ATI RN
Nursing Care of Children ATI
1. During the 2-month well-child checkup, the nurse expects the infant to respond to sound in which manner?
- A. Respond to name
- B. React to loud noise with Moro reflex
- C. Turn his or her head to side when sound is at ear level
- D. Locate sound by turning his or her head in a curving arc
Correct answer: B
Rationale: At 2 months, infants typically react to loud noises with the Moro reflex, a startle response that is normal at this stage of development.
2. Parents of a hospitalized toddler ask the nurse, "What is meant by family-centered care?" The nurse should respond with which statement?
- A. Family-centered care reduces the effect of cultural diversity on the family
- B. Family-centered care encourages family dependence on the health care system
- C. Family-centered care recognizes that the family is the constant in a child’s life
- D. Family-centered care avoids expecting families to be part of the decision-making process
Correct answer: C
Rationale: Family-centered care emphasizes the importance of the family as the constant in a child's life, involving them in all aspects of care and decision-making.
3. In teaching parents about appropriate pacifier selection, the nurse should recommend which characteristic?
- A. Easily grasped handle
- B. Detachable shield for cleaning
- C. Soft, pliable material
- D. Ribbon or string to secure to clothing
Correct answer: A
Rationale: A pacifier with an easily grasped handle is safer and more convenient for the infant to use without the risk of choking hazards that detachable parts might pose.
4. Which characteristic best describes the fine motor skills of an infant at age 5 months?
- A. Neat pincer grasp
- B. Strong grasp reflex
- C. Builds a tower of two cubes
- D. Able to grasp object voluntarily
Correct answer: D
Rationale: By 5 months, infants develop the ability to grasp objects voluntarily, showing improved motor control. The neat pincer grasp and building towers are skills that develop later.
5. What disease should be suspected in a 3-day-old infant presenting with abdominal distention, vomiting, and failure to pass meconium?
- A. Pyloric stenosis
- B. Intussusception
- C. Hirschsprung disease
- D. Celiac disease
Correct answer: C
Rationale: Hirschsprung disease should be suspected in a newborn with abdominal distention, vomiting, and failure to pass meconium. This condition arises from a congenital absence of nerve cells in a portion of the colon, leading to severe constipation and intestinal obstruction. Pyloric stenosis typically presents with non-bilious projectile vomiting in the first few weeks of life. Intussusception classically manifests with sudden onset of colicky abdominal pain and currant jelly stools. Celiac disease may present with chronic diarrhea, failure to thrive, and abdominal distention but is less likely in this scenario.
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