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?
- A. Initiating breast or bottle-feedings to stabilize the blood glucose level
- B. Maintaining pain management with an intravenous opioid
- C. Covering the intact bowel with a nonadherent dressing to prevent injury
- D. Performing immediate surgery
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. When Mateo was born prematurely to Yvonne, a cocaine addict, what can his caregivers expect?
- A. He will be very attentive to the environment
- B. His cries will be abnormally shrill and piercing
- C. He will overcome the harmful effects of drug exposure by age 3
- D. His motor development will be especially rapid during the first year
Correct answer: B
Rationale: Mateo, being born prematurely to a cocaine-addicted mother, is at risk for several health issues. One common effect of prenatal drug exposure is a higher likelihood of sensory and regulatory problems, such as having abnormally shrill and piercing cries. This is a potential outcome that Mateo's caregivers can expect due to his circumstances. Choice A is incorrect as there is no direct correlation between being born prematurely to a cocaine-addicted mother and being very attentive to the environment. Choice C is incorrect as overcoming harmful effects of drug exposure by age 3 is overly optimistic and may not be the case for all children exposed to drugs prenatally. Choice D is incorrect as rapid motor development is not typically associated with prenatal drug exposure.
3. Listed below are five categories that identify the responsibilities of the practical nurse manager in personnel management. Which of these categories is most appropriate for the task of training soldiers for survival on the battlefield?
- A. Accountability
- B. Personal/professional development
- C. Individual training
- D. Military appearance/physical condition
Correct answer: C
Rationale: The correct answer is C: Individual training. This category involves the specific task of preparing soldiers for battlefield survival, making it the most appropriate choice for the given scenario. Choice A, Accountability, focuses on being answerable for one's actions and decisions, which is not directly related to training soldiers. Choice B, Personal/professional development, pertains to personal growth and career advancement, not specific training for battlefield survival. Choice D, Military appearance/physical condition, deals with the physical aspects and presentation of soldiers, not the training required for battlefield survival.
4. When receiving change-of-shift report for children, which child should the nurse assess first?
- A. A toddler who has a concussion and an episode of forceful vomiting
- B. An adolescent with infective endocarditis who reports having a headache
- C. An adolescent who was placed into Halo traction 1 hour ago and rates his pain at a 6 on a 0-10 scale
- D. A school-age child with acute glomerulonephritis and brown-colored urine
Correct answer: A
Rationale: The nurse should assess the toddler with a concussion and an episode of forceful vomiting first when receiving change-of-shift report for children. Forceful vomiting in a toddler with a concussion indicates increased intracranial pressure, requiring immediate assessment and intervention to prevent further complications.
5. What is the appropriate nursing response when a patient refuses blood transfusion due to religious beliefs?
- A. Respect the patient's decision and notify the provider
- B. Attempt to persuade the patient to accept the transfusion
- C. Document the refusal and notify the healthcare provider
- D. Provide education on the benefits of blood transfusion
Correct answer: A
Rationale: The correct answer is A: "Respect the patient's decision and notify the provider." When a patient refuses a blood transfusion due to religious beliefs, it is essential to respect their autonomy and religious beliefs. Attempting to persuade the patient (Choice B) goes against the principle of respect for autonomy and can lead to ethical dilemmas. Documenting the refusal and notifying the healthcare provider (Choice C) is important for legal and ethical purposes but should be preceded by respecting the patient's decision. Providing education on the benefits of blood transfusion (Choice D) may be appropriate in other situations but is not indicated when a patient refuses based on religious beliefs.
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