ATI RN
ATI Nursing Care of Children 2019 B
1. What is the first-line treatment for a febrile seizure in a child?
- A. Antipyretics
- B. Anticonvulsants
- C. Cooling blankets
- D. IV fluids
Correct answer: A
Rationale: The correct answer is Antipyretics. Febrile seizures in children are usually associated with fever. The first-line treatment aims to reduce fever, which can help prevent febrile seizures. Antipyretics like acetaminophen or ibuprofen are commonly used for this purpose. Anticonvulsants, while used for treating seizures, are not typically the first-line treatment for febrile seizures as they are usually self-limited and resolve on their own. Cooling blankets can be used to lower body temperature in cases of hyperthermia but are not the primary treatment for febrile seizures. IV fluids may be administered in cases of dehydration due to fever or if the child cannot tolerate oral intake, but they are not the first-line treatment for febrile seizures.
2. Which sign is indicative of developmental dysplasia of the hip in infants?
- A. Ortolani sign
- B. Romberg sign
- C. Trendelenburg sign
- D. Gower's sign
Correct answer: A
Rationale: The Ortolani sign is a specific maneuver used during physical examination to detect hip instability or dislocation in infants. A positive Ortolani sign, where the hip is felt to slip back into the socket, is indicative of developmental dysplasia of the hip, a condition that can lead to long-term disability if not treated early. Romberg sign is used to assess sensory ataxia, Trendelenburg sign indicates weakness of the hip abductor muscles, and Gower's sign is seen in children with proximal muscle weakness climbing up their own body from a supine position due to conditions like muscular dystrophy.
3. A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent?
- A. Surgical therapy is indicated.
- B. Place the infant in a prone position for sleep after feeding.
- C. Thicken feedings and enlarge the nipple hole.
- D. Reduce the frequency of feeding by encouraging larger volumes of formula.
Correct answer: C
Rationale: The correct recommendation for decreasing the number and total volume of emesis in an infant with gastroesophageal reflux is to thicken feedings and enlarge the nipple hole. Thicker feedings can reduce the frequency and volume of emesis by making the food less likely to be regurgitated. Enlarging the nipple hole helps ensure the thickened feedings can pass through. Surgical therapy (Choice A) is not the initial recommendation for managing gastroesophageal reflux in infants. Placing the infant in a prone position for sleep after feeding (Choice B) is not recommended due to the increased risk of sudden infant death syndrome (SIDS). Reducing the frequency of feeding by encouraging larger volumes of formula (Choice D) can exacerbate the reflux symptoms.
4. What clinical manifestation should be the most suggestive of acute appendicitis?
- A. Rebound tenderness
- B. Bright red or dark red rectal bleeding
- C. Abdominal pain that is relieved by eating
- D. Colicky, cramping abdominal pain around the umbilicus
Correct answer: D
Rationale: The correct answer is D: Colicky, cramping abdominal pain around the umbilicus. This type of pain is a common early sign of acute appendicitis. Rebound tenderness, choice A, is a later sign seen in the physical examination of a patient with appendicitis. Rectal bleeding, as described in choice B, is not typically associated with appendicitis. Abdominal pain that is relieved by eating, as mentioned in choice C, is more indicative of peptic ulcer disease rather than appendicitis.
5. What dietary modification is recommended for a child with cystic fibrosis?
- A. High carbohydrate
- B. Low protein
- C. High calorie
- D. Low fat
Correct answer: C
Rationale: A high-calorie diet is recommended for children with cystic fibrosis due to their increased energy needs and malabsorption issues. Cystic fibrosis affects the pancreas, leading to poor digestion and absorption of nutrients, particularly fats, which requires dietary adjustments to maintain adequate nutrition. High carbohydrate (Choice A) is not the primary focus; the emphasis is on overall calorie intake. Low protein (Choice B) is not recommended as protein intake is essential for growth and development. Low fat (Choice D) is not the best option as fat-soluble vitamin absorption is already compromised in cystic fibrosis, hence fat restriction is not a priority.
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