ATI RN
RN Nursing Care of Children 2019 With NGN
1. What is an important consideration in understanding the reactions of parents when their infant is born with physical defects?
- A. Grief lasts until the defects are repaired.
- B. Denial is a common adaptive reaction.
- C. The psychologic reaction is similar to that with the death of an infant.
- D. Reactions of health professionals to the birth of an infant can affect parents’ reactions.
Correct answer: C
Rationale: When a parent's infant is born with physical defects, understanding the psychological reactions is crucial. The reaction is often similar to the grief experienced when facing the death of a child. Parents need to grieve for the loss of the expected child and adapt to the needs of a child with physical defects. The grief process typically involves stages like shock, frustration, and anger, which can last for years. Denial during the shock phase is not maladaptive but can help parents cope initially. Additionally, parents are sensitive to the behavior of health professionals, whose interactions can significantly influence the parents' reactions to the infant. Therefore, recognizing the similarity of the psychological reaction to grief is an important consideration in understanding how parents cope with their infant's physical defects.
2. At a well-child visit, parents ask the nurse how to know if a daycare facility is a good choice for their infant. Which observation should the nurse stress as especially important to consider when making the selection?
- A. Developmentally appropriate toys
- B. Nutritious snacks served to the children
- C. Handwashing by providers after diaper changes
- D. Certified caregivers for each of the age groups at the facility
Correct answer: C
Rationale: Ensuring that providers practice proper handwashing after diaper changes is crucial in preventing the spread of infections and maintaining a hygienic environment for the infants.
3. The parent of a 1-month-old infant voices concern about the infant’s respirations. The parent states the respirations are rapid and irregular. Which information should the nurse provide?
- A. The normal respiratory rate for an infant at this age is between 20 and 30 breaths per minute.
- B. The respirations of a 1-month-old infant are normally irregular and periodically pause.
- C. An infant at this age should have regular respirations.
- D. The irregularity of the infant's respirations is concerning; I will notify the health care provider.
Correct answer: B
Rationale: The correct answer is B. Irregular respirations with periodic pauses are normal in a 1-month-old infant. Choice A is incorrect because the normal respiratory rate for an infant at this age is higher than the range provided. Choice C is incorrect as irregular respirations are expected in infants. Choice D is not appropriate as irregular respirations with periodic pauses are a normal finding in young infants and do not necessarily indicate a concern that requires immediate notification of the healthcare provider.
4. An intravenous line is needed in a school-age child. What medication is an appropriate analgesic for use with this patient?
- A. TAC (tetracaine, epinephrine [Adrenalin], cocaine) 15 minutes before the procedure.
- B. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
- C. EMLA (eutectic mixture of local anesthetics) immediately before the procedure.
- D. LMX (4% liposomal lidocaine cream) 30 minutes before the procedure.
Correct answer: D
Rationale: LMX is an effective analgesic agent when applied to the skin 30 minutes before a procedure. It eliminates or reduces the pain from most procedures involving skin puncture. TAC provides skin anesthesia about 15 minutes after application to nonintact skin, making it more suitable for wound suturing. Transdermal fentanyl patches are designed for continuous pain control, not rapid pain control needed for a procedure like venipuncture. EMLA, for maximum effectiveness, must be applied approximately 60 minutes before the procedure, making it less suitable for immediate pain relief required for intravenous line placement.
5. Why is it difficult to assess a child’s dietary intake?
- A. No systematic assessment tool has been developed
- B. Biochemical analysis for assessing nutrition is expensive
- C. Families usually do not understand much about nutrition
- D. Recall of food consumption is frequently unreliable
Correct answer: D
Rationale: The correct answer is D. Recall of food intake, especially amounts eaten, is often unreliable. While systematic tools like the 24-hour recall and dietary history questionnaires exist, recall can still be challenging in accurately assessing a child's dietary intake. Choices A, B, and C are incorrect because systematic assessment tools do exist, biochemical analysis is not the primary method for dietary assessment, and families' understanding of nutrition may vary but is not the main reason for the difficulty in assessing a child's dietary intake.