ATI RN
ATI Nursing Care of Children 2019 B
1. Which of the following conditions is characterized by a 'machine-like' murmur in children?
- A. Patent ductus arteriosus
- B. Ventricular septal defect
- C. Atrial septal defect
- D. Coarctation of the aorta
Correct answer: A
Rationale: The correct answer is A, Patent ductus arteriosus. This condition is characterized by a continuous 'machine-like' murmur due to abnormal blood flow between the aorta and pulmonary artery. Ventricular septal defect (choice B) is characterized by a harsh holosystolic murmur, atrial septal defect (choice C) typically presents with a fixed split S2 and a pulmonary flow murmur, and coarctation of the aorta (choice D) is associated with a systolic murmur in the back and bilateral lower extremities.
2. When discussing discipline with the mother of a 4-year-old child, which should the nurse include?
- A. Parental control should be consistent.
- B. Withdrawal of love and approval is effective at this age.
- C. Children as young as 4 years rarely need to be disciplined.
- D. One should expect rules to be followed rigidly and unquestioningly.
Correct answer: A
Rationale: Consistent parental control is crucial for effective discipline, providing clear expectations and consequences for behavior.
3. What is the appropriate placement of a tongue blade for assessment of the mouth and throat?
- A. On the lower jaw
- B. Side of the tongue
- C. Against the soft palate
- D. Center back area of the tongue
Correct answer: B
Rationale: The side of the tongue is the appropriate place for a tongue blade to avoid triggering the gag reflex during assessment of the mouth and throat.
4. The nurse is performing an oral examination on a preschool child. Which strategies should the nurse use to encourage the child to open the mouth for the examination? (Select all that apply.)
- A. Lightly brush the palate with a cotton swab
- B. Perform the examination in front of a mirror
- C. Let the child examine someone else's mouth first
- D. All of the above
Correct answer: D
Rationale: Using a cotton swab, allowing the child to observe, and demonstrating on someone else are effective ways to encourage a preschooler to open their mouth for examination.
5. The caregiver asks why the 6-month-old infant needs to have solid foods when breast milk is such a good source of nutrition. What would be the best response by the nurse?
- A. Solid foods, especially iron-fortified cereals, are introduced to meet the infant's increased nutritional needs, including iron, which breast milk alone may not provide adequately.
- B. The extrusion reflex must be developed and feeding solid foods will help the infant to develop this reflex.
- C. Breastfeeding will become painful when the infant gets more teeth, so the infant needs to eat solid foods.
- D. By this age the infant becomes interested in trying new skills.
Correct answer: A
Rationale: The correct response is A. Solid foods, especially iron-fortified cereals, are introduced to meet the infant's increased nutritional needs, including iron, which breast milk alone may not provide adequately. Choice B is incorrect because the extrusion reflex is related to the tongue-thrust reflex, not the nutritional needs of the infant. Choice C is incorrect as breastfeeding does not become painful when the infant gets more teeth, and it is not a reason for introducing solid foods. Choice D is incorrect as the infant's interest in trying new skills is not a primary reason for introducing solid foods at this age.
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