ATI RN
Maternal Diseases During Pregnancy Questions
Question 1 of 5
The nurse is caring for a child who has had a ventriculoperitoneal shunt (VP) for hydrocephalus and observes an increasing abdominal girth. What is the most appropriate response?
Correct Answer: D
Rationale: Rationale: The correct response is option D) Notify the charge nurse of possible malabsorption. An increasing abdominal girth in a child with a ventriculoperitoneal shunt for hydrocephalus could indicate shunt malfunction, leading to increased intracranial pressure and subsequent hydrocephalus. Malabsorption may result from inadequate absorption of nutrients due to increased intracranial pressure affecting gastrointestinal function. This can lead to poor growth and development in the child. Option A) Elevating the child's head is not the priority in this situation as it does not address the potential underlying issue of shunt malfunction and malabsorption. Option B) Checking bowel sounds is important for gastrointestinal assessment but may not directly address the specific concern of increasing abdominal girth related to shunt malfunction. Option C) Recording retention of feeding does not address the urgent need to investigate and address the potential complications associated with the VP shunt and its impact on the child's overall health. In an educational context, understanding the complications associated with VP shunts and their potential effects on various body systems is crucial for nurses caring for pediatric patients with hydrocephalus. Recognizing signs of shunt malfunction early and taking appropriate action can prevent serious consequences and improve patient outcomes. Regular monitoring and prompt reporting of changes in the child's condition are essential in providing safe and effective care.
Question 2 of 5
After delivery, a mother asks the nurse about newborn screening tests. The nurse explains that what is the optimal time for testing for phenylketonuria?
Correct Answer: B
Rationale: The correct answer is B) After 2 to 3 days for testing for phenylketonuria in newborns. Phenylketonuria (PKU) is an inborn error of metabolism that requires early detection and intervention to prevent developmental delays. Testing for PKU is typically done after 24 hours of life because newborns need to have some protein intake before accurate screening can occur. Option A) In the first 24 hours of life is incorrect because newborns need to consume protein-containing feeds before testing for PKU to be accurate. Option C) At 4 to 6 weeks of age and option D) At 2 months of age are both too late for PKU testing as early detection is crucial for timely intervention and management. In an educational context, it is essential for healthcare providers working with mothers and newborns to understand the importance of timely newborn screening tests like PKU screening. By recognizing the optimal timing for these tests, healthcare professionals can ensure early detection of conditions like PKU, allowing for prompt interventions and improved outcomes for newborns.
Question 3 of 5
What would the nurse include when instructing parents about positioning their toddler who has just had a body spica cast applied?
Correct Answer: D
Rationale: In the context of a toddler who has just had a body spica cast applied, changing the child's position frequently (Option D) is the most appropriate instruction for parents. This is because maintaining the same position for extended periods can lead to discomfort, pressure sores, and potential complications such as decreased circulation or respiratory problems. By changing the child's position regularly, parents can help prevent these issues and promote comfort and well-being. Option A, propping the child upright with pillows for meals, may not provide adequate support and stability required for a child in a spica cast. This position could potentially lead to instability and risk of injury. Option B, using the bar between the legs to turn the child, is not recommended as it could cause discomfort, pain, or even damage to the cast or the child's body. Option C, putting the child on her abdomen to sleep, is not advisable as it may lead to increased pressure on the cast, discomfort, and potential breathing difficulties for the child. Educationally, it is essential for parents to understand the importance of frequent position changes to ensure the child's comfort, safety, and overall well-being while in a spica cast. Teaching parents proper positioning techniques can help prevent complications and promote optimal healing and recovery for the child.
Question 4 of 5
Parents of a newborn with a unilateral cleft lip are concerned about having the defect repaired. The nurse explains that a child with a cleft lip usually undergoes surgical repair at which time?
Correct Answer: B
Rationale: The correct answer is B) By 3 months of age. Surgical repair of a unilateral cleft lip is typically performed around 3 months of age for several reasons. Repairing the cleft lip early helps in the proper development of feeding skills, speech, and overall facial structure. It also aids in preventing potential social and emotional challenges that may arise as the child grows older. Option A) Immediately after birth is not usually the preferred timing for surgical repair due to the small size of the newborn and potential concerns related to anesthesia and surgical outcomes in such young infants. Option C) After 12 months of age is too late for optimal outcomes as delaying the surgery can lead to difficulties in feeding, speech development, and psychological impacts on the child. Option D) Varies in every case is incorrect because while there may be some individual variations in the exact timing of surgery based on specific circumstances, the general recommendation for unilateral cleft lip repair is around 3 months of age for the best long-term outcomes. Educationally, it is important for healthcare providers to educate parents about the optimal timing for cleft lip repair to ensure the best possible outcomes for their child's physical and emotional well-being. Parents should be supported with accurate information and guidance throughout the decision-making process regarding their child's care.
Question 5 of 5
What assessment made by the nurse would lead the nurse to suspect hip dysplasia?
Correct Answer: A
Rationale: In the context of maternal diseases during pregnancy, understanding the assessment findings associated with conditions like hip dysplasia is crucial for nurses to provide comprehensive care. In this case, the correct answer is A) Asymmetrical gluteal folds. Hip dysplasia is a condition where the hip socket doesn't fully cover the ball portion of the upper thighbone. This can lead to instability and potential dislocation of the hip joint. Asymmetrical gluteal folds, where one side appears higher or more prominent than the other, can indicate a possible hip dysplasia as one hip may be dislocated or subluxed compared to the other. Option B) Limited adduction of the affected side is not indicative of hip dysplasia specifically but may be seen in other conditions affecting the hip joint or muscles around it. Option C) Foot turned inward is more suggestive of conditions like clubfoot rather than hip dysplasia. Option D) Deep inguinal creases are not typically associated with hip dysplasia but can be seen in normal variations or other conditions. Educationally, this question highlights the importance of recognizing physical assessment findings that can indicate musculoskeletal issues in newborns, including hip dysplasia. Nurses should be trained to perform thorough assessments and recognize subtle differences in body structures to ensure early detection and intervention for conditions like hip dysplasia, which can impact a child's mobility and development if left untreated.