Nursing Care of Children ATI

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What time frame has the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists recommended that pregnant adolescents and women who are not protected against pertussis receive the tetanus, diphtheria, and pertussis (Tdap) vaccine?

  • A. Between 27 and 36 weeks of gestation or postpartum before discharge from the hospital
  • B. During the first prenatal visit when pregnancy is confirmed
  • C. The vaccine should be administered 24 hours prior to delivery
  • D. This vaccine is only recommended during the first trimester
Correct Answer: A

Rationale: The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists recommend that pregnant adolescents and women without protection against pertussis should receive the Tdap vaccine ideally between 27 and 36 weeks of gestation or postpartum before discharge from the hospital. This timeframe allows for the development of antibodies in the mother to protect her and provide passive immunity to the infant. Administering the vaccine during the first trimester (Choice D) is not recommended as the optimal time is between 27 and 36 weeks. Choice B, during the first prenatal visit, is too early for optimal protection, and Choice C, 24 hours prior to delivery, does not provide enough time for the vaccine to be effective before birth.

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The nurse is caring for a child after a cleft palate repair who is on a clear liquid diet. Which feeding device should the nurse use to deliver the clear liquid diet?

  • A. Straw
  • B. Spoon
  • C. Sippy cup
  • D. Open cup
Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

What may be a clinical manifestation of failure to thrive (FTT) in a 13-month-old include?

  • A. Irregularity in activities of daily living
  • B. Preferring solid food to milk or formula
  • C. Weight that is at or below the 10th percentile
  • D. Appropriate achievement of developmental landmarks
Correct Answer: C

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

When planning care for a child with a urinary tract infection, the nurse should give priority to which treatment measure?

  • A. Provide adequate nutrition to prevent dehydration.
  • B. Administer ordered antibiotics on schedule.
  • C. Prevent enuresis.
  • D. Restrict fluid.
Correct Answer: B

Rationale: Administering antibiotics on schedule is crucial in treating a UTI effectively and preventing complications. Antibiotics help to eliminate the infection-causing bacteria from the urinary tract. While maintaining adequate nutrition and hydration are important aspects of care, the priority in a UTI is to target the infection with antibiotics. Preventing enuresis (bedwetting) is not directly related to the treatment of the infection. Fluid restriction is not recommended in the management of a UTI; in fact, encouraging adequate fluid intake helps flush out bacteria from the urinary tract.

A breastfed infant is being seen in the clinic for a 6-month checkup. The mother tells the nurse that the infant recently began to suck her thumb. Which is the best nursing intervention?

  • A. Reassure the mother that this is normal at this age
  • B. Recommend the mother substitute a pacifier for her thumb
  • C. Assess the infant for other signs of sensory deprivation
  • D. Suggest the mother breastfeed the infant more often to satisfy her sucking needs
Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

When should the dressing change for a post-op pediatric patient that is expected to be very painful and frightening be performed?

  • A. In the patient's room
  • B. In the treatment room
  • C. After discharge when the patient is at home
  • D. In the playroom
Correct Answer: B

Rationale: The correct answer is B: 'In the treatment room.' Performing painful procedures in the treatment room helps the child associate their own room with safety and comfort, not pain. Choice A is incorrect because performing the dressing change in the patient's room may create a negative association with their safe space. Choice C is incorrect as it is important to ensure proper wound care and pain management before discharge. Choice D is incorrect as the playroom may not be equipped for a sterile dressing change.

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