ATI RN
Nursing Care of Children ATI
1. What is characteristic of a neonate’s vision?
- A. Pupils react to light
- B. Tear glands function
- C. Blink reflex is absent
- D. Ciliary muscles are mature
Correct answer: A
Rationale: The correct answer is A: 'Pupils react to light.' Newborns' pupils do react to light, indicating that the visual pathway is functioning. However, a neonate's vision is still developing, and they can only focus on objects close to their face. Choice B is incorrect because tear glands are functional at birth. Choice C is incorrect because the blink reflex is present in neonates and helps protect their eyes. Choice D is incorrect as neonates' ciliary muscles are not fully developed.
2. A parent brings their 4-year-old child for a check-up. Which finding would concern the nurse?
- A. Ectomorphic body type
- B. Resting pulse rate of 120
- C. Weight gain of 5 lb (2.27 kg) in the past year
- D. No increase in appetite compared with that in toddler years
Correct answer: B
Rationale: A resting pulse rate of 120 is elevated for a 4-year-old and may indicate an underlying issue that needs further investigation. An ectomorphic body type is a body shape and not typically a cause for concern. Weight gain within normal limits and no significant change in appetite are generally positive findings in a growing child.
3. Which food should be introduced first to a 6-month-old infant?
- A. Fruits
- B. Eggs
- C. Vegetables
- D. Meat
Correct answer: C
Rationale: Vegetables, particularly pureed ones, are often recommended as a first solid food for infants because they are easy to digest and less likely to cause allergies. Fruits can be introduced later due to their natural sweetness, while eggs and meat are typically introduced after fruits and vegetables as they may pose a higher risk of allergies.
4. A breastfed infant is being seen in the clinic for a 6-month checkup. The mother tells the nurse that the infant recently began to suck her thumb. Which is the best nursing intervention?
- A. Reassure the mother that this is normal at this age
- B. Recommend the mother substitute a pacifier for her thumb
- C. Assess the infant for other signs of sensory deprivation
- D. Suggest the mother breastfeed the infant more often to satisfy her sucking needs
Correct answer: A
Rationale: Thumb sucking is a normal self-soothing behavior in infants and usually does not indicate a problem. Reassuring the mother that this is normal is the appropriate response.
5. 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.
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