ATI RN
RN Nursing Care of Children 2019 With NGN
1. A 5-year-old has patient-controlled analgesia (PCA) for pain management after abdominal surgery. What information does the nurse include in teaching the parents about the PCA?
- A. The child may not be pain-free.
- B. The parents or nurse may push the button for a bolus if needed.
- C. The pump allows for a continuous basal rate to deliver a constant amount of medication for pain control.
- D. Monitoring is required every 1 to 2 hours to assess patient response.
Correct answer: C
Rationale: The correct answer is C because the PCA pump can be programmed to deliver a continuous basal rate of pain medication to maintain pain control. While the goal of PCA is effective pain relief, it does not guarantee a pain-free state. In the case of a 5-year-old child, the parents or nurse can administer boluses if necessary since the child may not fully comprehend using the PCA button. Monitoring every 1 to 2 hours for patient response is adequate and there is no need for monitoring every 15 minutes, as stated in choice D, unless specific circumstances dictate more frequent monitoring.
2. Identification and treatment of cryptorchid testes should be done by age 2 years. What is an important consideration?
- A. Medical therapy is not effective after this age.
- B. Treatment is necessary to maintain the ability to be fertile when older.
- C. The younger child can tolerate the extensive surgery needed.
- D. Sexual reassignment may be necessary if treatment is not successful.
Correct answer: B
Rationale: Early treatment of cryptorchidism is essential to preserve fertility and prevent complications such as testicular cancer. Surgery is usually well-tolerated, and sexual reassignment is not typically related to this condition.
3. According to Maslow’s hierarchy, what is the most advanced need provided by the home environment?
- A. Love
- B. Self-actualization
- C. Esteem
- D. Physiological
Correct answer: B
Rationale: The correct answer is B, self-actualization. Self-actualization is the highest level in Maslow's hierarchy of needs, representing the realization of one's full potential. While love is an essential need, self-actualization builds upon the fulfillment of basic needs like safety and love. Esteem needs relate to feelings of accomplishment and recognition, which come before self-actualization. Physiological needs such as food, water, and shelter are the most basic needs at the bottom of the hierarchy.
4. Parents of a newborn with ambiguous genitalia want to know how long they will have to wait to know whether they have a boy or a girl. The nurse answers the parents based on what knowledge?
- A. Chromosome analysis will be complete in 7 days.
- B. A physical examination will be able to provide a definitive answer.
- C. Additional laboratory testing is necessary to assign the correct gender.
- D. Gender assignment involves collaboration between the parents and a multidisciplinary team.
Correct answer: D
Rationale: Gender assignment in cases of ambiguous genitalia is a complex process that requires a multidisciplinary approach, including genetic, endocrinological, and psychological evaluations. The decision should be made collaboratively with the parents.
5. The nurse is caring for a child with acute renal failure. What laboratory findings should the nurse expect to find? (Select all that apply.)
- A. Hyponatremia
- B. Hyperkalemia
- C. All are applicable
- D. Elevated blood urea nitrogen level
Correct answer: C
Rationale: In acute renal failure, laboratory findings typically include hyperkalemia, hyponatremia, and elevated blood urea nitrogen (BUN) levels due to the kidneys' inability to excrete waste and balance electrolytes. Metabolic alkalosis is less common, with metabolic acidosis being more typical.
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