ATI RN
RN Nursing Care of Children 2019 With NGN
1. You are providing a home health care assessment for a very low-income mother with three young children under 5 who all appear to be at nutritional risk. Which program would you refer them to in an attempt to reduce the risk and safeguard the health of this family?
- A. Division of Maternal and Child Health
- B. Medicaid
- C. Supplemental Food Program for Women, Infants, and Children
- D. The State Children’s Health Insurance Program
Correct answer: C
Rationale: The correct answer is C, the Supplemental Food Program for Women, Infants, and Children (WIC). WIC provides nutritional assistance to low-income pregnant women, breastfeeding women, and children under 5. The Division of Maternal and Child Health (Choice A) focuses on promoting the health of mothers and children but does not provide direct nutritional assistance. Medicaid (Choice B) is a health insurance program for low-income individuals but does not specifically address nutritional needs. The State Children’s Health Insurance Program (Choice D) provides health insurance for children in low-income families but does not offer nutritional support like WIC does.
2. A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicles, and juices, are left. Which statement best explains this?
- A. The parent is trying to feed the child only what the child likes most
- B. Hispanics believe the evil eye enters when a person gets cold
- C. The parent is trying to restore normal balance through appropriate hot remedies
- D. Hispanics believe an innate energy called chi is strengthened by eating soup
Correct answer: C
Rationale: In Hispanic culture, the balance between hot and cold is important, and the parent may be giving the child broth to restore this balance while avoiding "cold" foods.
3. What is the priority assessment for a nurse when caring for an infant suspected of having necrotizing enterocolitis (NEC)?
- A. Hold feedings.
- B. Check gastric residuals before feedings.
- C. Take rectal temperature.
- D. Closely monitor abdominal distention.
Correct answer: D
Rationale: The correct answer is D: Closely monitor abdominal distention. Monitoring the abdomen for signs of distention is crucial in the early detection of necrotizing enterocolitis (NEC). In NEC, the bowel wall is edematous and breaking down, leading to abdominal distention. Holding feedings is important in the management of NEC, as feedings may need to be stopped temporarily. Checking gastric residuals before feedings helps in assessing the infant's tolerance to feedings. Taking rectal temperatures is contraindicated in NEC as it can lead to the perforation of the bowel.
4. The nurse is teaching a parent of a 6-month-old infant with gastroesophageal reflux (GER) before discharge. What instructions should the nurse include?
- A. Elevate the head of the bed in the crib to a 90-degree angle while the infant is sleeping.
- B. Hold the infant in the prone position after a feeding.
- C. Discontinue breastfeeding so that a formula and rice cereal mixture can be used.
- D. Prescribed cimetidine (Tagamet) should be given 30 minutes before feedings.
Correct answer: D
Rationale: Cimetidine is an H2 blocker that reduces stomach acid, helping manage GER. Holding the infant in the prone position is not recommended due to the risk of SIDS. Breastfeeding should not be discontinued unless advised by a physician. Elevating the head to 90 degrees is excessive.
5. Pretending a sheet is a cape to mimic a superhero is characteristic of which childhood phenomenon?
- A. Artificialism
- B. Symbolic functioning
- C. Critical thinking
- D. Dramatic play
Correct answer: B
Rationale: The correct answer is B, symbolic functioning. Symbolic functioning refers to children using objects, actions, or ideas to represent other objects, actions, or ideas. In this scenario, pretending a sheet is a cape to mimic a superhero demonstrates the child's ability to engage in symbolic play. Choice A, artificialism, is incorrect as it refers to the belief that inanimate objects have lifelike qualities. Choice C, critical thinking, does not directly relate to the imaginative play described in the question. Choice D, dramatic play, is close but not as precise as symbolic functioning, which specifically highlights the use of objects to represent something else.
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