ATI NS122 Pediatrics Monroe College NY PN

ATI NS122 Pediatrics Monroe College NY PN Related

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A nurse is reinforcing teaching with a parent of an infant who has gastroesophageal reflux. Which of the following statements by the parent indicates an understanding of the teaching?

  • A. I will have to feed my baby formula, rather than breast milk.
  • B. I should move my baby into a side-lying position during sleep.
  • C. My baby's formula can be thickened with oatmeal.
  • D. I will keep my baby in an upright position after feedings.
Correct Answer: D

Rationale: I will have to feed my baby formula, rather than breast milk.' - This statement indicates a misunderstanding. Breast milk is generally preferred for infants with gastroesophageal reflux (GER) because it is more easily digested and less likely to exacerbate reflux symptoms compared to formula. Breastfeeding mothers may be encouraged to continue breastfeeding, and formula-fed infants may benefit from specialized formulas designed to reduce reflux symptoms. 'I should move my baby into a side-lying position during sleep.' - This statement indicates a misunderstanding. Placing an infant in a side-lying position during sleep is not recommended due to the risk of sudden infant death syndrome (SIDS). Instead, infants with GER should be placed on their back to sleep, as recommended by safe sleep guidelines. Elevating the head of the crib or bassinet slightly may also help reduce reflux symptoms during sleep. 'My baby's formula can be thickened with oatmeal.' - This statement indicates an understanding of the teaching. Thickening formula with oatmeal or rice cereal can help reduce gastroesophageal reflux (GER) symptoms in infants by making the formula heavier and less likely to reflux back into the esophagus. However, this should only be done under the guidance of a healthcare provider to ensure proper preparation and feeding technique. 'I will keep my baby in an upright position after feedings.' - This statement indicates an understanding of the teaching. Keeping the baby in an upright position after feedings can help reduce reflux symptoms by allowing gravity to keep the stomach contents down. Parents can hold the baby upright on their shoulder or in an infant seat for a period of time after feeding to minimize reflux episodes.

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An infant with hydrocele is seen in the clinic for a follow-up visit at 1 month of age. The scrotum is smaller than it was at birth, but fluid is still visible on illumination. Which of the following actions is the physician likely to recommend?

  • A. No treatment is necessary, the fluid is reabsorbing normally
  • B. Keeping the infant in a flat, supine position until the fluid is gone
  • C. Referral to a surgeon for repair
  • D. Massaging the groin area twice a day until the fluid is gone.
Correct Answer: A

Rationale: No treatment is necessary, the fluid is reabsorbing normally: - This option suggests that the hydrocele is resolving spontaneously, which is often the case in infants. The physician may choose to observe the hydrocele over time as it is likely to resolve without intervention. Keeping the infant in a flat, supine position until the fluid is gone: - This option does not address the underlying cause of the hydrocele and is not a standard treatment recommendation. Additionally, positioning changes are unlikely to affect the resolution of the hydrocele. Referral to a surgeon for repair: - Surgical repair may be considered if the hydrocele persists beyond a certain age or if it causes discomfort or complications. However, it is typically not recommended in infants unless the hydrocele persists beyond infancy or causes other issues. Massaging the groin area twice a day until the fluid is gone: - Massaging the groin area is not a recommended treatment for hydrocele and may not be effective in resolving the condition. Additionally, manipulating the scrotum may cause discomfort or injury to the infant.

When assessing a child with Wilm's tumor, the nurse should keep in mind that it is most important to avoid which of the following?

  • A. Measuring the child's chest circumference
  • B. Palpating the child's abdomen
  • C. Measuring the child's occipitofrontal circumference
  • D. Placing the child in an upright position
Correct Answer: B

Rationale: Measuring the child's chest circumference: Measuring the chest circumference may not directly aid in the assessment of Wilm's tumor. While it's important for assessing respiratory conditions or monitoring growth, it's not a primary assessment for Wilm's tumor, which primarily affects the abdomen. Palpating the child's abdomen: This is an essential action in assessing for Wilm's tumor. The nurse should carefully palpate the abdomen to check for any masses, swelling, or tenderness, as these could be indicative of the tumor. Measuring the child's occipitofrontal circumference: This measurement pertains to the head circumference and is not directly related to the assessment of Wilm's tumor. While it's important for monitoring head growth and development, it's not a priority when assessing for Wilm's tumor. Placing the child in an upright position: Placing the child in an upright position may be necessary for certain assessments or procedures, but it's not directly related to assessing for Wilm's tumor. The focus should primarily be on abdominal assessment and palpation to detect any signs of the tumor.

A nurse is providing teaching to a parent of a child who has celiac disease. The nurse should include which of the following as an acceptable food choice for this child?

  • A. Barley
  • B. Rye
  • C. Rice
  • D. Wheat
Correct Answer: C

Rationale: Barley: Barley is a grain that contains gluten. Foods made from barley, such as barley flour or barley-based products like bread, cereal, or beer, should be avoided by individuals with celiac disease because gluten can trigger an immune response that damages the small intestine. Rye: Similar to barley, rye is another grain that contains gluten. Foods made from rye, such as rye bread or rye-based cereals, should also be avoided by individuals with celiac disease because they can trigger adverse reactions due to gluten. Rice: Rice is a gluten-free grain and is safe for individuals with celiac disease to consume. It does not contain gluten proteins that can cause intestinal damage or trigger immune responses in those with gluten sensitivity or celiac disease. Wheat: Wheat is a major source of gluten and should be strictly avoided by individuals with celiac disease. Foods made from wheat, such as wheat bread, pasta, or baked goods, can lead to symptoms and intestinal damage in individuals with gluten intolerance or celiac disease.

A nurse is caring for a child who is having a seizure. Which of the following actions should the nurse take? (Select all that apply.)

  • A. Place a tongue depressor in the child's mouth.
  • B. Restrain the child.
  • C. Clear the area of hard objects.
  • D. Loosen restrictive clothing.
  • E. Place the child in a prone position
Correct Answer: C,

Rationale: A. Place a tongue depressor in the child's mouth: This is an incorrect action. Placing a tongue depressor or any other object in the child's mouth during a seizure can cause injury to the child's mouth, teeth, or airway. It may also increase the risk of choking. It's a common misconception that people can swallow their tongues during a seizure, but this is not true. It's important to keep the child's mouth clear of objects and allow the seizure to run its course. B. Restrain the child: This is also an incorrect action. Restraint can cause further injury to the child and increase agitation, which may worsen the seizure. It's important to allow the child to move freely during a seizure while taking steps to ensure their safety, such as clearing the area of objects and protecting the head from injury. C. Clear the area of hard objects: This is a correct action. Removing hard objects from the area helps prevent injury to the child during a seizure. Objects such as furniture corners or sharp items can pose a risk if the child thrashes or moves unpredictably during the seizure. D. Loosen restrictive clothing: This is also a correct action. During a seizure, it's important to ensure that the child's clothing is not too tight or restrictive. Loosening clothing, especially around the neck and chest area, helps ensure adequate airflow and prevents restriction of movement during the seizure. E. Place the child in a prone position: This is an incorrect action. Placing the child in a prone (face-down) position during a seizure can increase the risk of airway obstruction and make it more difficult for the child to breathe. Instead, the child should be placed on their side (recovery position) to help maintain an open airway and prevent aspiration if vomiting occurs.

A nurse is caring for a child who has a suspected diagnosis of bacterial meningitis. Which of the following actions is the nurse's priority?

  • A. Maintain seizure precautions.
  • B. Document intake and output.
  • C. Administer antibiotics when available.
  • D. Reduce environmental stimuli.
Correct Answer: C

Rationale: Maintain seizure precautions: While seizures can occur as a complication of bacterial meningitis, maintaining seizure precautions is not the nurse's priority at this stage. Prompt administration of antibiotics to address the underlying infection takes precedence over seizure precautions. Document intake and output: Documenting intake and output is an important nursing responsibility, but it is not the priority when a child is suspected of having bacterial meningitis. The immediate priority is to initiate antibiotic therapy to treat the infection and prevent further complications. Administer antibiotics when available: Administering antibiotics is the priority in the care of a child with suspected bacterial meningitis. Antibiotics are crucial for treating the infection and preventing its progression to reduce the risk of serious complications such as brain damage or death. Reduce environmental stimuli: While reducing environmental stimuli can help manage symptoms and discomfort in a child with bacterial meningitis, it is not the priority at this time. Initiating antibiotic therapy is essential to address the underlying infection, which takes precedence over environmental stimuli reduction.

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