ATI RN
Community and Public Health Nursing Evidence for Practice Questions
Question 1 of 5
You will not give DPT 2 if the mother says that the infant had?
Correct Answer: A
Rationale: The correct answer is A because seizures following DPT1 indicate a serious adverse reaction, making it unsafe to administer DPT 2. Seizures are a contraindication for further DPT vaccines due to the risk of exacerbating neurological complications. Choices B, C, and D do not pose as immediate contraindications for giving DPT 2, as fever, abscess formation, and local tenderness are common and less severe reactions to the vaccine. Therefore, A is the correct choice based on safety concerns and potential harm to the infant.
Question 2 of 5
A 5-month old infant was brought by his mother to the health center because of diarrhea occurring 4 to 5 times a day. His skin goes back slowly affer a skin pinch and his eyes are sunken. Using the IMCI guidelines, you will classify this infant in which category?
Correct Answer: C
Rationale: The correct classification for this infant based on the symptoms described is severe dehydration. According to the Integrated Management of Childhood Illness (IMCI) guidelines, severe dehydration is characterized by skin pinch returning slowly, sunken eyes, and frequent diarrhea. These signs indicate significant fluid loss and the need for immediate intervention. No signs of dehydration (choice A) would not be accurate given the symptoms presented. Some dehydration (choice B) may not fully capture the severity of the infant's condition. The data being insufficient (choice D) is incorrect as the symptoms provided clearly indicate severe dehydration.
Question 3 of 5
A 1 1/2 year old child was classified as having 3rd degree of protein energy malnutrition, kwashjorkor. Which of the following signs will be most apparent in this child?
Correct Answer: D
Rationale: The correct answer is D: Edema. In severe protein energy malnutrition like kwashiorkor, edema is a hallmark sign due to low protein levels causing fluid to leak into tissues. A: Voracious appetite is incorrect as malnourished children often have reduced appetite. B: Wasting is more associated with marasmus, another form of malnutrition. C: Apathy can be seen in malnourished children, but it is not specific to kwashiorkor. In summary, edema is the most apparent sign in a child with 3rd-degree protein energy malnutrition, distinguishing it from other forms of malnutrition.
Question 4 of 5
During the physical examination of a young child, what is the earliest sign of xerophthalmia that may observe?
Correct Answer: D
Rationale: The correct answer is D: Conjunctival xerosis. This is the earliest sign of xerophthalmia as it indicates dryness and thickening of the conjunctiva due to lack of vitamin A. Keratomalacia (A) and corneal opacity (B) occur at later stages and are more severe manifestations. Night blindness (C) is a symptom of vitamin A deficiency but typically appears after conjunctival xerosis. Therefore, observing conjunctival xerosis during a physical examination of a young child would be the earliest sign of xerophthalmia.
Question 5 of 5
The major sign of iron deficiency anemia is pallor. What part is best examined for pallor?
Correct Answer: D
Rationale: Step 1: Lower conjunctival sac is the best area to examine for pallor as it is a mucous membrane that reflects the true color of blood vessels. Step 2: Anemia causes decreased hemoglobin levels, leading to paleness visible in lower conjunctival sac. Step 3: Palms, nailbeds, and around the lips may also show pallor, but they can be affected by other factors like skin pigmentation or lighting. Summary: Lower conjunctival sac is the best site for assessing pallor due to its direct reflection of blood vessel color, making it superior to other areas prone to external influences.