ATI RN
RN Nursing Care of Children Online Practice 2019 A
1. Chemicals, agents, or factors that cause physical defects in the developing embryo and are most harmful during organogenesis are:
- A. Teratogens
- B. Heterozygous
- C. Inborn errors
- D. Multifactorial
Correct answer: A
Rationale: Teratogens are substances that can cause congenital abnormalities, especially during the first trimester when organogenesis occurs. Choice A, Teratogens, is the correct answer as it specifically refers to substances that cause physical defects in the developing embryo. Choices B, Heterozygous, C, Inborn errors, and D, Multifactorial, are incorrect as they do not directly relate to substances that cause physical defects in embryos during organogenesis.
2. Which one of the following strategies might be recommended for an infant with failure to thrive (FTT) to increase caloric intake?
- A. Vary the schedule for routine activities on a daily basis.
- B. Be persistent through 10 to 15 minutes of food refusal.
- C. Avoid solids until after the bottle is well accepted.
- D. Use developmental stimulation by a specialist during feedings.
Correct answer: B
Rationale: Being persistent through 10 to 15 minutes of food refusal is recommended to help increase caloric intake in infants with FTT. Establishing a routine and using developmental stimulation can also be helpful, but the priority is ensuring adequate caloric intake.
3. What findings would the nurse consider normal in assessing the anterior fontanel of a neonate?
- A. Closed anterior fontanel
- B. Sunken anterior fontanel
- C. Bulging anterior fontanel
- D. Pulsating anterior fontanel
Correct answer: D
Rationale: The correct answer is D: Pulsating anterior fontanel. The fontanel should feel flat, firm, and well demarcated. Pulsations are frequently visible at the anterior fontanel, which is a normal finding in a neonate. A closed anterior fontanel, as mentioned, is a potential sign of a major abnormality. A sunken or bulging fontanel (when the infant is quiet) may be indicative of distress or a major abnormality. Therefore, options A, B, and C are considered abnormal findings when assessing the anterior fontanel of a neonate.
4. A health care provider prescribes feedings of 1 to 2 oz Pedialyte every 3 hours and to advance to 1/2 strength Similac with iron as tolerated postoperatively for an infant who had a pyloromyotomy. The nurse should decide to advance the feeding if which occurs?
- A. The infant's IV line has infiltrated.
- B. The infant has not voided since surgery.
- C. The infant's mother states the infant is tolerating the feeding okay.
- D. The infant is taking the Pedialyte without vomiting or distention.
Correct answer: D
Rationale: The decision to advance feedings after a pyloromyotomy is based on the infant's ability to tolerate the current feedings without vomiting or abdominal distention. Ensuring the infant can keep down Pedialyte is the key indicator for moving to the next stage of feeding. Choices A, B, and C are incorrect because they do not directly relate to the infant's ability to tolerate the feeding. An infiltrated IV line, lack of voiding, or the mother's statement do not provide direct information on the infant's tolerance to the feeding, unlike the absence of vomiting and distention.
5. The nurse is preparing to administer an intramuscular injection to a toddler-age client. Which is the most appropriate statement by the nurse prior to this procedure?
- A. "We will give you your shot when your mommy comes back."
- B. "I will wipe your skin with a magic wipe and then hold the needle like this and say one, two, three, go and give you your shot. Are you ready?"
- C. "It is all right to cry. After we are done, you can go to the box and pick out your favorite sticker."
- D. "This is a magic sword that will give you your medicine and make you all better."
Correct answer: C
Rationale: The correct answer is C because it acknowledges the child's feelings, provides clear instructions, and offers comfort and rewards to help the child cope with the procedure. Choice A is not appropriate as it may create anxiety about the injection. Choice B uses the term 'magic,' which may confuse the child and lead to fear. Choice D introduces a fantasy element that may not be beneficial in preparing the child for the injection.