ATI RN
RN Nursing Care of Children 2019 With NGN
1. A 7-year-old has been diagnosed with cystic fibrosis. Chest physiotherapy has been ordered. What information should the nurse give to the parents regarding when chest physiotherapy is done?
- A. Before aerosol treatment
- B. After suctioning
- C. Before postural drainage
- D. Before meals
Correct answer: D
Rationale: The correct answer is D: 'Before meals'. Chest physiotherapy should be performed before meals to reduce the risk of vomiting and to ensure that the airways are clear for effective nutrition. Choices A, B, and C are incorrect because chest physiotherapy is ideally done before meals to optimize its benefits and avoid complications associated with timing.
2. When assessing a child with leukemia, which clinical manifestations should the nurse anticipate?
- A. Petechiae, fever, fatigue
- B. Headache, papilledema, irritability
- C. Muscle wasting, weight loss, fatigue
- D. Decreased intracranial pressure, psychosis, confusion
Correct answer: A
Rationale: The correct answer is A: Petechiae, fever, fatigue. Children with leukemia commonly present with petechiae (due to low platelet count), fever (due to infection), and fatigue (due to anemia), which are classic manifestations of the disease. Option B is incorrect because headache, papilledema, and irritability are more indicative of increased intracranial pressure, not leukemia. Option C is incorrect as muscle wasting and weight loss are not typical initial manifestations of leukemia in children. Option D is incorrect as decreased intracranial pressure, psychosis, and confusion are not commonly associated with leukemia.
3. What condition is the most common cause of acute renal failure in children?
- A. Pyelonephritis
- B. Tubular destruction
- C. Severe dehydration
- D. Upper tract obstruction
Correct answer: C
Rationale: Severe dehydration is the most common cause of acute renal failure in children, as it leads to prerenal azotemia, which can progress to renal failure if not corrected. Other causes like pyelonephritis and tubular destruction are less common and usually secondary to other conditions.
4. A child is hospitalized in acute renal failure and has a serum potassium greater than 7 mEq/L. What temporary measures that will produce a rapid but transient effect to reduce the potassium should the nurse expect to be prescribed? (Select all that apply.)
- A. Dialysis
- B. All below
- C. Sodium bicarbonate
- D. Glucose 50% and insulin
Correct answer: A
Rationale: Calcium gluconate, sodium bicarbonate, and glucose with insulin are used as temporary measures to rapidly reduce serum potassium levels. They help shift potassium into cells and stabilize the heart but do not remove potassium from the body like dialysis does.
5. A toddler’s mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurse’s response should be based on which premise?
- A. An emergency laparotomy is very likely.
- B. The location needs to be confirmed by radiographic examination.
- C. Surgery will be necessary if the battery has not passed in the stool in 48 hours.
- D. Careful observation is essential because an ingested battery cannot be accurately detected.
Correct answer: B
Rationale: Radiographic examination is essential to confirm the location of the battery, as it can cause significant damage, particularly if lodged in the esophagus. Immediate surgery may be required depending on its location and the potential for causing harm.
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