RN ATI MATERNAL NEWBORN PROCTORED EXAM (ATI CHILD CARE 2.0)

RN ATI MATERNAL NEWBORN PROCTORED EXAM (ATI CHILD CARE 2.0) 1 The parents of a 5-month-old infant state that their infant seems to eat very little. Most of the food comes out of the infant's mouth and onto his clothes. Which of the following explanations should the nurse give to the parents? Trying to introduce food after the intake of a bottle formula is usually not recommended because the infant is satiated and has no inclination to try something new. Solid foods should be offered at 4 to 6 months. The gastrointestinal tract has matured enough to handle more nutrients and is less sensitive to potentially allergenic foods. This deprives the infant of the pleasure of learning new tastes and developing a discriminating palate. It may cause problems with poor chewing because of lack of experience. Due to the extrusion (protrusion) reflex, the infant’s tongue pushes the food out of the mouth. It is most helpful to suggest using a longhandled spoon and placing the food in the back of the infant's mouth to avoid the reflex. "Give the baby a bottle of formula before solid food to assure adequate caloric intake." "Stop the solid foods and try again when the baby is 12 months old." "Put the cereal in a bottle and feed the baby through a nipple with a large hole." "Place the food in the back of the baby's mouth using a long-handled spoon." 2 A nurse smells an odor identified as marijuana coming from a room. Which of the following client findings would confirm inhalation of the substance? All are findings of a client who has smoked/inhaled cannabis/marijuana. These clients are typically euphoric or somewhat mildly intoxicated. They have poor coordination with bloodshot (red) eyes and may laugh inappropriately. These findings are more commonly due to of the effects of depressants. These findings are more commonly due to the effects of opiates. These findings are more commonly due to the effects of cocaine. Poor coordination, red eyes, and euphoria Slurred speech, confusion, and combativeness Loss of consciousness, respiratory depression, and coma Hypertension, tachycardia, and hyperflexia 3 A nurse is checking children at an orthopedic outpatient setting. Which of the following should the nurse expect to see as manifestations of scoliosis? Lumbar curvature is a manifestation of lordosis. These are manifestations of scoliosis. Often parents observe that a child's skirt doesn't hang straight or the pant legs are uneven. Tenderness is a general symptom that may indicate something is wrong in an underlying organ. A nurse could not see changes such as swelling of the spine. These symptoms could be associated with other orthopedic problems but are not characteristic of scoliosis. Pain and an exaggerated lumbar curvature Uneven shoulder heights and poorly fitting slacks Tenderness and swelling of the spine Limited range of motion of the back and a limp 4 A nurse is providing client/patient education to the mother of an 8-year-old child diagnosed with B-hemolytic streptococci infection (strep throat). The nurse emphasizes the importance of promptly starting and completing the entire course of antibiotics. The mother asks why this is important. The nurse states that the antibiotic will Pain may interfere with oral intake, but this is not the priority concern with prompt diagnosis and care of strep throat. Cool fluids or ice chips may be comforting. Relief to the neck may be provided by the application of cold or warm compresses to the area. Warm saline gargles may also relieve throat discomfort. Sinusitis and abscess formation on the pharyngeal and peri tonsillar areas are complications that can develop with a strep throat infection, but these complications are not of the greatest concern with this infection. Anterior cervical lymphadenopathy is a symptom of a streptococcal infection resulting in pharyngitis and tender lymph nodes. This usually subsides in 3 to 5 days if uncomplicated. Antibiotics should be initiated as soon as possible and taken as prescribed to quickly and completely eliminate the streptococcal organism, which can lead to acute rheumatic fever, glomerulonephritis, and acute renal failure. alleviate painful swallowing to avoid complications of dehydration and malnutrition. prevent sinusitis or abscess formation on the pharyngeal or peri tonsillar areas. reduce the risk of anterior cervical lymphadenopathy. eliminate organisms that might initiate acute renal failure or rheumatic fever. 5 A nurse is reinforcing teaching about accidental poisoning to a parent during a routine well-child visit. The nurse asks the parent, "What would be your first response if your child accidentally took an overdose of acetaminophen (Tylenol)?" Which of the following statements by the parent would indicate a correct understanding? Syrup of ipecac is no longer recommended as a routine home treatment of poisoning. Giving syrup of ipecac might possibly be appropriate, but certain substances that are corrosive would make using this measure contraindicated because it would increase the damage to the mucosa lining. Placing the child into a side-lying position is an appropriate measure to prevent aspiration. Calling the Poison Control Center is the best initial response to an accidental poisoning because each case needs to be dealt with by getting prompt medical attention to initiate the appropriate emergency treatment actions. Giving the child one sip of water, not a full glass, is appropriate to dilute the ingested poison. However, this is not the first action that should be taken. "I will give my child a dose of ipecac." "I will place my child on her back." "I will call the Poison Control Center." "I will get my child to drink a full glass of water." 6 A nurse is caring for a 23-month-old child with iron-deficiency anemia. The parents indicate they have been taught about the diagnosis, but are concerned that they are not doing all that they need to do. Which of the following should the nurse include when reinforcing teaching? Cow's milk contains substances that bind with iron and interfere with its absorption. Iron should not be given with milk or milk products. There are no food limitations or suggestions when children are taking oral iron preparations. Foods with vitamin C, such as citrus fruits, enhance the absorption of iron. Oral iron supplements do not cause GI bleeding or ulcers. Liquid iron may stain the teeth, so the nurse should instruct the parents to give it through a straw placed in the back of the child's mouth to avoid staining the teeth. Give the oral iron supplementation with a glass of cow's milk to prevent stomach problems. Provide diet instructions including limiting citrus fruits in favor of more vegetables. Provide information about complications of iron including gastrointestinal bleeding and ulcers. Give liquid iron through a straw placed in the back of the mouth. 7 A nurse is reviewing discharge teaching with the parents of a child who has pediculosis. Which of the following should the nurse include in the teaching? Children should not share combs, hair ornaments, hats, caps, scarves, coats, and other items used on or near the hair. Pets are not carriers of lice. Clothes should be dried in a hot dryer for at least 20 min to kill the lice. Lice need a blood source to survive. Placing the nonwashable items in a sealed plastic bag for 14 days will kill the lice. "Children can share scarves and coats, but not hats or combs." "Household pets can carry and transmit lice to people." "After washing clothing, hang clothes outside to dry." "Seal nonwashable items in plastic bags for 14 days." 8 A nurse is caring for a toddler who is in an oxygen tent. Which of the following actions should the nurse take in order to promote comfort while maintaining the child's safety? Not all toys are safe to put inside an oxygen tent. Vinyl or plastic toys that do not absorb moisture are suitable to put inside the tent. Stuffed animals absorb moisture and are difficult to dry. High levels of oxygen are a source of sparks, so mechanical or electrical toys are a potential fire hazard. The moisture inside an oxygen tent will make the child cold and the child’s clothes moist. Therefore, the nurse should try to keep the child warm and dry by changing bedding and clothes, which will enhance the child's comfort without compromising safety. Oxygen is heavier than air; therefore, oxygen loss will be greater at the bottom of the tent. The tent should be tucked snugly without open edges to prevent oxygen loss. Some tents are opened at the top. Oxygen is a heavy gas and most of it will stay at the bottom of the tent. This measure does not promote the child's comfort while in the oxygen tent. Give the child a stuffed animal and car with rubber wheels to play with. Change the bedding and the child's clothing frequently or as often as needed. Tuck the bottom of the tent under the mattress on three sides, leaving one side open so the child can look out. Cover the opening on the roof of the tent with a blanket to prevent the child from becoming chilled. 9 A nurse is reinforcing teaching with the parent of a child with a urinary tract infection. Which of the following statements made by the parent indicates understanding of how to prevent future infections? Children should be encouraged to void frequently, especially before long trips or other circumstances in which toilet facilities may not be available for an extended period of time. Urine that is held can harbor bacteria that can result in a urinary tract infection. Cotton underwear allows for more air flow to the perineal area and reduces the risk of urinary tract infections. Wiping from back to front increases the risk of feces entering the urethra and causing a urinary tract infection. Bubble baths and perfumed perineal products can irritate the urethra and lead to a urinary tract infection. These should be avoided, especially for girls. "I will bring my child to the bathroom before we leave for extended trips." "I need to switch my child from cotton underwear to nylon underwear." "I should teach my child to wipe from back to front after urinating." "I will have my child soak in a bubble bath once or twice a week." 10 A nurse is reviewing discharge instructions with the parent of an infant who has acute laryngotracheobronchitis (croup). Which of the following statements made by the parent indicates a need for further teaching? This is a correct intervention. Corticosteroids have an anti-inflammatory effect that decreases subglottic edema. This will make breathing easier. This is a correct intervention. Clearing the nasal passages decreases the amount of secretions in the upper and lower airways. Dry air will exacerbate the child's croup. Cool temperature therapies are advocated for this condition. Cool mist constricts edematous blood vessels. A cool air vaporizer can be used at home to maintain high humidity and provide relief. Warm mist from warm running water such as a hot shower in a closed bathroom may be beneficial. It is essential that children with laryngotracheobronchitis (croup) be allowed and encouraged to drink any fluids they like to increase fluid intake. "I will give my child the corticosteroids prescribed by the doctor." "I will clear the child's nasal passages with a bulb syringe to aid in breathing." "I will place a dehumidifier in my child's room." "I will encourage my child to take plenty of fluids over the next several days."