ATI RN
Nursing Care of Children Final ATI
1. An adolescent states, “I want to be a doctor or a lawyer when I grow up because I like taking care of people.” Which Eriksonian challenge is the adolescent attempting?
- A. Identity vs. role diffusion
- B. Trust vs. mistrust
- C. Industry vs. inferiority
- D. Autonomy vs. shame and doubt
Correct answer: A
Rationale: The correct answer is A: Identity vs. role diffusion. During adolescence, individuals face the challenge of forming a cohesive sense of self and identity. In this scenario, the adolescent's desire to become a doctor or lawyer reflects the exploration of potential roles and career paths, indicating an attempt to establish a clear identity. Choices B, C, and D are incorrect. Trust vs. mistrust is a challenge experienced in infancy, industry vs. inferiority is relevant to the school-age period, and autonomy vs. shame and doubt is associated with the toddler stage, not adolescence.
2. What is a physical characteristic of infants whose mothers smoked during pregnancy?
- A. Being large for gestational age
- B. Growth restriction in weight only
- C. Preterm but size appropriate for gestational age
- D. Growth restriction in weight, length, and chest and head circumference
Correct answer: D
Rationale: The correct answer is D: Growth restriction in weight, length, and chest and head circumference. Infants born to mothers who smoke during pregnancy exhibit growth failure in weight, length, chest, and head circumference. This growth failure is directly related to the number of cigarettes smoked by the mother. Choices A, B, and C are incorrect because infants exposed to maternal smoking do not tend to be large for gestational age, experience growth restriction in weight only, or be preterm but size appropriate for gestational age.
3. A mother has just given birth to a newborn with a cleft lip. Sensing that something is wrong, she starts to cry and asks the nurse, "What is wrong with my baby?" What is the most appropriate nursing action?
- A. Encourage the mother to express her feelings
- B. Explain in simple language that the baby has a cleft lip
- C. Provide emotional support until the practitioner can talk to the mother
- D. Tell the mother a pediatrician will talk to her as soon as the baby is examined
Correct answer: A
Rationale: Encouraging the mother to express her feelings allows her to process the situation and prepares her for receiving further information in a supportive environment.
4. What condition is the most common cause of acute renal failure in children?
- A. Pyelonephritis
- B. Tubular destruction
- C. Severe dehydration
- D. Upper tract obstruction
Correct answer: C
Rationale: Severe dehydration is the most common cause of acute renal failure in children, as it leads to prerenal azotemia, which can progress to renal failure if not corrected. Other causes like pyelonephritis and tubular destruction are less common and usually secondary to other conditions.
5. Why are neonates predisposed to problems with thermoregulation?
- A. Renal function is not fully developed.
- B. Flexed posture favors heat loss.
- C. A large body surface area favors heat loss to the environment.
- D. A thick layer of subcutaneous fat provides excellent insulation.
Correct answer: C
Rationale: Neonates have a large surface area relative to their weight, which makes them prone to heat loss to the environment, leading to thermoregulation issues. The underdeveloped kidney affecting urine concentration (Choice A) is unrelated to the thermal regulation process. While a flexed posture can help retain heat (Choice B), it does not outweigh the impact of the large body surface area in neonates. Although subcutaneous fat (Choice D) provides insulation, in neonates, the large body surface area is more significant in contributing to heat loss than the fat's insulating properties.
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