mr lopez has a 7 year old son with growth hormone gh deficiency he shares to the nurse the desire of his son to play ball games however his wife feels

ATI LPN

Pediatric ATI Proctored Test

1. Mr. Lopez has a 7-year-old son with growth hormone (GH) deficiency. He shares with the nurse the desire of his son to play ball games. However, his wife feels the child will be in danger since he is smaller than the other children. In planning anticipatory guidance for these parents, the nurse should keep in mind which of the following?

A. The child should be allowed to play because doing so can foster healthy self-esteem
B. The risk for fractures is increased because GH deficiency results in fragile bones
C. Activity could aggravate insulin sensitivity, causing hyperglycemia
D. Activity would aggravate the child's joints, already overtasked by obesity

Correct answer: A

Rationale: Children with GH deficiency may face challenges due to their size, but it is important to encourage their participation in activities like playing ball games to promote healthy self-esteem. Allowing the child to play can help in building confidence and a sense of accomplishment, which are essential for their overall well-being.

2. The student nurse has performed a gestational age assessment of an infant and finds the infant to be at 32 weeks. On which set of characteristics is the nurse basing this assessment?

A. Lanugo mostly gone, little vernix remaining on the body
B. Prominent clitoris, enlarging labia minora, patent anus
C. Full areola, 5 to 10 mm nipple bud, pinkish-brown areola
D. Skin opaque, cracking at wrists and ankles, no visible vessels

Correct answer: B

Rationale: The correct answer is B. At 30 to 32 weeks' gestation, the clitoris is prominent, and the labia minora are enlarging. The labia majora are small and widely separated. As gestational age increases, the labia majora increase in size. At 36 to 40 weeks, they almost cover the clitoris. At 40 weeks and beyond, the labia majora cover the labia minora and clitoris. Choices A, C, and D do not align with the characteristic features seen at 32 weeks of gestation, making them incorrect.

3. Which of the following statements regarding SIDS is correct?

A. SIDS can occur in premature infants.
B. It is most commonly a result of child abuse.
C. Death usually occurs during sleep.
D. SIDS can be prevented by placing the baby on its back to sleep.

Correct answer: C

Rationale: The correct statement regarding SIDS is that death usually occurs during sleep. Sudden Infant Death Syndrome (SIDS) is the unexpected death of a seemingly healthy infant, typically occurring during sleep. The exact cause of SIDS is not fully understood. While placing the baby on its back to sleep is a recommended preventive measure to reduce the risk of SIDS, it cannot guarantee prevention. Choice A is incorrect as SIDS is not limited to premature infants. Choice B is incorrect as SIDS is not primarily caused by child abuse.

4. In growing children, growth hormone deficiency results in short stature and very slow growth rates. Short stature may result from which of the following?

A. Anterior pituitary gland hypofunction
B. Posterior pituitary gland hyperfunction
C. Parathyroid gland hyperfunction
D. Thyroid gland hyperfunction

Correct answer: A

Rationale: Short stature in growing children can result from anterior pituitary gland hypofunction, which leads to growth hormone deficiency. The anterior pituitary gland plays a crucial role in stimulating the release of growth hormone, and when it is underactive (hypofunction), insufficient growth hormone is produced, resulting in short stature and slow growth rates.

5. What is the most important intervention to decrease the stressors of hospitalization for a 9-month-old infant being treated for a bacterial infection?

A. Encourage the infant's parents to remain at the bedside and actively participate in the infant's care.
B. Provide a brightly lit environment for the infant.
C. Play tapes of the mother's voice.
D. Assign the same nurse to the infant as much as possible.

Correct answer: A

Rationale: Encouraging the infant's parents to remain at the bedside and actively participate in the infant's care is crucial in decreasing the stressors of hospitalization for the infant. Parental presence provides comfort and security, promotes bonding, and maintains a sense of familiarity for the infant during a potentially stressful situation. This involvement can help reduce anxiety and promote better outcomes for the infant's emotional well-being and overall hospital experience. Providing a brightly lit environment (choice B) can actually increase stress for the infant, as infants generally prefer dimly lit environments for better sleep. Playing tapes of the mother's voice (choice C) may offer some comfort but does not substitute for parental presence. While assigning the same nurse to the infant (choice D) can provide continuity of care, it is not as effective as having the parents present for emotional support and bonding.