ATI RN
RN Nursing Care of Children 2019 With NGN
1. The nurse is caring for an infant after a cleft lip repair. Which of these measures should be included in the plan of care?
- A. Position prone
- B. Provide fluids from a cup
- C. Position supine
- D. Avoid elbow restraints
Correct answer: C
Rationale: The correct measure that should be included in the plan of care for an infant after a cleft lip repair is to position the infant supine. Placing the infant in a supine position helps protect the surgical site from injury and promotes proper healing. Choice A, 'Position prone,' is incorrect as placing the infant prone can put pressure on the surgical site and hinder healing. Choice B, 'Provide fluids from a cup,' is not directly related to the surgical care of a cleft lip repair. Choice D, 'Avoid elbow restraints,' is not specific to the postoperative care of a cleft lip repair.
2. What are signs and symptoms of a possible kidney transplant rejection in a child? (Select all that apply.)
- A. Fever
- B. Hypotension
- C. All are applicable
- D. Swelling and tenderness of graft area
Correct answer: B
Rationale: Signs of kidney transplant rejection include fever, diminished urinary output, and swelling/tenderness in the graft area. These symptoms indicate that the body may be rejecting the transplanted organ, requiring immediate medical attention.
3. At what stage can infants raise their heads and gain control of their trunks before walking due to which directional pattern of development?
- A. Cephalocaudal
- B. Anterior to posterior
- C. Proximodistal
- D. Normal growth curve charts
Correct answer: A
Rationale: The correct answer is A: Cephalocaudal. The cephalocaudal pattern of development means that growth and motor control proceed from the head downward through the body. This explains why infants can raise their heads before they can sit and gain control of their trunks before walking. Choices B, C, and D are incorrect. Anterior to posterior refers to development from the front to the back, while proximodistal refers to development from the center of the body outward. Normal growth curve charts are used to track physical growth over time and are not directly related to the directional pattern of development in infants.
4. The nurse understands that blocks to therapeutic communication include what? (Select all that apply.)
- A. Socializing
- B. All are applicable
- C. Using clichés
- D. Defending a situation
Correct answer: B
Rationale: Socializing, using clichés, and defending a situation are all barriers to effective therapeutic communication. Silence is a useful tool in therapeutic communication.
5. When assessing an infant with intussusception, what type of stool would the nurse expect to find?
- A. Soft, seedy stool
- B. Currant-jelly stool
- C. Ribbon-like stool
- D. Soft and pasty stool
Correct answer: B
Rationale: The correct answer is B: Currant-jelly stool. This type of stool, which is red and mucous-like, is a classic sign of intussusception in infants. Choice A (Soft, seedy stool) is incorrect as it does not specifically describe the characteristic stool associated with intussusception. Choice C (Ribbon-like stool) is incorrect; ribbon-like stool may be seen in conditions like colon cancer, not intussusception. Choice D (Soft and pasty stool) is also incorrect as it does not match the typical stool finding in intussusception.