ATI RN
Nursing Care of Children Final ATI
1. 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.
2. The nurse is caring for a child with a urinary tract infection who is on intravenous gentamicin (Garamycin). What interventions should the nurse plan for this child with regard to this medication? (Select all that apply.)
- A. Encourage fluids.
- B. Monitor urinary output.
- C. Monitor sodium serum levels.
- D. All above
Correct answer: D
Rationale: Gentamicin is an aminoglycoside antibiotic that requires monitoring of serum peak and trough levels to avoid toxicity, particularly nephrotoxicity and ototoxicity. Encouraging fluids and monitoring urinary output are also crucial to minimize the risk of kidney damage.
3. The nurse is caring for a child with hypernatremia. The nurse evaluates the child for which signs and symptoms of hypernatremia? (Select all that apply.)
- A. All below
- B. Lethargy
- C. Oliguria
- D. Intense thirst
Correct answer: A
Rationale: Hypernatremia typically presents with lethargy, oliguria, and intense thirst due to the body's attempt to conserve water. Apathy can also occur, but lethargy and thirst are more consistent indicators.
4. A 4-month-old infant is discharged home after surgery for the repair of a cleft lip. What should instructions to the parents include?
- A. Provide crib toys for distraction
- B. Breast- or bottle-feeding can begin immediately
- C. Give pain medication to the infant to minimize crying
- D. Leave the infant in the crib at all times to prevent suture strain
Correct answer: C
Rationale: Pain management is essential postoperatively to reduce crying, which could place strain on the surgical site. Feeding and holding the infant are allowed, but care should be taken to avoid placing pressure on the suture line.
5. 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.