ATI RN
RN Nursing Care of Children Online Practice 2019 A
1. An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Postoperative nursing care would include what?
- A. Monitor closely for signs of infection.
- B. Place the child with the operative side of the head up.
- C. Avoid pumping the shunt reservoir to maintain patency.
- D. Avoid maintaining a Trendelenburg position to decrease pressure on the shunt.
Correct answer: A
Rationale: Postoperative nursing care for an infant with hydrocephalus who underwent ventriculoperitoneal shunt placement includes monitoring closely for signs of infection, as infection is the greatest hazard in the postoperative period. Signs of cerebrospinal fluid infection to watch for include elevated temperature, poor feeding, vomiting, decreased responsiveness, and seizure activity. The child should be placed with the operative side of the head up to reduce pressure on the valve. The shunt reservoir should not be pumped to maintain patency, as this can disrupt its function. Maintaining a Trendelenburg position to decrease pressure on the shunt is contraindicated as it can lead to increased intracranial pressure and compromise the shunt's effectiveness.
2. The nurse is teaching a child experiencing severe edema associated with minimal change nephrotic syndrome about his diet. The nurse should discuss what dietary need?
- A. Consuming a regular diet
- B. Increasing protein
- C. Restricting fluids
- D. Decreasing calories
Correct answer: C
Rationale: Fluid restriction is often necessary to manage severe edema associated with MCNS. Increasing protein is not typically recommended due to the risk of exacerbating proteinuria, and calorie reduction is not generally needed.
3. Which statement best describes colic?
- A. Periods of abdominal pain resulting in weight loss
- B. Usually the result of poor or inadequate mothering
- C. Periods of abdominal pain and crying occurring in infants older than age 6 months
- D. A paroxysmal abdominal pain or cramping manifested by episodes of loud crying
Correct answer: D
Rationale: Colic is characterized by episodes of loud, inconsolable crying, often due to abdominal discomfort, and typically occurs in infants younger than 6 months. It is not related to poor mothering, nor does it necessarily result in weight loss.
4. After 8 weeks in the neonatal intensive care unit, Chris will soon be discharged. His parents seem apprehensive and worry that he may still be in danger. What is this considered by the nurse?
- A. A common parental reaction
- B. Suggestive of maladaptation
- C. A reason to postpone discharge
- D. Suggestive of inadequate bonding
Correct answer: A
Rationale: Parents become apprehensive and worried as the time for discharge approaches, which is a common parental reaction. They often have concerns and insecurities about caring for their infant. The worry about potential dangers is a normal adaptive response reflecting the parents' concern for their child's well-being. It is essential for healthcare providers to acknowledge these feelings and support parents in gaining confidence in caring for their infant. Choices B, C, and D are incorrect because the parents' apprehension in this context is a typical emotional response and not indicative of maladaptation, a reason to postpone discharge, or inadequate bonding.
5. If the needs of the infant are met in a loving, consistent manner, the infant will develop a sense of:
- A. Trust
- B. Love
- C. Independence
- D. Responsibility
Correct answer: A
Rationale: The correct answer is A: Trust. According to Erikson's psychosocial development theory, when infants receive consistent and loving care, they develop trust. This trust forms the basis of the first stage of psychosocial development, known as Trust vs. Mistrust. Trust is essential for healthy social and emotional development. Choice B, Love, is incorrect as it is more of an emotion than a developmental stage. Choice C, Independence, typically occurs later in development during Erikson's Autonomy vs. Shame and Doubt stage. Choice D, Responsibility, is also not the correct answer as it relates more to later stages of development where individuals develop a sense of duty and obligation.
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