what should preoperative care of a newborn with an anorectal malformation include
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Nursing Elites

ATI RN

ATI Nursing Care of Children 2019 B

1. What should preoperative care of a newborn with an anorectal malformation include?

Correct answer: C

Rationale: Preoperative care for a newborn with an anorectal malformation should include feedings with sterile water only. This approach is important to avoid complications before surgery. Gastrointestinal decompression is necessary to prevent abdominal distention and potential aspiration, making choice B incorrect. Frequent suctioning and placing the newborn in a supine position with the head elevated are not typically part of the preoperative care protocol for an anorectal malformation, thus choices A and D are incorrect.

2. Pretending a sheet is a cape to mimic a superhero is characteristic of which childhood phenomenon?

Correct answer: B

Rationale: The correct answer is B, symbolic functioning. Symbolic functioning refers to children using objects, actions, or ideas to represent other objects, actions, or ideas. In this scenario, pretending a sheet is a cape to mimic a superhero demonstrates the child's ability to engage in symbolic play. Choice A, artificialism, is incorrect as it refers to the belief that inanimate objects have lifelike qualities. Choice C, critical thinking, does not directly relate to the imaginative play described in the question. Choice D, dramatic play, is close but not as precise as symbolic functioning, which specifically highlights the use of objects to represent something else.

3. What is the recommended method to assess hydration status in infants?

Correct answer: C

Rationale: The correct answer is C: Urine output. Assessing urine output is a recommended method to determine hydration status in infants. Adequate urine output indicates good hydration, while decreased urine output may suggest dehydration. Capillary refill time (Choice A) is more indicative of circulatory status rather than hydration. Skin turgor (Choice B) is a useful assessment in adults but can be less reliable in infants. Checking mucous membranes (Choice D) can provide some information on hydration, but it is not as reliable as assessing urine output in infants.

4. Which pediatric disorder is associated with a 'boot-shaped' heart on a chest x-ray?

Correct answer: A

Rationale: The correct answer is A: Tetralogy of Fallot. Tetralogy of Fallot is often associated with a 'boot-shaped' heart appearance on a chest x-ray due to the characteristic heart anatomy in this condition. This appearance is caused by the combination of pulmonary stenosis, overriding aorta, ventricular septal defect, and right ventricular hypertrophy. Choice B, Transposition of the great arteries, is incorrect because it presents with a 'egg-on-a-string' appearance on x-ray due to the abnormal position of the aorta and pulmonary artery. Choice C, Coarctation of the aorta, typically presents with rib notching on x-ray. Choice D, Ventricular septal defect, does not produce the 'boot-shaped' heart appearance seen in Tetralogy of Fallot.

5. The nurse is preparing to administer a prescribed, as-needed antiemetic drug for a child diagnosed with cancer. Which action by the nurse is most appropriate?

Correct answer: B

Rationale: Administering the antiemetic prophylactically before the next dose of chemotherapy is the most appropriate action. This approach helps prevent nausea and vomiting associated with chemotherapy. Waiting until the child is already nauseated, as stated in option A, is less effective as it is reactive rather than proactive. Administering the drug after chemotherapy, as in option C, may not be as beneficial in preventing chemotherapy-induced nausea and vomiting. Option D, administering the drug only if the child is experiencing diarrhea, is not relevant to the prevention of chemotherapy-induced nausea.

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