ATI RN
RN Nursing Care of Children 2019 With NGN
1. What term is appropriate terminology to use for an infant whose intrauterine growth rate was slowed and whose birth weight falls below the 10th percentile on intrauterine growth charts?
- A. Postterm
- B. Postmature
- C. Low birth weight
- D. Small for gestational age
Correct answer: D
Rationale: The correct answer is D, 'Small for gestational age.' A small for gestational age, or small-for-date, infant is any child whose intrauterine growth rate was slowed and whose birth weight falls below the 10th percentile on intrauterine growth curves. Choices A and B, 'Postterm' and 'Postmature,' refer to infants born after 42 weeks of gestational age regardless of birth weight, and do not specifically address growth rate. Choice C, 'Low birth weight,' refers to infants with a birth weight less than 2500 g (5.5 pounds) regardless of gestational age, which is a different classification compared to being small for gestational age.
2. What is the first sign of puberty in girls?
- A. Acne
- B. Hair growth in the pubic area and underarms
- C. Thelarche
- D. Menarche
Correct answer: C
Rationale: The correct answer is C, Thelarche. Thelarche refers to the onset of breast development, which is typically the first sign of puberty in girls. This occurs before menarche (the first menstrual period). Choices A and B, acne and hair growth in the pubic area and underarms, are not the first signs of puberty in girls. While acne can be a common occurrence during puberty, it usually appears after other physical changes. Hair growth in the pubic area and underarms also occurs later in the puberty process.
3. The nurse is teaching a child experiencing severe edema associated with minimal change nephrotic syndrome about his diet. The nurse should discuss what dietary need?
- A. Consuming a regular diet
- B. Increasing protein
- C. Restricting fluids
- D. Decreasing calories
Correct answer: C
Rationale: Fluid restriction is often necessary to manage severe edema associated with MCNS. Increasing protein is not typically recommended due to the risk of exacerbating proteinuria, and calorie reduction is not generally needed.
4. What is the primary concern in a child with nephrotic syndrome?
- A. Hypotension
- B. Hyperkalemia
- C. Hyperlipidemia
- D. Hypocalcemia
Correct answer: C
Rationale: The correct answer is C: Hyperlipidemia. Children with nephrotic syndrome often present with hyperlipidemia due to altered lipid metabolism, making it a primary concern in these patients. Hypotension (choice A) is not a primary concern in nephrotic syndrome. Hyperkalemia (choice B) and hypocalcemia (choice D) are not typically associated with nephrotic syndrome and are less likely to be primary concerns in these patients.
5. During examination of a toddler's extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is which?
- A. Abnormal and requires further investigation
- B. Abnormal unless it occurs in conjunction with knock-knee
- C. Normal if the condition is unilateral or asymmetric
- D. Normal because the lower back and leg muscles are not yet well developed
Correct answer: D
Rationale: Bowleggedness is normal in toddlers due to the development of lower back and leg muscles. It usually resolves as the child grows.