ATI RN
RN Nursing Care of Children 2019 With NGN
1. Parents of a newborn with ambiguous genitalia want to know how long they will have to wait to know whether they have a boy or a girl. The nurse answers the parents based on what knowledge?
- A. Chromosome analysis will be complete in 7 days.
- B. A physical examination will be able to provide a definitive answer.
- C. Additional laboratory testing is necessary to assign the correct gender.
- D. Gender assignment involves collaboration between the parents and a multidisciplinary team.
Correct answer: D
Rationale: Gender assignment in cases of ambiguous genitalia is a complex process that requires a multidisciplinary approach, including genetic, endocrinological, and psychological evaluations. The decision should be made collaboratively with the parents.
2. A nurse is carrying on a conversation with a 7-year-old child during an office visit. Which is an example of the level of language development the nurse should expect in this child?
- A. Fascination with bathroom language
- B. Difficulty understanding the concept of 'half past' in reference to time
- C. Ability to carry on an adult conversation
- D. Inability to speak in full sentences
Correct answer: B
Rationale: The correct answer is B. Understanding time concepts like 'half past' can be challenging for a 7-year-old, indicating the level of language development. Choice A is incorrect as fascination with bathroom language is common in this age group but not necessarily indicative of language development. Choice C is incorrect as a 7-year-old typically cannot carry on an adult conversation due to cognitive and experiential limitations. Choice D is incorrect as by the age of 7, children should be able to speak in full sentences.
3. Which heart sound is produced by vibrations within the heart chambers or in the major arteries from the back-and-forth flow of blood?
- A. S1 and S2
- B. S3 and S4
- C. Murmur
- D. Physiologic splitting
Correct answer: C
Rationale: A murmur is produced by turbulent blood flow within the heart or major arteries, resulting in audible vibrations.
4. A 12-month-old child presents to the clinic for a well visit after missing several appointments. The child began her immunization schedule but has missed several follow-up appointments and doses of immunizations. What is the most appropriate nursing intervention?
- A. Administer initial immunizations from the beginning of the schedule.
- B. The child cannot receive missed immunizations if the schedule is not followed and will not be vaccinated.
- C. The child should only receive the missed doses of immunizations based on the catch-up schedule.
- D. The child should receive double-strength immunizations at this well visit.
Correct answer: C
Rationale: Children who began primary immunization at the recommended age but fail to receive all the doses do not need to begin the series again but should receive only the missed doses. The child may receive missed vaccinations on a catch-up schedule per CDC guidelines.
5. 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.
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