ATI RN
RN Nursing Care of Children 2019 With NGN
1. A child diagnosed with a soft tissue tumor is being treated with chemotherapy. Prior to administering the chemotherapy, which laboratory test should the nurse monitor to determine if the child has any capability of fighting infections?
- A. Hemoglobin
- B. Red blood cell count
- C. Platelets
- D. Absolute neutrophil count (ANC)
Correct answer: D
Rationale: The Absolute Neutrophil Count (ANC) is crucial for determining the child's ability to fight infections. Neutrophils play a key role in combating bacterial infections. Monitoring the ANC is essential before administering chemotherapy, as a low ANC indicates an increased risk of infection. Hemoglobin, red blood cell count, and platelets are important for assessing oxygen-carrying capacity, anemia, and clotting function, respectively, but they do not directly reflect the child's capability to fight infections.
2. After surgery yesterday for gastroesophageal reflux, the nurse finds that the infant has somehow removed the nasogastric (NG) tube. What nursing action is most appropriate to perform at this time?
- A. Notify the healthcare provider.
- B. Insert a new NG tube for feedings.
- C. Replace the NG tube to maintain gastric decompression.
- D. Leave the NG tube out as it may have been in long enough.
Correct answer: A
Rationale: The most appropriate action for the nurse to take in this situation is to notify the healthcare provider immediately. This is important as the removal of the NG tube can disrupt postoperative care, especially in terms of maintaining gastric decompression. Inserting a new NG tube without practitioner direction can be unsafe and is not within the nurse's scope of practice. Similarly, replacing the NG tube or leaving it out should be decided by the healthcare provider to ensure the infant's safety and appropriate postoperative care.
3. The nurse is conducting a teaching session for parents on nutrition. Which characteristics of families should the nurse consider that can cause families to struggle in providing adequate nutrition? (Select all that apply.)
- A. Homelessness
- B. Lower income
- C. Migrant status
- D. All of the above
Correct answer: D
Rationale: Factors like homelessness, lower income, and migrant status can create barriers to providing adequate nutrition for children.
4. The parents of a child with acute postinfectious glomerulonephritis (APIGN) ask how they will know that the condition is improving. How should the nurse respond?
- A. Your child’s urine output will increase, and the urine will become less brown in color.
- B. Your child will rest more comfortably.
- C. Your child’s appetite will decrease.
- D. Your child’s laboratory test values will show increased BUN.
Correct answer: A
Rationale: Improvement in APIGN is indicated by an increase in urine output and a change in urine color from brown (due to hematuria) to a more normal appearance. This reflects a reduction in glomerular inflammation and improved kidney function. Choice B is incorrect because resting more comfortably is not a direct indicator of kidney function improvement. Choice C is incorrect because a decrease in appetite is not typically associated with improvement in APIGN. Choice D is incorrect because an increased BUN value would suggest worsening kidney function rather than improvement.
5. Urinary tract anomalies are frequently associated with what irregularities in fetal development?
- A. Myelomeningocele
- B. Cardiovascular anomalies
- C. Malformed or low-set ears
- D. Defects in lower extremities
Correct answer: C
Rationale: Malformed or low-set ears are often associated with congenital urinary tract anomalies, as both the ears and kidneys develop around the same time during fetal growth. Myelomeningocele, cardiovascular anomalies, and lower extremity defects are less commonly associated with UT anomalies.
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