ATI RN
ATI Nursing Care of Children 2019 B
1. What is the primary symptom of congenital diaphragmatic hernia in a newborn?
- A. Cyanosis
- B. Bradycardia
- C. Absent breath sounds
- D. Tachypnea
Correct answer: C
Rationale: Absent breath sounds on the affected side are a primary symptom of congenital diaphragmatic hernia. Cyanosis, bradycardia, and tachypnea may also be present but are not the primary symptom. Cyanosis is a bluish discoloration of the skin due to poor oxygenation, bradycardia is a slower than normal heart rate, and tachypnea is rapid breathing.
2. The nurse suspects fluid overload in an infant receiving intravenous fluids. What clinical manifestation is suggestive of water intoxication?
- A. Oliguria
- B. Weight loss
- C. Irritability and seizures
- D. Muscle weakness and cardiac dysrhythmias
Correct answer: C
Rationale: Water intoxication can lead to cerebral edema, causing neurological symptoms such as irritability and seizures. Oliguria, weight loss, and muscle weakness are not typical signs of water intoxication.
3. Clinical manifestations of sodium excess (hypernatremia) include which signs or symptoms?
- A. Hyperreflexia
- B. Abdominal cramps
- C. Cardiac dysrhythmias
- D. Dry, sticky mucous membranes
Correct answer: D
Rationale: Hypernatremia often presents with dry, sticky mucous membranes due to dehydration. Hyperreflexia and abdominal cramps may also occur, but dry mucous membranes are more consistently observed in cases of sodium excess.
4. The nurse is discussing development and play activities with the parent of a 2-month-old boy. Which statement by the parent would indicate a correct understanding of the teaching?
- A. I can give my baby a ball of yarn to pull apart or different textured fabrics to feel
- B. I can use a music box and soft mobiles as appropriate play activities for my baby
- C. I should introduce a cup and spoon or push-pull toys for my baby at this age
- D. I do not have to worry about appropriate play activities at this age
Correct answer: B
Rationale: At 2 months, infants are most stimulated by visual and auditory activities, such as a music box or soft mobiles. These activities help in sensory development and are appropriate for this age.
5. What may be a clinical manifestation of failure to thrive (FTT) in a 13-month-old include?
- A. Irregularity in activities of daily living
- B. Preferring solid food to milk or formula
- C. Weight that is at or below the 10th percentile
- D. Appropriate achievement of developmental landmarks
Correct answer: C
Rationale: FTT is characterized by weight that falls below the 10th percentile, often accompanied by delayed developmental milestones and poor feeding habits. Regularity in activities and preference for solid food over milk or formula are less commonly associated with FTT.
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