ATI RN
ATI Nursing Care of Children 2019 B
1. What is the most common symptom of gastroesophageal reflux in infants?
- A. Projectile vomiting
- B. Bilious vomiting
- C. Frequent spitting up
- D. Diarrhea
Correct answer: C
Rationale: Frequent spitting up is indeed a common symptom of gastroesophageal reflux in infants. It is caused by the backward flow of stomach contents into the esophagus, leading to infants regurgitating milk or formula shortly after feeding. Projectile vomiting (choice A) is more commonly associated with conditions like pyloric stenosis rather than gastroesophageal reflux. Bilious vomiting (choice B) often indicates an obstruction in the gastrointestinal tract. Diarrhea (choice D) is not typically a primary symptom of gastroesophageal reflux in infants.
2. The nurse is performing an assessment on a 10-week-old infant. The nurse understands that the developmental characteristic of hearing at this age is which?
- A. The infant responds to his own name.
- B. The infant localizes sounds by turning his head directly to the sound.
- C. The infant turns his head to the side when sound is made at the level of the ear.
- D. The infant locates sound by turning his head to the side and then looking up or down.
Correct answer: C
Rationale: By 10 weeks, infants typically turn their heads to the side to locate the source of a sound made at ear level.
3. A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should the nurse explain?
- A. This cannot be prevented
- B. Infants do not feel pain as adults do
- C. This is not a good reason for refusing
- D. A topical anesthetic can be applied
Correct answer: D
Rationale: The nurse should explain that a topical anesthetic can be applied to the injection site before the immunization to reduce discomfort.
4. During examination of a toddler's extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is which?
- A. Abnormal and requires further investigation
- B. Abnormal unless it occurs in conjunction with knock-knee
- C. Normal if the condition is unilateral or asymmetric
- D. Normal because the lower back and leg muscles are not yet well developed
Correct answer: D
Rationale: Bowleggedness is normal in toddlers due to the development of lower back and leg muscles. It usually resolves as the child grows.
5. Which best describes signs and symptoms as part of a nursing diagnosis?
- A. Description of potential risk factors
- B. Identification of actual health problems
- C. Human response to state of illness or health
- D. Cues and clusters derived from patient assessment
Correct answer: D
Rationale: Signs and symptoms are cues and clusters derived from patient assessments that are used to form a nursing diagnosis, guiding the development of a care plan.
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