ATI RN
Nursing Care of Children Final ATI
1. Why does the nurse have a 2-year-old boy sit in a “tailor” position while palpating for the presence of the testes?
- A. It prevents the cremasteric reflex
- B. Undescended testes can be palpated
- C. The child has an inguinal hernia
- D. The child does not yet have a need for privacy
Correct answer: A
Rationale: The tailor position stretches the muscle responsible for the cremasteric reflex, preventing it from contracting and pulling the testes into the pelvic cavity. This position helps accurately palpate the testes. Choice B is incorrect because the position does not facilitate the palpation of undescended testes specifically. Choice C is incorrect as it does not relate to the rationale behind the tailor position. Choice D is incorrect as the reason for using the tailor position is not related to the child's need for privacy.
2. Which parental statement indicates correct understanding of information presented regarding the prevention of iron deficiency anemia in infants?
- A. "We will add green leafy vegetables to our child’s low-iron formula."
- B. "We will discontinue the use of vitamin C supplements by 6 months of age."
- C. "We will begin an iron-fortified infant cereal at 4 to 6 months of age."
- D. "We will introduce cow’s milk by 6 months of age."
Correct answer: C
Rationale: The correct answer is C. Introducing iron-fortified cereal between 4 to 6 months of age is a recommended practice to prevent iron deficiency anemia in infants. Iron-fortified infant cereals are a good source of iron for infants. Choices A and B are incorrect because adding green leafy vegetables to low-iron formula and discontinuing vitamin C supplements do not directly address the prevention of iron deficiency anemia. Choice D is incorrect because cow's milk should be avoided before 12 months of age as it is low in iron and can lead to intestinal blood loss, increasing the risk of iron deficiency anemia.
3. Which data should be included in a health history?
- A. Review of systems
- B. Physical assessment
- C. Growth measurements
- D. Record of vital signs
Correct answer: A
Rationale: The review of systems is a critical part of a health history, helping to identify any symptoms or conditions that need further evaluation.
4. The nurse is caring for an adolescent who is overweight. Which of the following psychological effects of being overweight during adolescence will the nurse consider when planning care for the adolescent?
- A. Poor body image
- B. Sexual promiscuity
- C. Feelings of contempt for thin peers
- D. Lack of independence
Correct answer: A
Rationale: Adolescents who are overweight often struggle with poor body image, which can lead to low self-esteem and mental health issues. Addressing body image concerns and promoting healthy lifestyle changes are important aspects of care. Choices B, C, and D are incorrect. Sexual promiscuity is not a direct psychological effect of being overweight; feelings of contempt for thin peers are not a common or recommended psychological response; lack of independence is a broad term that does not specifically relate to the psychological effects of being overweight.
5. Apgar scoring is conducted at 1 minute and 5 minutes after birth. It is used to determine:
- A. Major body systems’ responses at birth
- B. Future intelligence of the newborn
- C. Level of parent and newborn interaction
- D. Gestational age of the newborn
Correct answer: A
Rationale: The Apgar score assesses a newborn's physical condition immediately after birth by evaluating heart rate, respiratory effort, muscle tone, reflex response, and color. Therefore, the correct answer is A. The other choices are incorrect because B) the Apgar score does not predict future intelligence, C) it does not measure parent and newborn interaction, and D) it is not used to determine gestational age.
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