the nurse is performing an otoscopic examination on a child which are normal findings the nurse should expect select all that apply

ATI RN

ATI Nursing Care of Children

1. The nurse is performing an otoscopic examination on a child. Which are normal findings the nurse should expect? (Select all that apply.)

A. All below
B. A well-defined light reflex
C. A small, round, concave spot near the center of the drum
D. The tympanic membrane is a nontransparent grayish color

Correct answer: A

Rationale: A well-defined light reflex, a small concave spot, and a grayish, nontransparent tympanic membrane are normal findings during an otoscopic examination in a child.

2. What is often the initial sign of acute rheumatic fever in children?

A. Polyarthritis
B. Carditis
C. Erythema marginatum
D. Sydenham chorea

Correct answer: A

Rationale: Polyarthritis is indeed frequently the initial sign of acute rheumatic fever in children. It presents as joint pain, swelling, and redness. Carditis (inflammation of the heart), Erythema marginatum (a skin rash), and Sydenham chorea (involuntary muscle movements) are typically seen in the later stages of acute rheumatic fever and not as the initial sign.

3. The nurse is discussing parenting in reconstituted families with a new stepparent. The nurse is aware that the new stepparent understands the teaching when which statement is made?

A. "I am glad there will be no disruption in my lifestyle."
B. "I don’t think children really want to live in a two-parent home."
C. "I realize there may be power conflicts bringing two households together."
D. "I understand contact between grandparents should be kept to a minimum."

Correct answer: C

Rationale: Recognizing the potential for power conflicts when blending two households indicates an understanding of the complexities in reconstituted families.

4. What is an important consideration in understanding the reactions of parents when their infant is born with physical defects?

A. Grief lasts until the defects are repaired.
B. Denial is a common adaptive reaction.
C. The psychologic reaction is similar to that with the death of an infant.
D. Reactions of health professionals to the birth of an infant can affect parents’ reactions.

Correct answer: C

Rationale: When a parent's infant is born with physical defects, understanding the psychological reactions is crucial. The reaction is often similar to the grief experienced when facing the death of a child. Parents need to grieve for the loss of the expected child and adapt to the needs of a child with physical defects. The grief process typically involves stages like shock, frustration, and anger, which can last for years. Denial during the shock phase is not maladaptive but can help parents cope initially. Additionally, parents are sensitive to the behavior of health professionals, whose interactions can significantly influence the parents' reactions to the infant. Therefore, recognizing the similarity of the psychological reaction to grief is an important consideration in understanding how parents cope with their infant's physical defects.

5. What factor predisposes an infant to fluid imbalances?

A. Decreased surface area
B. Lower metabolic rate
C. Immature kidney functioning
D. Decreased daily exchange of extracellular fluid

Correct answer: C

Rationale: Infants have immature kidneys that are less efficient at concentrating urine, making them more susceptible to fluid imbalances. Their higher surface area to volume ratio also contributes to greater insensible fluid losses.