ATI RN
Nursing Care of Children Final ATI
1. A child is admitted with renal failure. Which of these findings should the nurse expect?
- A. Decreased BUN
- B. Azotemia and oliguria
- C. Increased glomerular filtration rate (GFR)
- D. Polyuria and elevated creatinine clearance
Correct answer: B
Rationale: Azotemia (elevated BUN and creatinine) and oliguria (reduced urine output) are classic signs of renal failure, indicating impaired kidney function. In renal failure, the kidneys are unable to effectively filter waste products, leading to an increase in BUN and creatinine levels in the blood. Additionally, oliguria occurs due to decreased kidney function. Increased GFR (Choice C) is not expected in renal failure as it signifies improved kidney function, which is not the case in renal failure. Polyuria and elevated creatinine clearance (Choice D) are not typical findings in renal failure. Polyuria is more commonly associated with conditions like diabetes insipidus, while elevated creatinine clearance would indicate increased kidney function, which is contrary to the impaired function seen in renal failure.
2. After working at your job for 10 months and feeling unable to tolerate the tension and stress between staff nurses and the laissez-faire nurse manager who is not a leader, what is the best course of action?
- A. Submit a resignation and leave within 30 days.
- B. Complain to staff about the nurse manager.
- C. Seek another position within the healthcare organization and apply for a transfer.
- D. Inform the chief nursing officer that you are leaving and explain your dissatisfaction with the lack of leadership.
Correct answer: C
Rationale: In this situation, it is best to seek another position within the healthcare organization and apply for a transfer. Making professional decisions should involve careful evaluation and consideration. It is important to align personal values with the organizational culture. By seeking advice from a mentor or counselor, you can gain valuable insights and consider different perspectives. Resigning abruptly, complaining to staff, or informing the chief nursing officer without exploring other options may not be the most effective or professional approach in this scenario.
3. The nurse is caring for a child with hypernatremia. The nurse evaluates the child for which signs and symptoms of hypernatremia? (Select all that apply.)
- A. All below
- B. Lethargy
- C. Oliguria
- D. Intense thirst
Correct answer: A
Rationale: Hypernatremia typically presents with lethargy, oliguria, and intense thirst due to the body's attempt to conserve water. Apathy can also occur, but lethargy and thirst are more consistent indicators.
4. A nurse is preparing to administer a unit of packed RBCs to a client. Which of the following actions should the nurse take?
- A. Prime the IV tubing with 0.9% sodium chloride.
- B. Verify the client's blood type and Rh factor.
- C. Administer the blood over 8 hours.
- D. Use a 22-gauge needle for venous access.
Correct answer: B
Rationale: The correct answer is to verify the client's blood type and Rh factor. This action is crucial to ensure that the correct blood is administered, matching the client's blood type and Rh factor, which helps prevent transfusion reactions. Priming the IV tubing with 0.9% sodium chloride (Choice A) is not directly related to ensuring the correct blood product is administered. Administering the blood over 8 hours (Choice C) is not the standard practice for packed RBCs, which are usually given over a shorter period. Using a 22-gauge needle for venous access (Choice D) is not specific to the preparation for administering packed RBCs.
5. A patient with a urinary tract infection (UTI) requires treatment. What is the most appropriate intervention?
- A. Encourage the patient to increase fluid intake.
- B. Administer antibiotics as prescribed.
- C. Recommend the patient take over-the-counter pain relievers.
- D. Encourage the patient to limit physical activity.
Correct answer: B
Rationale: The correct answer is to administer antibiotics as prescribed. Antibiotics are the primary treatment for urinary tract infections as they help eliminate the bacteria causing the infection. Encouraging the patient to increase fluid intake (Choice A) is a supportive measure to help flush out the bacteria but doesn't directly treat the infection. Over-the-counter pain relievers (Choice C) may help with discomfort but do not address the underlying infection. Limiting physical activity (Choice D) may be recommended for some conditions but is not the primary intervention for treating a UTI.