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. A newborn is admitted to the nursery with a complete bilateral cleft lip and palate. The mother refuses to see or hold her infant. What should the nurse do first?
- A. Restate what the physician has told her about plastic surgery
- B. Suggest holding her baby without making eye contact
- C. Encourage and allow the mother to express her feelings
- D. Recognize and allow the mother to express her feelings
Correct answer: D
Rationale: In this situation, the priority is to acknowledge and validate the mother's feelings, creating a supportive environment for her. Option D is correct as it focuses on recognizing and allowing the mother to express her emotions. This approach can help build trust and facilitate communication. Options A and B are incorrect as they do not address the mother's emotional needs and may come across as dismissive. Option C is less appropriate as it only encourages expression without explicitly recognizing the mother's current emotional state.
3. Which dietary information should the nurse include in the teaching plan for a school-age child with chronic renal failure?
- A. High in sodium
- B. Low in Vitamin D
- C. Low in phosphorus
- D. Supplementation of vitamins C, E, K
Correct answer: C
Rationale: A low-phosphorus diet is recommended for children with chronic renal failure to prevent hyperphosphatemia, which can lead to bone disease and other complications. Phosphorus is found in many processed foods and should be limited. Choices A, B, and D are incorrect because high sodium intake can lead to fluid retention and hypertension, while Vitamin D supplementation and vitamins C, E, K are not specifically indicated for dietary recommendations in chronic renal failure.
4. A new dad is concerned about his toddler's play patterns. The nurse informs him that ____________ play is normally exhibited by toddlers:
- A. Associative
- B. Team
- C. Solitary
- D. Parallel
Correct answer: D
Rationale: The correct answer is D, 'Parallel.' Parallel play is a common play pattern observed in toddlers where they play alongside each other without direct interaction. This type of play allows toddlers to observe and mimic each other's actions, aiding in their social development. Choices A, B, and C are incorrect. Associative play involves some interaction between children, team play involves organized group activities, and solitary play is when a child plays alone, all of which are not typically exhibited by toddlers during play.
5. How is family systems theory best described?
- A. The family is viewed as the sum of individual members
- B. A change in one family member cannot create a change in other members
- C. Individual family members are readily identified as the source of a problem
- D. When the family system is disrupted, change can occur at any point in the system
Correct answer: D
Rationale: Family systems theory views the family as a whole, where changes in one member affect the entire system, and changes can occur at any point within the system.
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