ATI RN
ATI Nursing Care of Children 2019 B
1. An infant with short bowel syndrome is receiving total parenteral nutrition (TPN). The practitioner has added continuous enteral feedings through a gastrostomy tube. The nurse recognizes this as important for which reason?
- A. Wean the infant from TPN gradually
- B. Stimulate adaptation of the small intestine
- C. Provide additional nutrients that cannot be included in the TPN
- D. Offer parents encouragement that the child is close to discharge
Correct answer: B
Rationale: Continuous enteral feedings help stimulate the small intestine's adaptation in short bowel syndrome, promoting better nutrient absorption and eventually reducing reliance on TPN. This approach is crucial for long-term management and improving the child's prognosis. Choice A is incorrect because weaning off TPN typically occurs gradually over time, not the next day. Choice C is incorrect because TPN can be adjusted to provide necessary nutrients, and enteral feedings are mainly used to stimulate intestinal function. Choice D is incorrect as the addition of enteral feedings does not necessarily indicate imminent discharge; it primarily focuses on enhancing intestinal adaptation and reducing reliance on TPN.
2. A child receives a vaccine for MMR. Six hours after the injection, the child�s parent reports local soreness, erythema, lethargy, and a fever of 101�F to a nurse. Which action should the nurse take?
- A. Give instructions on relieving symptoms with acetaminophen
- B. Seek emergency help, because these symptoms are signs of anaphylactic reaction
- C. Tell the parent that a live vaccine will cause a mild case of measles
- D. Obtain and fill out a Vaccine Adverse Event Report form
Correct answer: A
Rationale: Low-grade fever, malaise, and muscle aches are common reactions. Acetaminophen usually alleviates these problems. MMR is a live vaccine but it is attenuated or completely avirulent and does not cause measles in healthy children, only immunocompromised children.
3. A nurse is reinforcing teaching about food choices with the mother of an 8-month-old infant. Which of the following statements by the mother indicates a need for further teaching?
- A. I will give my child strained carrots and mashed egg yolks.
- B. I will give my child rice cereal and crackers.
- C. I will give my child pureed liver and strained pears.
- D. I will give my child applesauce and green peas.
Correct answer: I will give my child rice cereal and crackers.
Rationale: Choice B, 'I will give my child rice cereal and crackers,' indicates a need for further teaching. Infants should not be given crackers at 8 months of age due to the risk of choking. Rice cereal is appropriate for infants, but it should be introduced carefully to avoid digestive issues. Choices A, C, and D are appropriate food choices for an 8-month-old infant, providing a variety of nutrients and textures suitable for their age and developmental stage.
4. Which heart sound is produced by vibrations within the heart chambers or in the major arteries from the back-and-forth flow of blood?
- A. S1 and S2
- B. S3 and S4
- C. Murmur
- D. Physiologic splitting
Correct answer: C
Rationale: A murmur is produced by turbulent blood flow within the heart or major arteries, resulting in audible vibrations.
5. When educating a client about to undergo a pacemaker insertion, the nurse explains the normal phases of cardiac muscle tissue. During the repolarization phase, the nurse will stress that membranes must be repolarized before they can be re-excited. Within the cell, the nurse understands that:
- A. Potassium channels open while sodium channels close, causing repolarization to the resting state.
- B. The influx of calcium is the primary stimulus for the repolarization of cardiac tissue.
- C. Only the electrical activity within the heart will determine when repolarization occurs.
- D. The cell membranes need to stay calm, resulting in muscle tissue becoming refractory.
Correct answer: A
Rationale: During the repolarization phase of cardiac muscle tissue, potassium channels open while sodium channels close. This process is crucial for the cardiac muscle to return to its resting state after depolarization. Potassium moving out of the cell and sodium staying out helps reset the membrane potential and prepare the cell for the next depolarization phase. The influx of calcium is not the primary stimulus for repolarization in cardiac tissue; it is mainly involved in the depolarization phase. While electrical activity within the heart influences repolarization, the specific ion movements described in choice A are what physiologically drive repolarization. Cell membranes need to be in an active state during repolarization, not calm, to facilitate the necessary ion movements for muscle tissue to properly function.
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