ATI RN
ATI Nursing Care of Children 2019 B
1. What intervention is contraindicated in a suspected case of appendicitis?
- A. Enemas
- B. Palpating the abdomen
- C. Administration of antibiotics
- D. Administration of antipyretics for fever
Correct answer: A
Rationale: Enemas are contraindicated in cases of suspected appendicitis because they can increase the risk of perforation. The pressure from the enema can exacerbate inflammation and potentially lead to the rupture of the appendix. Palpating the abdomen gently is essential for diagnosing appendicitis, as it helps identify the characteristic signs like rebound tenderness. Antibiotics are commonly used to treat the infection associated with appendicitis, and antipyretics are administered to manage fever, which is a common symptom of the condition. Therefore, enemas are the intervention to avoid in suspected appendicitis cases.
2. During a routine health assessment, the nurse notes that an 8-month-old infant has a significant head lag. Which is the most appropriate action?
- A. Recheck head control at the next visit
- B. Teach the parents appropriate exercises
- C. Schedule the child for further evaluation
- D. Refer the child for further evaluation if the anterior fontanel is still open
Correct answer: C
Rationale: Significant head lag at 8 months is concerning and warrants further evaluation, as it may indicate developmental delays or neurological issues.
3. The parent asks when the soft area in the infant's head will go away. What is the best response by the nurse?
- A. The area is called the anterior fontanel (fontanelle) and typically closes anytime up to 18 months of age.
- B. The area is called a fontanel (fontanelle). They remain open to allow for rapid brain growth in the first months of life.
- C. The soft spots may stay open until your infant is 2 or 3 years old.
- D. Soft spots on the infant's head should have closed by now.
Correct answer: A
Rationale: The best response by the nurse is A, as the anterior fontanel typically closes between 12-18 months of age, allowing for brain growth during infancy. Choice B is incorrect because it does not provide a specific timeframe for the closure of the fontanel. Choice C is incorrect as it suggests a later closure timeframe than usual. Choice D is incorrect as it states that the soft spots should have closed already, which is inaccurate for a 6-month-old infant.
4. Which condition is characterized by a 'seal-like' barking cough in children?
- A. Croup
- B. Asthma
- C. Bronchitis
- D. Pneumonia
Correct answer: A
Rationale: Croup is the correct answer. Croup is characterized by a 'seal-like' barking cough due to inflammation and narrowing of the upper airways, particularly the larynx and trachea. It is most common in young children and can cause significant respiratory distress, especially at night. Treatment often includes humidified air and corticosteroids. Asthma (choice B) typically presents with wheezing and shortness of breath, not a barking cough. Bronchitis (choice C) is characterized by productive cough with mucus, not a barking cough. Pneumonia (choice D) often presents with fever, productive cough, and chest pain, not a barking cough.
5. What is the best indicator of fluid balance in a pediatric patient?
- A. Blood pressure
- B. Heart rate
- C. Weight
- D. Urine output
Correct answer: C
Rationale: Weight is the most accurate indicator of fluid balance in pediatric patients. Changes in weight reflect shifts in body fluid levels more directly compared to other parameters. Blood pressure and heart rate may be affected by various factors other than fluid balance. While urine output is important in assessing renal function, it may not provide a comprehensive picture of overall fluid balance in pediatric patients.
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