimental to her health.

The correct answer is c.) 10 years

Scoliosis screenings typically begin around 10 years of age, which is during the early stages of adolescence when children are going through growth spurts. Early detection is important to address any potential spinal deformities before they become more pronounced.

Why the other options are incorrect:

a.) 9 years: While screening may begin around age 10, it is generally not recommended to start at 9 years old unless there are specific concerns.

b.) 11 years: Screening can begin as early as age 10, so waiting until 11 years may be slightly later than necessary

d.) 12 years: Waiting until age 12 may miss earlier signs of scoliosis, as the condition is often more manageable when detected earlier.

Summary:

​​​​​​​Scoliosis screenings should begin at age 10 to ensure early detection and intervention.

The correct answer is Increase in the chance of breakthrough pain

Breakthrough pain refers to a sudden increase in pain that occurs despite the patient being on a pain management regimen. If the nurse is delayed in administering the prescribed analgesic, there is a risk that the child’s pain will become inadequately controlled, leading to breakthrough pain. Regular administration of pain medications as prescribed is critical to maintaining consistent pain relief and preventing this issue.

Other options:

Decrease in the chance of withdrawal symptoms: This would occur if analgesics were tapered appropriately, not if they were delayed.

Decrease in the chance of addiction: Delaying analgesics would not decrease the chance of addiction; addiction concerns are generally associated with the overuse or long-term use of opioids.

Increase in the child’s pain tolerance: Pain tolerance does not typically increase with delays in pain management. Inadequate pain control can lead to heightened pain sensitivity or discomfort rather than an increase in tolerance.

Summary:

If analgesics are not administered on time, the child is more likely to experience breakthrough pain, which occurs when pain resurges before the next dose is due. This emphasizes the importance of timely pain management following surgery or injury.

The correct answer is B. Uses the concepts of respect, family strengths, diversity, and collaboration with family.

Family-centered care is an approach that recognizes the family as an integral part of the child's health care team. It involves:

Respecting the family’s values, culture, and preferences.

Acknowledging the family’s strengths and resources.

Collaborating with the family to make decisions about the child’s care.

Valuing diversity, as each family may have different cultural, religious, and socioeconomic factors that influence their approach to healthcare.

This approach improves care outcomes by empowering families to be involved in decision-making, ensuring the child’s emotional and developmental needs are met, and promoting effective communication between healthcare providers and families.

Why the Other Options Are Wrong:

A. Encourages the family to allow the physician to make health care decisions for the child: While the physician plays a key role in providing medical expertise, family-centered care emphasizes shared decision-making rather than having the physician make decisions alone. The family should be actively involved in decisions regarding their child’s care.

C. Advises the family to choose a pediatric provider who is on the child's health care plan: While this is important for insurance and logistical reasons, it is not directly related to family-centered care. Family-centered care focuses more on the relationship between the family and healthcare providers, and ensuring that the child’s needs are met in a supportive environment.

D. Recognizes that families undergoing stress related to the child's illness cannot make good decisions: While it’s true that illness can cause stress, family-centered care involves supporting families during stressful times, helping them to make informed decisions. It recognizes that families may need assistance, but it does not assume they are incapable of making decisions.

Summary:

Family-centered care prioritizes collaboration, respect, and understanding of each family’s unique strengths and challenges. The best approach is to use the concepts of respect, family strengths, diversity, and collaboration in working with families to make decisions that are in the best interest of the child.

The correct answers are:

Hypnosis

Guided imagery

Fentanyl patch

Hypnosis: Hypnosis is a complementary therapy that can be effective in managing chronic pain in pediatric clients. It can help reduce pain perception and anxiety by promoting relaxation and focusing the child's attention away from the pain.

Guided imagery: This is another non-pharmacologic method used to manage chronic pain. It involves helping the child imagine a calming, pleasant environment or experience, which can reduce the perception of pain and promote relaxation.

Fentanyl patch: Fentanyl is a potent opioid often used for chronic pain management in pediatric clients. The fentanyl patch is a transdermal delivery method that provides continuous pain relief over time and is commonly used for managing chronic pain, particularly in cases like cancer or severe, ongoing conditions.

Why the other options are not correct:

Patient-controlled analgesia (PCA): While PCA can be used to manage acute pain, it is generally not the first-line treatment for chronic pain. PCA is more often used in postoperative or post-injury settings where pain needs to be managed on an as-needed basis, not for long-term chronic pain management.

EMLA cream: EMLA cream (a topical anesthetic containing lidocaine and prilocaine) is effective for numbing the skin for short procedures like needle insertions or venipuncture. It is not appropriate for managing chronic pain, as it is not effective for deeper, ongoing pain like that from conditions such as juvenile idiopathic arthritis or cancer.

Summary:

For pediatric clients experiencing chronic pain, hypnosis, guided imagery, and fentanyl patches are appropriate complementary interventions. PCA is typically more suited for acute pain, and EMLA cream is only effective for short-term procedural pain, not for ongoing chronic pain.

Correct Answer: False

The statement is false because while peer group influence does increase during the school-age years, parental values still play a significant role in a child's development. In fact, during this stage, children are still highly influenced by their parents, especially in terms of core values, ethics, and general behavior. Even though peer group values become more important in areas like friendships and social activities, parents continue to guide their children in moral and ethical decisions. It's normal for children to seek peer approval, but parental influence often shapes how children handle conflicts between their peer group and their family values. Healthy communication and role modeling from parents are still crucial at this age. So, while peer influence is strong, parental guidance is still key in resolving conflicts and guiding children through challenging situations.

The correct answer is   “What do you usually do or say during a temper tantrum?”

At the age of 2, temper tantrums are a normal part of child development. The nurse should take a supportive and nonjudgmental approach to help the mother manage her anxiety and address the situation appropriately. Asking the mother about her usual response helps to assess if her actions are reinforcing the tantrum or whether there are strategies she is using that could be more effective. By engaging the mother in a discussion about her typical response, the nurse can offer tailored advice, provide reassurance, and promote a calm approach to managing the tantrum.  This empowers the mother to take control of the situation and builds her confidence in managing her child’s behavior.

Why the other options are incorrect:

“Let’s ignore this behavior. It will stop sooner.”: Ignoring the behavior can sometimes be helpful for certain tantrums, but this response is too simplistic without understanding the child’s individual needs or context. Additionally, it may make the mother feel unsupported or unsure about how to manage the tantrum.

“This is definitely a temper tantrum. I know exactly what you are feeling right now.”: While the nurse may be trying to empathize with the mother, this statement could feel dismissive or overly generalized. It does not engage the mother in understanding the behavior or developing a plan to handle it.

“Pick up and cuddle your child now, please.”: While comfort is important, this response may inadvertently reinforce the tantrum behavior by rewarding it with attention. It is important for the nurse to explore the mother’s typical response to understand if this action might reinforce the unwanted behavior.

Summary:

The most appropriate response is to ask the mother what she usually does during a temper tantrum. This helps to engage her in the process, provides an opportunity to assess her response to the tantrum, and offers a chance to provide helpful guidance on managing the behavior. This approach supports the mother while acknowledging the normalcy of temper tantrums at this stage of development.