ATI RN
ATI Nursing Care of Children 2019 B
1. A child with pyloric stenosis is having excessive vomiting. The nurse should assess for what potential complication?
- A. Hyperkalemia
- B. Hyperchloremia
- C. Metabolic acidosis
- D. Metabolic alkalosis
Correct answer: D
Rationale: Excessive vomiting in pyloric stenosis leads to the loss of stomach acid (hydrochloric acid), resulting in metabolic alkalosis, not hyperkalemia, hyperchloremia, or metabolic acidosis. Metabolic alkalosis is characterized by a higher pH level in the blood due to the loss of acid and a relative increase in bicarbonate. Hyperkalemia is an elevated level of potassium in the blood and is not directly related to excessive vomiting in pyloric stenosis. Hyperchloremia is an excess of chloride in the blood, which is not typically associated with this condition. Metabolic acidosis is a condition characterized by a lower pH level in the blood, caused by an excess of acid or a loss of bicarbonate, which is not the typical complication seen in pyloric stenosis with excessive vomiting.
2. The LPN is caring for a 1-month-old patient post-surgery. Which pain scale is expected to be used to evaluate post-op pain?
- A. Oucher
- B. Wong-Baker FACES
- C. FLACC
- D. 0-10 pain scale
Correct answer: C
Rationale: The FLACC (Face, Legs, Activity, Cry, Consolability) scale is commonly used to assess pain in infants and young children who are unable to verbally communicate their pain. This scale is particularly useful in assessing post-operative pain in infants as it evaluates different behaviors and physiological responses to pain. The Oucher scale is more commonly used with children who are older and can provide self-report of pain intensity. Wong-Baker FACES scale is primarily used with children who are older and can indicate their pain level by pointing to facial expressions. The 0-10 pain scale is typically used with older children and adults who can rate their pain on a numerical scale.
3. Which muscle is contraindicated for the administration of immunizations in infants and young children?
- A. Deltoid
- B. Dorsogluteal
- C. Ventrogluteal
- D. Anterolateral thigh
Correct answer: B
Rationale: The dorsogluteal muscle is contraindicated for immunizations in infants and young children due to the risk of injury to the sciatic nerve. The anterolateral thigh is the preferred site.
4. In pediatric patients, what is the primary concern with untreated vesicoureteral reflux (VUR)?
- A. Recurrent UTIs
- B. Chronic renal failure
- C. Hypertension
- D. Bladder dysfunction
Correct answer: B
Rationale: The primary concern with untreated vesicoureteral reflux (VUR) in pediatric patients is chronic renal failure. Untreated VUR can lead to this complication due to recurrent urinary tract infections and kidney damage. While recurrent UTIs (Choice A) are a common consequence of VUR, the ultimate worry is the development of chronic renal failure. Hypertension (Choice C) may occur as a result of renal damage but is not the primary concern. Bladder dysfunction (Choice D) is not the most significant consequence of untreated VUR in terms of long-term outcomes compared to chronic renal failure.
5. What is an approximate method of estimating output for a child who is not toilet trained?
- A. Have parents estimate output.
- B. Weigh diapers after each void.
- C. Place a urine collection device on the child.
- D. Have the child sit on a potty chair 30 minutes after eating.
Correct answer: B
Rationale: Weighing diapers is the most accurate way to estimate urine output in a child who is not toilet trained. This method provides a measurable and reliable estimate of fluid output.
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