an infant is diagnosed with a tracheoesophageal fistula which assessment finding should the nurse expect
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Nursing Elites

ATI RN

Nursing Care of Children ATI

1. An infant is diagnosed with a tracheoesophageal fistula. Which assessment finding should the nurse expect?

Correct answer: D

Rationale: Coughing with excessive secretion is a common sign of tracheoesophageal fistula. In this condition, the connection between the trachea and esophagus allows saliva and food to enter the airways, leading to coughing and excessive secretions. Choice A, jaundice, is not typically associated with tracheoesophageal fistula. Hyperactive bowel sounds (Choice B) are more likely seen in conditions like gastroenteritis. Absence of sucking and vomiting (Choice C) is not a typical finding related to tracheoesophageal fistula.

2. By which age should the nurse expect that an infant will be able to pull to a standing position?

Correct answer: C

Rationale: Pulling to a standing position typically occurs between 11 to 12 months, marking the progression towards walking.

3. Which nonpharmacologic intervention appears to be effective in decreasing neonatal procedural pain?

Correct answer: D

Rationale: Oral sucrose and nonnutritive sucking are effective nonpharmacologic interventions for reducing procedural pain in neonates.

4. A four-year-old child has a history of repeated otitis media despite antibiotic treatment. Which treatment measure should the nurse discuss with the parents?

Correct answer: C

Rationale: The correct answer is C: The insertion of tympanostomy (pressure equalizing) tubes. This treatment measure is appropriate for a child with recurrent otitis media as it helps drain fluid from the middle ear and prevent further infections. Adenoidectomy (choice B) involves the removal of the adenoids, which may not directly address the ear infections. Antibiotic treatment (choice A) has already been ineffective in this case, so alternative measures are necessary. Tonsillectomy (choice D) is not typically indicated for otitis media unless there are specific reasons such as enlarged tonsils contributing to the condition.

5. What is characteristic of a neonate’s vision?

Correct answer: A

Rationale: The correct answer is A: 'Pupils react to light.' Newborns' pupils do react to light, indicating that the visual pathway is functioning. However, a neonate's vision is still developing, and they can only focus on objects close to their face. Choice B is incorrect because tear glands are functional at birth. Choice C is incorrect because the blink reflex is present in neonates and helps protect their eyes. Choice D is incorrect as neonates' ciliary muscles are not fully developed.

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