ATI RN
RN Nursing Care of Children 2019 With NGN
1. A 12-year-old girl has recently begun menstruating and is well into puberty. The child is visiting the health care provider today for a routine physical examination. Which finding should cause concern in the nurse?
- A. Breasts of slightly different sizes
- B. Irregular periods
- C. Vulvar irritation
- D. Supernumerary nipple
Correct answer: C
Rationale: Vulvar irritation may indicate an infection or other issues and should be further evaluated. In a pubescent girl, breasts of slightly different sizes and irregular periods are common variations of normal development. Supernumerary nipple, an extra nipple, is a benign condition that is not typically concerning during puberty.
2. A client with heart failure is prescribed furosemide 20 mg PO twice daily. Which of the following instructions should the nurse include during discharge teaching?
- A. Monitor for increased blood pressure
- B. Increase intake of high-potassium foods
- C. Expect an increase in swelling in the hands and feet
- D. Take the second dose at bedtime
Correct answer: B
Rationale: The correct answer is to instruct the client to increase their intake of high-potassium foods. Furosemide can lead to hypokalemia, a condition of low potassium levels in the blood. Increasing the consumption of high-potassium foods helps prevent this adverse effect. Monitoring for increased blood pressure (choice A) is not directly related to furosemide use. Expecting an increase in swelling (choice C) is incorrect as furosemide is a diuretic that helps reduce swelling. Taking the second dose at bedtime (choice D) is not necessary unless prescribed by the healthcare provider.
3. Which of the following describes the damage to the brain that results in cerebral palsy?
- A. Reversible with cognitive therapy in infancy
- B. Transient and resolves in adulthood through physical therapy
- C. Manifests in adulthood after regular childhood activities
- D. Irreversible and occurs before, during, or after birth or infancy
Correct answer: D
Rationale: The correct answer is D. Cerebral palsy involves irreversible damage to the brain that occurs before, during, or shortly after birth, impacting movement and coordination. Choices A, B, and C are incorrect because cerebral palsy is not reversible with cognitive therapy or physical therapy, does not resolve in adulthood, and does not manifest in adulthood after regular childhood activities.
4. Which of the following drugs has a therapeutic effect that increases cardiac output and slows heart rate?
- A. Heparin
- B. Alprazolam
- C. Digoxin
- D. Levothyroxine
Correct answer: C
Rationale: Digoxin is the correct answer. It is a medication known for its positive inotropic effects, which increase cardiac output, and negative chronotropic effects, which slow the heart rate. These effects are achieved by inhibiting the sodium-potassium ATPase pump in myocardial cells. Therefore, Digoxin is commonly prescribed to manage conditions like heart failure and atrial fibrillation, where enhancing cardiac output and reducing heart rate are beneficial. Choices A, B, and D are incorrect because Heparin is an anticoagulant, Alprazolam is a benzodiazepine used for anxiety disorders, and Levothyroxine is a thyroid hormone replacement drug, none of which have the specified therapeutic effects on cardiac function.
5. How do social determinants impact health?
- A. They directly affect health behaviors and outcomes.
- B. They primarily influence genetic predisposition.
- C. They have minimal impact on overall health.
- D. They determine access to health resources.
Correct answer: A
Rationale: Social determinants play a significant role in impacting health by directly influencing health behaviors and outcomes. These determinants include factors such as socioeconomic status, education, neighborhood, and access to healthcare, which shape the conditions in which individuals live, work, and age, ultimately affecting their health status.