ATI RN
RN Nursing Care of Children Online Practice 2019 A
1. When describing play by the school-aged child to a group of nursing students, the instructor would emphasize the need for which of the following?
- A. Recreation
- B. Ritualism
- C. Physical activity
- D. Rules
Correct answer: D
Rationale: The correct answer is D: Rules. When discussing play in school-aged children, rules are essential as they help in structuring games and social interactions. Rules provide a framework for play, ensuring fairness and cooperation among children. Choice A, recreation, is too broad and doesn't specifically address the importance of rules in play. Choice B, ritualism, is unrelated to the concept of play in school-aged children. Choice C, physical activity, is important for overall health but doesn't capture the specific aspect of rules that are crucial in the play of school-aged children.
2. At what stage can infants raise their heads and gain control of their trunks before walking due to which directional pattern of development?
- A. Cephalocaudal
- B. Anterior to posterior
- C. Proximodistal
- D. Normal growth curve charts
Correct answer: A
Rationale: The correct answer is A: Cephalocaudal. The cephalocaudal pattern of development means that growth and motor control proceed from the head downward through the body. This explains why infants can raise their heads before they can sit and gain control of their trunks before walking. Choices B, C, and D are incorrect. Anterior to posterior refers to development from the front to the back, while proximodistal refers to development from the center of the body outward. Normal growth curve charts are used to track physical growth over time and are not directly related to the directional pattern of development in infants.
3. An infant with short bowel syndrome is receiving total parenteral nutrition (TPN). The practitioner has added continuous enteral feedings through a gastrostomy tube. The nurse recognizes this as important for which reason?
- A. Wean the infant from TPN gradually
- B. Stimulate adaptation of the small intestine
- C. Provide additional nutrients that cannot be included in the TPN
- D. Offer parents encouragement that the child is close to discharge
Correct answer: B
Rationale: Continuous enteral feedings help stimulate the small intestine's adaptation in short bowel syndrome, promoting better nutrient absorption and eventually reducing reliance on TPN. This approach is crucial for long-term management and improving the child's prognosis. Choice A is incorrect because weaning off TPN typically occurs gradually over time, not the next day. Choice C is incorrect because TPN can be adjusted to provide necessary nutrients, and enteral feedings are mainly used to stimulate intestinal function. Choice D is incorrect as the addition of enteral feedings does not necessarily indicate imminent discharge; it primarily focuses on enhancing intestinal adaptation and reducing reliance on TPN.
4. Several types of long-term central venous access devices are used. What is a benefit of using an implanted port (e.g., Port-a-Cath)?
- A. You do not need to pierce the skin for access.
- B. It is easy to use for self-administered infusions.
- C. The patient does not need to limit regular physical activity, including swimming.
- D. The catheter cannot dislodge from the port even if the child plays with the port site.
Correct answer: C
Rationale: Implanted ports like the Port-a-Cath are fully implanted under the skin, allowing the child to maintain regular physical activities, including swimming, without the risk of dislodging the catheter. Piercing the skin is still required for access, and self-administration is more complex.
5. What condition is the most common cause of acute renal failure in children?
- A. Pyelonephritis
- B. Tubular destruction
- C. Severe dehydration
- D. Upper tract obstruction
Correct answer: C
Rationale: Severe dehydration is the most common cause of acute renal failure in children, as it leads to prerenal azotemia, which can progress to renal failure if not corrected. Other causes like pyelonephritis and tubular destruction are less common and usually secondary to other conditions.
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