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2024 ATI RN Maternal Newborn Proctored 2024 NGN (REVISED FULL EXAM).
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2024 ATI RN Maternal Newborn Proctored 2024 NGN (REVISED FULL EXAM).
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1. A 3-year-old Native American child is admitted to the pediatric unit for emergency surgery. Which of the following questions should the nurse include when taking the admission history from the child’s parents? 1. “Does your Indian tribe believe in immunizing children?” 2. “Do you attend Native American powwows with the family?” 3. “Have you consulted with your tribal healer about your child’s illness?” 4. “What herbal remedies have you given your child today?” 2. The parents of an infant have just been informed by the infant’s primary health -care provider that their child has an aggressive form of cancer. The parents have previously communicated that they are Jewish. Which of the following statements would be appropriate for the nurse to make? “It is often comforting for parents of very sick children to: 1. speak with their rabbis.” 2. read the sacred scriptures of Jesus.” 3. go to their church to pray.” 4. consult with members of the mosque.” 3. The nurse notes in a toddler’s medical record that the child was adopted internationally at 1 week of age. The child has been diagnosed with a terminal autosomal dominant genetic disease. Which of the following statements would be appropriate for the nurse to make? 1. “I will provide you with a referral for a meeting with a genetic counselor regarding your pregnancy risks.” 2. “It is very important that the mother be notified of the baby’s genetic condition.” 3. “What a shame that you adopted a sick child rather than a healthy child.” 4. “If you would like to learn more about your child’s disease, I can refer you to a genetic counselor.” 4. A second grader enters the school nurse’s office crying and states, “I feel sick. My belly hurts.” The nurse replies, “I’ll call your mommy or daddy to pick you up.” The child replies, “I don’t have a mommy, I have 2 daddies.” Which of the following comments by the nurse is appropriate? 1. “That’s right. I forgot that your parents are gay.” 2. “Of course you have a mommy. You just don’t live with your mommy.” 3. “I’ll call one of your daddies to pick you up.” 4. “It must be interesting to live with two men and no women in the house.” 5. A 10-year-old Hindu child who has just been diagnosed with diabetes is admitted to the pediatric clinical unit. The nurse is counseling the parents and child regarding the child’s dietary needs. Which of the following statements by the nurse would be appropriate? 1. “It is very important for you to eat protein at each meal. Meat is an excellent source of protein.” 2. “I understand that you do not usually eat fruit, but because you are diabetic, it will be essential for you to eat fruit.” 3. “To be able to provide you with the best information about dietary needs, I need to ask whether you follow a vegan diet.” 4. “Diabetes is a very serious illness. It may be necessary for you to consume foods that you are unaccustomed to eating.” REVIEW ANSWERS 1. ANSWER: 3 Rationale: 1. This is an inappropriate question. It should not be asked. 2. This is an inappropriate question. It should not be asked. 3. This question should be included when the nurse is taking the admission history. 4. This is an inappropriate question. It should not be asked. TEST-TAKING TIP: Because Native American families often seek counseling from a tribal healer, it is important to include that question. Questions that could be construed as insulting or that make assumptions about care should not be asked. Content Area: Pediatrics Integrated Processes: Nursing Process: Assessment Client Need: Psychosocial Integrity: Cultural Diversity Cognitive Level: Application 2. ANSWER: 1 Rationale: 1. This statement is appropriate. The Jewish spiritual leader is called a rabbi. 2. This statement is not appropriate. Jews do not read the scriptures that discuss Jesus. 3. This statement is not appropriate. The Jewish house of worship is called either a temple or a synagogue. 4. This statement is not appropriate. The Muslim holy sanctuary is called a mosque. TEST-TAKING TIP: It is appropriate to suggest to clients that they seek counsel with their religious advisor or clergyperson. The nurse must, however, be aware that there are differences in clients’ belief systems. For example, the nurse should never make parents feel uncomfortable if they should decide not to seek counsel from a clergyperson. In addition, if the nurse is not familiar with the clients’ beliefs, it is best to use generic terms or to consult someone who is knowledgeable. Content Area: Pediatrics Integrated Processes: Nursing Process: Implementation Client Need: Psychosocial Integrity: Cultural Diversity Cognitive Level: Application 3. ANSWER: 4 Rationale: 1. This statement is inappropriate. This child has been adopted. The child’s adoptive mother is not the child’s biological mother. This statement is inappropriate. The adoption was performed in another country. It is probable that the adoptive parents are unaware of the identity of the biological mother. 2. This statement is inappropriate. The nurse must always communicate an understanding that an adopted child is cherished as much as a biological child. 3. This statement is appropriate. Because the disease is genetic, the professionals who are most knowledgeable about the disease are genetic counselors. TEST-TAKING TIP: It must be assumed that adopted children are cherished as much as biological children. The nurse should refer to the child as the parent’s child, not as the parent’s adopted child. Content Area: Pediatrics Integrated Processes: Nursing Process: Implementation Client Need: Psychosocial Integrity: Cultural Diversity Cognitive Level: Application 4. ANSWER: 3 Rationale: 1. This statement is inappropriate. 2. Although this statement is accurate, it is inappropriate. 3. The nurse should respond with this statement. 4. This statement is inappropriate. TEST-TAKING TIP: Nurses must be prepared to care for children with same-sex parents. The children should never be made to feel that the family structure is abnormal. Content Area: Pediatrics Integrated Processes: Nursing Process: Implementation Client Need: Psychosocial Integrity: Cultural Diversity Cognitive Level: Application 5. ANSWER: 3 Rationale: 1. This statement is not appropriate. Although not universal, many Hindus are vegetarians. 2. This statement is inaccurate. Hindus do eat fruit. 3. This statement is correct. Although some vegetarians eat eggs and drink milk, others follow a more restrictive, vegan diet. 4. This statement is not appropriate. Vegetarian diets are compatible with diabetic diets. TEST-TAKING TIP: Many Hindus are vegetarians. The nurse should assume, unless advised by a licensed nutritionist, that the vegetarian diet is compatible with the diets required of medical illnesses, including diabetes. Content Area: Pediatrics Integrated Processes: Nursing Process: Implementation Client Need: Psychosocial Integrity: Cultural Diversity Cognitive Level: Application REVIEW QUESTIONS 1. The mother of a 1 -month -old states that she is curious as to whether her infant is developing normally. Which of the following developmental milestones would the nurse inform the mother that the infant is expected to perform at this age? 1. Rolling from back to front 2. Smiling and laughing out loud 3. Turning head from side to side 4. Holding a rattle for ten seconds 2. An 8 -month -old is seen in the well -child clinic. Which of the following behaviors would the nurse expect to see? Select all that apply. 1. Plays peek -a-boo 2. Walks independently 3. Feeds self with a spoon 4. Stacks two blocks into a tower 5. Transfers objects from hand to hand 3. A nurse is educating a parent regarding the immunizations that a child is to receive during the first year of life. Which of the following immunizations did the nurse discuss? 1. Measles 2. Mumps 3. Rubella 4. Polio 4. A nurse is educating a parent regarding the psychosocial stage of development of the infancy period. Which of the following information did the nurse include in the discussion? 1. Infants should have their needs met in a timely fashion. 2. Mothers should let their babies cry themselves to sleep each night. 3. Infants should be scolded for bad behavior whenever they break objects. 4. Mothers should sneak out of the room when they must leave their babies. 5. The parent of a 10-month -old is being interviewed by the nurse preceding an examination by the pediatric nurse practitioner and states, “My baby loves all kinds of food, and he always drinks his milk from a sippy cup, except in the evening when he wants a bottle.” Which of the following follow -up questions is most important for the nurse to ask? 1. “Have you decided when you will wean your child from the bottle entirely?” 2. “Is your child drinking cow’s milk from the sippy cup and bottle?” 3. “Which fruits and vegetables have you fed your child so far?” 4. “Have you fed your child any foods that he can feed himself, like cereal or peas?” 6. The mother of a 2-month -old who is being seen in the pediatrician’s office states, “I am really worried because my child’s head is not shaped right.” The nurse should ask a question to obtain which of the following information? 1. Is the child yet able to roll over by himself? 2. Do the parents put the child on his stomach during supervised play? 3. Is the child turning his head to follow an object? 4. Do the parents elicit a smile from the child when they speak to him? 7. The nurse is visiting the home pictured above. A 6-month -old child lives in the home. Please select the image in the picture that the nurse should inform the parents presents a potential danger to the child. 8. A mother visits her child’s primary health -care provider for the child’s 12 -month visit. The child weighed 2,800 grams at birth. Which of the following weights is most consistent with the expected weight for this child? 1. 7,500 grams 2. 8,000 grams 3. 8,500 grams 4. 9,000 grams 9. The nurse assesses a 2-month -old girl. The baby weighed 3,400 grams at birth, 3,800 grams at 1 month, and 4,000 grams at 2 months of age. The nurse plots the information on the scale below. Which of the following conclusions and actions would be appropriate for the nurse to make? 1. Conclusion: the child’s growth is normal. Action—no change: the baby is growing appropriately, therefore no feeding changes are needed. 2. Conclusion: the child’s growth is excessive. Action—change: the baby is overweight, and the information should be reported. 3. Conclusion: the child’s growth is inconsistent. Action—no change: the baby’s weight was larger than normal at birth, but the current weight is appropriate. 4. Conclusion: the child’s growth is below expected. Action—change: the baby’s weight is markedly lower than normal, and the information should be reported. 10. A 6-month -old child received the following play things as a gift from a relative. The nurse should advise the parents that which of the items is potentially dangerous for the child to play with? 1. Stuffed animal 2. Balloon 3. Toy cell phone 4. Shape sorter 11. A mother of an 8 -month -old boy states that the family is vacationing in a beach house for the next 2 weeks. Which of the following information should the nurse educate the mother about in relation to sun exposure? Select all that apply. 1. Reapply sun lotions to all exposed skin every 4 to 6 hours. 2. Use sun lotions that protect against both UVA and UVB rays. 3. Have the baby wear child -sized sunglasses whenever he is in the sun. 4. Avoid exposing the child to the sun between the hours of 12 and 2 p.m. 5. Dress the child in lightweight clothing that covers the majority of his skin. 12. The mother of an 11-month -old states, “My child has 8 teeth. I brush them every morning with bubble gum -flavored toothpaste. My child loves it.” Which of the following responses by the nurse is appropriate? 1. “That is great. Even though they are baby teeth, it is very important to brush them with toothpaste.” 2. “I am so glad to hear that your child loves the toothpaste. So many babies get cavities because they refuse to use toothpaste.” 3. “I am very happy to know that you are cleaning your baby’s teeth, but I am afraid that the bubble gum flavor will spoil him.” 4. “It is wonderful that you are brushing your child’s teeth, but it is recommended for you not to use toothpaste.” 13. A mother questions the nurse regarding car seat safety for her infant. Which of the following information should the nurse include in the discussion? 1. Place the infant car seat rear facing in the back seat of the car. 2. Move the car seat to the forward -facing position when the child reaches 1 year of age. 3. Keep the child in a bucket seat until the child is at least 12 months of age. 4. Tighten the straps of the seat so that only an adult fist fits under the straps. REVIEW ANSWERS 1. ANSWER: 3 Rationale: 1. Infants roll from back to front at about 6 to 7 months of age. 2. Infants smile when they are 1½ to 2 months of age and laugh out loud when they reach 6 to 7 months of age. 3. At one month of age, children still perform basic skills like moving their heads from side to side. 4. Infants begin to hold rattles, if placed in their hands, at about 3 months of age. TEST-TAKING TIP: Development is progressive. Although babies develop a social smile at 6 to 8 weeks of age, they usually do not laugh out loud until they are much older. Content Area: Pediatrics —Infant Integrated Processes: Nursing Process: Implementation; Teaching/Learning Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions Cognitive Level: Application 2. ANSWER: 1 and 5 Rationale: 1. 8-month -old children do play peek -a-boo with their parents. 2. Children are not expected to walk independently until they reach 15 months of age. 3. It is too early for a child to be expected to feed him/ herself with a spoon. 4. Children are able to stack blocks into a 2-block tower at about 18 months of age. 5. Babies can transfer objects from hand to hand at 7 months of age. TEST-TAKING TIP: The key to answering multiple response items correctly is to view each response independently. In other words, read the first response after carefully reading the stem of the question. If it is accurate, it should be chosen. Then read the second response, and compare it to the stem. If it is accurate, then it should be chosen. Continue to compare each response independently until all responses have been reviewed.The benefits of buying summaries with Stuvia:
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