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. What is the required number of milliliters of fluid needed per day for a 14-kg child?
- A. 800
- B. 1000
- C. 1200
- D. 1400
Correct answer: D
Rationale: The fluid requirement for a 14-kg child is approximately 100 mL/kg/day, so for a 14-kg child, the requirement is around 1400 mL/day.
3. The nurse is discussing parenting in reconstituted families with a new stepparent. The nurse is aware that the new stepparent understands the teaching when which statement is made?
- A. "I am glad there will be no disruption in my lifestyle."
- B. "I don’t think children really want to live in a two-parent home."
- C. "I realize there may be power conflicts bringing two households together."
- D. "I understand contact between grandparents should be kept to a minimum."
Correct answer: C
Rationale: Recognizing the potential for power conflicts when blending two households indicates an understanding of the complexities in reconstituted families.
4. What is the recommended position for a child after a tonsillectomy?
- A. Supine
- B. Prone
- C. Side-lying
- D. Fowler's position
Correct answer: C
Rationale: The correct answer is C: Side-lying. The side-lying position is recommended after a tonsillectomy to facilitate drainage of secretions and reduce the risk of aspiration. This position helps prevent blood from pooling in the back of the throat, decreasing the chance of bleeding postoperatively. Supine (lying face up), while commonly used in other situations, may not be ideal immediately after a tonsillectomy due to the risk of airway obstruction from blood clots. Prone (lying face down) is not recommended as it can hinder breathing and increase the risk of complications. Fowler's position (semi-sitting) is also not typically used after a tonsillectomy because it may cause discomfort and hinder proper drainage.
5. A parent calls the hospital nursing hotline and asks, 'My 8-week-old infant cries 8 hours a day, and is hard to console. Is that normal?' What should the nurse's response be to this parent?
- A. No, call your health care provider.
- B. Let me ask you some more questions to see if there are symptoms of colic.
- C. Yes, maybe your infant is just tired.
- D. Yes, infants cry all the time at that age.
Correct answer: B
Rationale: The correct response for the nurse to provide in this situation is to ask more questions to determine if the infant is displaying symptoms of colic. Colic is a common condition in infants that can lead to prolonged crying and fussiness. It is essential to assess for other symptoms before giving advice to the parent. Choices A, C, and D are incorrect because they do not address the possibility of colic or the need for further assessment of the infant's condition.
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