ATI RN
RN Nursing Care of Children 2019 With NGN
1. A newborn has been diagnosed with Hirschsprung’s disease. The parent asks the nurse about the symptoms that led to the diagnosis. Which symptoms should the nurse include in the response?
- A. Acute diarrhea and dehydration
- B. Current jelly-like stools and pain
- C. Failure to pass meconium and abdominal distension
- D. Projectile vomiting and altered electrolytes
Correct answer: C
Rationale: The correct answer is C: Failure to pass meconium and abdominal distension. Hirschsprung’s disease is commonly diagnosed in newborns due to the failure to pass meconium within the first 24-48 hours after birth and abdominal distension, indicating a bowel obstruction. Choices A, B, and D are incorrect because they do not correspond to the typical symptoms of Hirschsprung’s disease. Acute diarrhea and dehydration, current jelly-like stools and pain, and projectile vomiting with altered electrolytes are not characteristic of this condition.
2. A 4-month-old infant is discharged home after surgery for the repair of a cleft lip. What should instructions to the parents include?
- A. Provide crib toys for distraction
- B. Breast- or bottle-feeding can begin immediately
- C. Give pain medication to the infant to minimize crying
- D. Leave the infant in the crib at all times to prevent suture strain
Correct answer: C
Rationale: Pain management is essential postoperatively to reduce crying, which could place strain on the surgical site. Feeding and holding the infant are allowed, but care should be taken to avoid placing pressure on the suture line.
3. What is most important in the management of cellulitis?
- A. Burow solution compresses
- B. Oral or parenteral antibiotics
- C. Topical application of an antibiotic
- D. Incision and drainage of severe lesions
Correct answer: B
Rationale: Oral or parenteral antibiotics are essential in treating cellulitis to eliminate the infection. Topical antibiotics are not sufficient, and incision and drainage are only for abscesses.
4. A mother delivers an infant at 30 weeks gestation and asks if formula is better than breast milk since the baby is premature. What should the nurse respond?
- A. Human milk is preferred over other types of nutrition
- B. Human milk lacks essential nutrients for preterm infants
- C. Commercial infant formulas are preferred for preterm infants
- D. Commercial formulas have not been designed to meet preterm infants' needs
Correct answer: A
Rationale: Human milk is preferred, even for preterm infants, because it contains essential nutrients and antibodies that are particularly beneficial for their growth and development. Choice B is incorrect because human milk is rich in essential nutrients necessary for preterm infants. Choice C is incorrect as commercial infant formulas do not provide the same benefits as human milk. Choice D is incorrect as specialized formulas are available to meet the unique nutritional needs of preterm infants, but human milk remains the optimal choice.
5. The clinic nurse is teaching parents about physiologic anemia that occurs in infants. What statement should the nurse include about the cause of physiologic anemia?
- A. Maternally derived iron stores are depleted in the first 2 months.
- B. Fetal hemoglobin results in a shortened survival of red blood cells.
- C. The production of adult hemoglobin decreases in the first year of life.
- D. Low levels of fetal hemoglobin depress the production of erythropoietin.
Correct answer: B
Rationale: Physiologic anemia is caused by the transition from fetal to adult hemoglobin, with fetal hemoglobin having a shorter lifespan, leading to a temporary decrease in red blood cells.