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ATI Pediatrics Proctored Exam 2023 with NGN
1. In educating the parents of a child diagnosed with hypothyroidism, the nurse mentions that the child should avoid goitrogens. Which of the following will the nurse mention as an example?
- A. Orange
- B. Tomatoes
- C. Cabbage
- D. Grapes
Correct answer: C
Rationale: Cabbage is an example of a goitrogen that should be avoided in children with hypothyroidism. Goitrogens are substances that can interfere with thyroid function by inhibiting iodine uptake, potentially worsening the condition. Cabbage, along with other cruciferous vegetables like broccoli and cauliflower, contains compounds that can affect thyroid hormone production. Oranges, tomatoes, and grapes are not classified as goitrogens. Therefore, it is important for parents to be aware of foods like cabbage and to limit their child's intake to help manage their hypothyroidism effectively.
2. A breastfeeding mother reports breast engorgement. The nurse advises her to:
- A. Increase the frequency of feedings
- B. Apply ice packs to the breasts
- C. Avoid breastfeeding until the pain subsides
- D. Use a breast pump to empty the breasts completely
Correct answer: A
Rationale: Breast engorgement occurs when the breasts become overfilled with milk. By increasing the frequency of feedings, the mother can ensure that her breasts are emptied regularly, helping to relieve the discomfort associated with engorgement. This advice promotes effective milk removal and prevents further accumulation, which can worsen the condition. Applying ice packs may provide temporary relief, but it does not address the underlying issue of milk accumulation. Avoiding breastfeeding can lead to further engorgement and potential complications. Using a breast pump to empty the breasts completely may be necessary in some cases, but increasing the frequency of feedings is the initial and most appropriate intervention to manage breast engorgement.
3. An 18-month-old child presents with fever, nasal flaring, intercostal retractions, and a respiratory rate of 50 bpm. What is the most appropriate nursing diagnosis?
- A. High risk for altered body temperature - hyperthermia
- B. Ineffective breathing pattern
- C. Ineffective individual coping
- D. Knowledge deficit
Correct answer: B
Rationale: In this case, the child is showing signs of respiratory distress, such as nasal flaring, intercostal retractions, and an increased respiratory rate. These are indicative of an ineffective breathing pattern. The child's compromised respiratory function requires immediate attention and intervention, making 'Ineffective breathing pattern' the most appropriate nursing diagnosis. Choices A, C, and D do not address the respiratory distress the child is experiencing and are not the priority in this situation.
4. How can a new mother tell if her baby is getting enough breast milk?
- A. If your baby sleeps through the night, they are getting enough milk.
- B. If your baby has six to eight wet diapers a day, they are getting enough milk.
- C. If your baby cries frequently, they are getting enough milk.
- D. If your baby is awake and alert, they are getting enough milk.
Correct answer: B
Rationale: The correct answer is B. If a new mother observes that her baby has six to eight wet diapers a day, it indicates that the baby is getting enough breast milk. This is a crucial indicator of adequate milk intake and hydration in infants. Conversely, choices A, C, and D are incorrect. A baby sleeping through the night, crying frequently, or being awake and alert are not reliable indicators of sufficient breast milk intake. It is essential for new mothers to track their baby's diaper output to ensure they are receiving the necessary nutrition.
5. During the initial assessment of the newborn, which of the following data would be considered normal?
- A. Chest circumference 31.5 cm, head circumference 33.5 cm
- B. Chest circumference 30 cm, head circumference 29 cm
- C. Chest circumference 38 cm, head circumference 31.5 cm
- D. Chest circumference 32.5 cm, head circumference 36 cm
Correct answer: A
Rationale: The correct answer is A. During the initial assessment of a newborn, the average head circumference at birth is 32 to 37 cm, while the average chest circumference ranges from 30 to 35 cm. Normally, the head's circumference is about 2 cm greater than the chest circumference at birth. Choice A provides measurements of chest circumference 31.5 cm and head circumference 33.5 cm, both falling within the normal range in terms of actual size and relative size. Choices B, C, and D do not align with the typical measurements seen in a healthy newborn. Choice B has both circumferences below the average range, choice C has the chest circumference above the average, and choice D has the head circumference notably higher than the chest circumference, which is not typical for a newborn.
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