a thorough systemic physical assessment is necessary in the extremely low birth weight elbw infant to detect what

ATI RN

ATI Nursing Care of Children

1. A thorough systemic physical assessment is necessary in the extremely low-birth-weight (ELBW) infant to detect what?

A. Weight gain reflective of fluid retention
B. Difficulties in maternal-child attachment
C. Subtle changes that may be indicative of an underlying problem
D. Changes in Apgar score over the first 24 hours of life

Correct answer: C

Rationale: In extremely low-birth-weight (ELBW) infants, a thorough systemic physical assessment is crucial to detect subtle changes that may indicate an underlying problem. These infants are highly vulnerable and may show signs of stress through changes in feeding behavior, activity, color, oxygen saturation, or vital signs. Monitoring weight in ELBW infants primarily reflects genitourinary function rather than fluid retention. Difficulties in maternal-child attachment are important but are usually assessed during parental visits and are not the primary focus of a systemic physical assessment. Changes in the Apgar score are used immediately after birth to assess the transition to extrauterine life and are not as relevant in the following 24 hours to detect ongoing subtle issues.

2. What is the most common cause of acute kidney injury in children?

A. Dehydration
B. Glomerulonephritis
C. Hemolytic uremic syndrome
D. Sepsis

Correct answer: C

Rationale: Hemolytic uremic syndrome is the most common cause of acute kidney injury in children. While dehydration can lead to prerenal acute kidney injury, it is not the most common cause in children. Glomerulonephritis is a common cause of chronic kidney disease but not typically the most common cause of acute kidney injury in children. Sepsis can lead to acute kidney injury, but in children, hemolytic uremic syndrome is more prevalent.

3. Congenital defects of the genitourinary tract, such as hypospadias, are usually repaired as early as possible to accomplish what?

A. Minimize separation anxiety
B. Prevent urinary complications.
C. Increase acceptance of hospitalization.
D. Promote development of normal body image.

Correct answer: D

Rationale: Early repair of congenital genitourinary defects like hypospadias is important to promote a normal body image and avoid psychological issues as the child grows. It also helps prevent urinary complications and allows for normal development.

4. The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurse's reply?

A. The antibiotic therapy contributes to labile blood pressure values.
B. Hypotension leading to sudden shock can develop at any time.
C. Acute hypertension is a concern that requires monitoring.
D. Blood pressure fluctuations indicate that the condition has become chronic.

Correct answer: C

Rationale: Acute hypertension is a common complication of acute glomerulonephritis, requiring frequent monitoring to prevent complications such as encephalopathy or heart failure. Blood pressure fluctuations can occur but are not necessarily indicative of chronic disease.