ATI RN
ATI Nursing Care of Children 2019 B
1. A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include?
- A. Dilating the stoma
- B. Assessing bowel function
- C. Limitation of physical activities
- D. Measures to prevent prolapse of the rectum
Correct answer: B
Rationale: Postoperative teaching should focus on assessing bowel function to ensure the colostomy is functioning properly. This includes monitoring stool output, color, consistency, and signs of infection or blockage. Choice A, dilating the stoma, is not recommended without healthcare provider guidance, as it can lead to complications. Choice C, limitation of physical activities, may not be as crucial immediately after colostomy creation. Choice D, measures to prevent prolapse of the rectum, is more relevant for conditions like rectal prolapse and not specifically for a colostomy.
2. During examination of a toddler's extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is which?
- A. Abnormal and requires further investigation
- B. Abnormal unless it occurs in conjunction with knock-knee
- C. Normal if the condition is unilateral or asymmetric
- D. Normal because the lower back and leg muscles are not yet well developed
Correct answer: D
Rationale: Bowleggedness is normal in toddlers due to the development of lower back and leg muscles. It usually resolves as the child grows.
3. A child who has just had definitive repair of a high rectal malformation is to be discharged. What should the nurse address in the discharge preparation of this family?
- A. Safe administration of daily enemas
- B. Necessity of firm stools to keep suture line clean
- C. Bowel training beginning as soon as the child returns home
- D. Changes in stooling patterns to report to the practitioner
Correct answer: D
Rationale: Postoperative care should focus on monitoring changes in stooling patterns, which could indicate complications such as stenosis or obstruction. It is crucial to educate the family on the importance of promptly reporting any changes in stooling patterns to the healthcare provider. Options A and B are not recommended unless specifically ordered by the physician as they can potentially cause harm or discomfort postoperatively. Option C may not be appropriate immediately after surgery and should be guided by the healthcare provider's recommendations.
4. Which immunization is typically administered at birth?
- A. Hepatitis B
- B. DTaP
- C. MMR
- D. Varicella
Correct answer: A
Rationale: The correct answer is A, Hepatitis B. The Hepatitis B vaccine is usually given at birth to protect against hepatitis B, a virus that can lead to chronic liver disease and liver cancer. This vaccination is crucial for newborns, especially those born to mothers who are carriers of hepatitis B. Choices B, C, and D are incorrect because DTaP (B), MMR (C), and Varicella (D) vaccines are not typically administered at birth. DTaP is given in a series starting at 2 months, MMR is usually given around 12-15 months, and Varicella is given between 12-15 months of age.
5. Several types of seizures can occur in neonates. What is characteristic of clonic seizures?
- A. Apnea
- B. Tremors
- C. Extension of all four limbs
- D. Jerking that cannot be stopped by flexion of the affected limb
Correct answer: D
Rationale: Clonic seizures are characterized by slow, rhythmic, jerking movements that cannot be stopped by flexion of the affected limb. Therefore, the correct characteristic of clonic seizures is option D. Option A, apnea, is not characteristic of clonic seizures. Option B, tremors, does not describe clonic seizures accurately. Option C, extension of all four limbs, is not a typical feature of clonic seizures but rather seen in tonic seizures.
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