ATI RN
ATI Nursing Care of Children 2019 B
1. What is the most common complication following surgical correction of esophageal atresia with tracheoesophageal fistula in infants?
- A. Gastroesophageal reflux
- B. Respiratory distress
- C. Stricture formation
- D. Aspiration pneumonia
Correct answer: C
Rationale: The most common complication following surgical correction of esophageal atresia with tracheoesophageal fistula in infants is stricture formation. This complication occurs due to the healing process after surgery, leading to the narrowing of the esophagus. Gastroesophageal reflux (Choice A) can be a concern but is not the most common complication. Respiratory distress (Choice B) may happen but is not the primary complication. Aspiration pneumonia (Choice D) is a risk but is typically not as common as stricture formation in these cases.
2. An infant, age 5 months, is brought to the clinic by his parents for a well-baby checkup. What is the best advice that the nurse should include at this time about injury prevention?
- A. Keep buttons, beads, and other small objects out of his reach.
- B. Do not permit him to chew paint from window ledges because he might absorb too much lead.
- C. When he learns to roll over, you must supervise him whenever he is on a surface from which he might fall.
- D. Lock the crib sides securely because he may stand and lean against them and fall out of bed.
Correct answer: A
Rationale: Small objects are a choking hazard for infants, so it is crucial to keep them out of reach to prevent injury.
3. Which congenital heart defect causes a "boot-shaped" heart on a chest x-ray?
- A. Tetralogy of Fallot
- B. Coarctation of the aorta
- C. Transposition of the great arteries
- D. Ventricular septal defect
Correct answer: A
Rationale: The correct answer is A: Tetralogy of Fallot. Tetralogy of Fallot, a congenital heart defect with four distinct abnormalities, often presents with a "boot-shaped" heart on chest x-ray due to right ventricular hypertrophy. This characteristic finding is due to the specific combination of defects in this condition. Coarctation of the aorta (choice B), Transposition of the great arteries (choice C), and Ventricular septal defect (choice D) do not typically result in a "boot-shaped" heart on a chest x-ray like Tetralogy of Fallot does.
4. Melena, the passage of black, tarry stools, suggests bleeding from which source?
- A. The perianal or rectal area
- B. The upper gastrointestinal (GI) tract
- C. The lower GI tract
- D. Hemorrhoids or anal fissures
Correct answer: B
Rationale: Melena indicates bleeding from the upper GI tract. The black, tarry appearance of the stool results from the partial digestion of blood as it passes through the intestines, typically originating from sources like the stomach or duodenum. Lower GI bleeding usually presents as bright red blood in the stool, originating from sources like the colon or rectum. Choices A, C, and D are incorrect because melena specifically points to upper GI bleeding rather than issues in the perianal/rectal area, lower GI tract, or hemorrhoids/anal fissures.
5. A young mother asks if her 9-month-old can begin drinking cow’s milk instead of formula. You explain that:
- A. Cow’s milk is easier to digest than formula
- B. Breast milk or formula should be used for now because whole cow’s milk is not recommended for infants under 1 year
- C. As long as whole milk is given and not skim milk, it is okay
- D. Cow’s milk will decrease the chance of iron deficiency anemia
Correct answer: B
Rationale: Breast milk or formula should be used for now because whole cow’s milk is not recommended for infants under 1 year. Cow’s milk is not suitable for infants under 1 year of age as it lacks essential nutrients like iron and can lead to iron deficiency. Therefore, it is important to continue with breast milk or formula to ensure the baby's nutritional needs are met. Choice A is incorrect as cow’s milk is not easier to digest than formula for infants. Choice C is incorrect as the type of milk, whether whole or skim, is not the primary concern at this age. Choice D is incorrect as cow’s milk can actually increase the risk of iron deficiency anemia in infants.
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