the nurse is preparing to care for a newborn with an omphalocele the nurse should understand that care of the infant should include what intervention
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Nursing Elites

ATI RN

ATI Nursing Care of Children 2019 B

1. The nurse is preparing to care for a newborn with an omphalocele. The nurse should understand that care of the infant should include what intervention?

Correct answer: C

Rationale: The priority intervention for an infant with an omphalocele is to cover the intact bowel with a nonadherent dressing to protect the exposed organs and prevent infection. This intervention is crucial to prevent injury and maintain the infant's safety. Initiating feedings or maintaining pain management are not the immediate priorities in the care of an infant with an omphalocele. Performing immediate surgery may be required in the future, but initially, covering the bowel is the first critical step in management.

2. A parent brings their 2-year-old son in for a well visit. The nurse assesses his growth since the last appointment. Which finding should concern the nurse?

Correct answer: D

Rationale: The correct answer is D. A total weight gain of 15 lb in one year for a 2-year-old is excessive and may indicate an underlying issue such as a metabolic disorder or overfeeding. This rapid weight gain can put the child at risk for health problems. Choices A, B, and C are not typically concerning findings in a 2-year-old. A prominent abdomen can be normal at this age due to a toddler's slightly protruding belly, a forward curve of the spine at the sacral area is a typical finding in young children, and an increase in height of 5 inches in a year is within the expected range of growth for a 2-year-old.

3. The nurse is performing an oral examination on a preschool child. Which strategies should the nurse use to encourage the child to open the mouth for the examination? (Select all that apply.)

Correct answer: D

Rationale: Using a cotton swab, allowing the child to observe, and demonstrating on someone else are effective ways to encourage a preschooler to open their mouth for examination.

4. Which assessment findings should the nurse expect in a child with sickle cell anemia experiencing an acute vaso-occlusive crisis?

Correct answer: D

Rationale: The correct answer is D. Vaso-occlusive crises in sickle cell anemia are characterized by painful swelling of the joints in the hands and feet (hand-foot syndrome) and tissue engorgement due to the obstruction of blood flow by sickled cells. Choices A, B, and C are incorrect because circulatory collapse, hypovolemia, cardiomegaly, systolic murmur, hepatomegaly, and intrahepatic cholestasis are not typically associated with an acute vaso-occlusive crisis in sickle cell anemia.

5. The nurse is discussing home care with a mother whose 6-year-old child has hepatitis A. What information should the nurse include?

Correct answer: B

Rationale: Teaching infection control measures is crucial as Hepatitis A is highly contagious, especially in household settings. Proper hand hygiene and avoiding sharing personal items can prevent the spread of the virus within the family. Option A is incorrect because bed rest is not typically required for hepatitis A. Option C is incorrect as the child can return to school once feeling well and no longer contagious, not necessarily after a specific duration. Option D is incorrect because hepatitis A can be transmitted through contaminated food, water, or close personal contact.

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