at which age should the nurse expect an infant to begin smiling in response to pleasurable stimuli

ATI RN

Nursing Care of Children ATI

1. At which age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?

A. 1 month
B. 2 months
C. 3 months
D. 4 months

Correct answer: B

Rationale: Infants typically begin to smile in response to pleasurable stimuli by 2 months, which is an early sign of social interaction and emotional development.

2. During a well-child checkup, the parent of a 5-year-old child reports the child seems much smaller than the 2 older siblings did at this same age. A review of the medical record reveals that the child is 44 inches tall and weighs 42 pounds. What information should be included in the response by the nurse?

A. The weight of your child at this time is within normal limits for this age but the child is moderately taller than other children this age.
B. Your child is within the acceptable range for height but the child is significantly smaller in weight for this age.
C. Your child is within normal limits for weight but the child is slightly shorter in stature than other children this age.
D. Your child is slightly taller than other children this age but the child’s weight is normal.

Correct answer: D

Rationale: The correct answer is D. The child is slightly taller than average, but the weight is within normal limits. This information should be reassuring to the parent and provides insights into normal growth patterns. Choice A is incorrect as it inaccurately states that the child is taller than other children this age. Choice B is incorrect because the child's weight is actually within normal limits. Choice C is incorrect as it inaccurately states that the child is shorter in stature than other children this age.

3. The parents of a child with acute postinfectious glomerulonephritis (APIGN) ask how they will know that the condition is improving. How should the nurse respond?

A. Your child’s urine output will increase, and the urine will become less brown in color.
B. Your child will rest more comfortably.
C. Your child’s appetite will decrease.
D. Your child’s laboratory test values will show increased BUN.

Correct answer: A

Rationale: Improvement in APIGN is indicated by an increase in urine output and a change in urine color from brown (due to hematuria) to a more normal appearance. This reflects a reduction in glomerular inflammation and improved kidney function. Choice B is incorrect because resting more comfortably is not a direct indicator of kidney function improvement. Choice C is incorrect because a decrease in appetite is not typically associated with improvement in APIGN. Choice D is incorrect because an increased BUN value would suggest worsening kidney function rather than improvement.

4. 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.