ATI RN
Nursing Care of Children Final ATI
1. The educator is teaching about the process of physical growth and development. Which of these describes the directional pattern from head to tail?
- A. Cephalodistal
- B. Cephalocaudal
- C. Proximodistal
- D. Proximocaudal
Correct answer: B
Rationale: Cephalocaudal development is the correct term that describes the directional pattern of growth from head to tail. This means that the head and upper body parts develop before the lower parts. Choice A, 'Cephalodistal,' refers to growth from the center of the body outward, not head to tail. Choice C, 'Proximodistal,' describes growth from the center of the body towards the extremities, not specifically from head to tail. Choice D, 'Proximocaudal,' is not a recognized term in the context of physical growth and development.
2. An infant is suspected of having esophageal atresia/tracheoesophageal fistula. While waiting for the pediatrician to see the infant, which action should the nurse take?
- A. Position the infant with the head of the bed slightly elevated
- B. Allow the infant to bond with the mother in her room
- C. Offer the infant breastfeeding instead of formula feeding
- D. Wrap the infant in blankets and place in a crib by the viewing window
Correct answer: A
Rationale: Positioning the infant with the head of the bed elevated helps to prevent aspiration and manage secretions until further treatment can be provided. Choice B is incorrect as the priority is ensuring the infant's safety and health, not immediate bonding. Choice C is incorrect as breastfeeding may worsen the condition. Choice D is incorrect as it does not address the potential risk of aspiration associated with esophageal atresia/tracheoesophageal fistula.
3. The nurse is caring for an adolescent who has just started dialysis. The child always seems angry, hostile, or depressed. The nurse should recognize that this is most likely related to what underlying cause?
- A. Physiologic manifestations of renal disease
- B. The fact that adolescents have few coping mechanisms
- C. Neurologic manifestations that occur with dialysis
- D. Resentment of the control and enforced dependence imposed by dialysis
Correct answer: D
Rationale: Adolescents may feel anger and depression due to the loss of independence and control over their lives, which is imposed by the need for regular dialysis treatments. This reaction is common as they struggle with the restrictions placed on their social and personal lives.
4. The nurse is teaching the family of a child with a long-term central venous access device about signs and symptoms of bacteremia. What finding indicates the presence of bacteremia?
- A. Hypertension
- B. Pain at the entry site
- C. Fever and general malaise
- D. Redness and swelling at the entry site
Correct answer: C
Rationale: Fever and general malaise are systemic signs of bacteremia, indicating that the infection may have spread beyond the local entry site. Localized pain, redness, and swelling are signs of a localized infection but do not necessarily indicate bacteremia.
5. In assessing sexual maturity levels, which tool would you expect to use?
- A. Denver II Developmental Screening
- B. Tanner staging
- C. Antibody testing
- D. Nursing process
Correct answer: B
Rationale: The correct answer is B: Tanner staging. Tanner staging is a tool specifically used to assess sexual maturity in adolescents based on the development of secondary sexual characteristics. The Tanner scale ranges from stage 1 (prepubertal) to stage 5 (adult maturity). This tool helps healthcare providers evaluate the physical development and sexual maturation of individuals. Choice A, the Denver II Developmental Screening, is used to assess developmental milestones in children. Choice C, antibody testing, is a diagnostic tool used to detect the presence of specific antibodies in the blood. Choice D, the nursing process, is a systematic method that nurses use to deliver patient-centered care, involving assessment, diagnosis, planning, implementation, and evaluation.
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