the nurse is caring for an infant who was born 24 hr ago to a mother who received no prenatal care the infant is a poor feeder but sucks avidly on his
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Nursing Elites

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Nursing Care of Children ATI

1. The nurse is caring for an infant who was born 24 hr ago to a mother who received no prenatal care. The infant is a poor feeder but sucks avidly on his hands. Clinical manifestations also include hyperactive reflexes, tremors, sneezing, and a high-pitched shrill cry. What does the nurse consider as a possible diagnosis for this infant?

Correct answer: B

Rationale: In this case, the infant's symptoms are consistent with narcotic withdrawal. Infants exposed to drugs in utero may display withdrawal symptoms starting around 12 to 24 hours post-birth. The presentation often includes hyperactive reflexes, tremors, sneezing, high-pitched shrill cry, poor feeding, and sucking avidly on hands. Signs such as loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating are common. These symptoms are not indicative of a seizure disorder. Placental insufficiency typically leads to a small-for-gestational-age child, which is not mentioned in the scenario. Meconium aspiration syndrome primarily presents with respiratory distress, not the symptoms described in this case.

2. The clinic nurse is reviewing the immunization guidelines for hepatitis B. Which are true of the guidelines for this vaccine?

Correct answer: B

Rationale: Hepatitis B vaccination should start at birth, and any child or adolescent not vaccinated should complete the series. Adolescents should receive three doses if they were not previously vaccinated.

3. The nurse needs to start an intravenous (IV) line on an 8-year-old child to begin administering intravenous antibiotics. The child starts to cry and tells the nurse, "Do it later, okay?" What action should the nurse take?

Correct answer: B

Rationale: Starting the IV as planned while allowing the child to express feelings afterward helps build trust and ensures the timely administration of necessary antibiotics. Delaying the procedure or changing the route could compromise the child's treatment.

4. The nurse is explaining different parenting styles to a group of parents. The nurse explains that an authoritative parenting style can lead to which child behavior?

Correct answer: B

Rationale: An authoritative parenting style, which balances warmth with firmness, is associated with fostering self-reliance and independence in children.

5. The nurse is performing an assessment on a 12-month-old infant. Which fine or gross motor developmental skill demonstrates the proximodistal acquisition of skills?

Correct answer: C

Rationale: The development of a pincer grasp reflects fine motor skills, which develop in a proximodistal pattern (from the center of the body outward).

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