ATI RN
ATI Nursing Care of Children 2019 B
1. 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.
2. The nurse is testing an infant's visual acuity. By which age should the infant be able to fix on and follow a target?
- A. 1 month
- B. 1 to 2 months
- C. 3 to 4 months
- D. 6 months
Correct answer: C
Rationale: By 3 to 4 months of age, an infant should be able to fix on and follow a target, indicating proper visual development.
3. A thorough systemic physical assessment is necessary in the extremely low-birth-weight (ELBW) infant to detect what?
- A. Weight gain reflective of fluid retention
- B. Difficulties in maternal-child attachment
- C. Subtle changes that may be indicative of an underlying problem
- D. Changes in Apgar score over the first 24 hours of life
Correct answer: C
Rationale: In extremely low-birth-weight (ELBW) infants, a thorough systemic physical assessment is crucial to detect subtle changes that may indicate an underlying problem. These infants are highly vulnerable and may show signs of stress through changes in feeding behavior, activity, color, oxygen saturation, or vital signs. Monitoring weight in ELBW infants primarily reflects genitourinary function rather than fluid retention. Difficulties in maternal-child attachment are important but are usually assessed during parental visits and are not the primary focus of a systemic physical assessment. Changes in the Apgar score are used immediately after birth to assess the transition to extrauterine life and are not as relevant in the following 24 hours to detect ongoing subtle issues.
4. What play activities should the nurse implement to encourage fluid intake for a child? (Select all that apply.)
- A. Have a tea party.
- B. Use a crazy straw.
- C. Cut gelatin into fun shapes.
- D. All of the above
Correct answer: D
Rationale: Encouraging fluid intake can be fun and engaging through activities like having a tea party, using a crazy
5. Which condition is characterized by a 'seal-like' barking cough in children?
- A. Croup
- B. Asthma
- C. Bronchitis
- D. Pneumonia
Correct answer: A
Rationale: Croup is the correct answer. Croup is characterized by a 'seal-like' barking cough due to inflammation and narrowing of the upper airways, particularly the larynx and trachea. It is most common in young children and can cause significant respiratory distress, especially at night. Treatment often includes humidified air and corticosteroids. Asthma (choice B) typically presents with wheezing and shortness of breath, not a barking cough. Bronchitis (choice C) is characterized by productive cough with mucus, not a barking cough. Pneumonia (choice D) often presents with fever, productive cough, and chest pain, not a barking cough.
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