ATI RN
Nursing Care of Children ATI
1. At which age should the nurse expect most infants to begin to say mama and dada with meaning?
- A. 4 months
- B. 6 months
- C. 10 months
- D. 14 months
Correct answer: C
Rationale: By around 10 months, infants often start to say "mama" and "dada" with meaning, associating these words with their parents.
2. The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the presenting signs?
- A. Gastrointestinal perforation may have occurred.
- B. The object may have been aspirated.
- C. The object may be lodged in the esophagus.
- D. The object may be embedded in the stomach wall.
Correct answer: C
Rationale: The symptoms of gagging and drooling suggest that the foreign object is likely lodged in the esophagus. This can cause significant discomfort and potential complications, requiring immediate medical evaluation.
3. What interventions should be implemented to maintain the skin integrity of a preterm infant born at 30 weeks?
- A. Avoid cleaning the skin
- B. Bathe the infant with sterile water
- C. Cleanse the skin with a gentle alkaline-based soap and water
- D. Thoroughly rinse the skin with plain water after bathing
Correct answer: B
Rationale: The correct intervention to maintain the skin integrity of a preterm infant born at 30 weeks is to bathe the infant with sterile water. Bathing with sterile water or a neutral pH solution is recommended to protect the delicate skin of preterm infants, which is more permeable and prone to damage. Choices A, C, and D are incorrect as avoiding cleaning the skin may lead to hygiene issues, cleansing with alkaline-based soap can be harsh on the delicate skin, and thoroughly rinsing with plain water after bathing may not be as gentle and protective for preterm infants.
4. When assessing a child with chronic renal failure, which clinical manifestations would the nurse expect to find?
- A. Uremic frost
- B. Hypotension
- C. Massive hematuria
- D. Severe metabolic acidosis
Correct answer: A
Rationale: When assessing a child with chronic renal failure, the nurse would expect to find uremic frost as a clinical manifestation. Uremic frost, a white powdery deposit of urea on the skin, occurs in severe cases of chronic renal failure due to the accumulation of urea and other waste products in the blood. Hypotension and massive hematuria are less common in chronic renal failure, while severe metabolic acidosis is typically mild to moderate and not a prominent clinical manifestation.
5. A major reason for the development of respiratory distress syndrome in the preterm infant is:
- A. Excessive surfactant
- B. Lack of surfactant
- C. Immature immune system
- D. Lack of body fat
Correct answer: B
Rationale: The correct answer is B: Lack of surfactant. Respiratory distress syndrome (RDS) in preterm infants is primarily due to a lack of surfactant, which is crucial for keeping the lungs inflated. Without adequate surfactant, the alveoli collapse, leading to breathing difficulties. Choice A, Excessive surfactant, is incorrect as RDS is caused by an insufficient amount of surfactant. Choice C, Immature immune system, and Choice D, Lack of body fat, are not directly related to the development of respiratory distress syndrome in preterm infants.
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