ATI RN
RN Nursing Care of Children 2019 With NGN
1. During a well-child checkup, the parent of a 5-year-old child reports the child seems much smaller than the 2 older siblings did at this same age. A review of the medical record reveals that the child is 44 inches tall and weighs 42 pounds. What information should be included in the response by the nurse?
- A. The weight of your child at this time is within normal limits for this age but the child is moderately taller than other children this age.
- B. Your child is within the acceptable range for height but the child is significantly smaller in weight for this age.
- C. Your child is within normal limits for weight but the child is slightly shorter in stature than other children this age.
- D. Your child is slightly taller than other children this age but the child’s weight is normal.
Correct answer: D
Rationale: The correct answer is D. The child is slightly taller than average, but the weight is within normal limits. This information should be reassuring to the parent and provides insights into normal growth patterns. Choice A is incorrect as it inaccurately states that the child is taller than other children this age. Choice B is incorrect because the child's weight is actually within normal limits. Choice C is incorrect as it inaccurately states that the child is shorter in stature than other children this age.
2. A nurse is preparing to perform a bladder scan for a client who has overflow incontinence. Which of the following actions should the nurse take?
- A. Place the client in a supine position.
- B. Obtain a prescription for insertion of an indwelling catheter.
- C. Cleanse the client's abdomen with an antiseptic solution.
- D. Prepare the client for urinary catheterization.
Correct answer: D
Rationale: The correct answer is to prepare the client for urinary catheterization. Overflow incontinence may indicate bladder distention, where a bladder scan helps assess the need for catheterization. Placing the client in a supine position (Choice A) is not directly related to the procedure. Obtaining a prescription for an indwelling catheter (Choice B) is not necessary before performing a bladder scan. Cleansing the client's abdomen with an antiseptic solution (Choice C) is not specific to preparing for a bladder scan in this situation.
3. The early stages of atheroma development are characterized by:
- A. macrophages full of oxidized low-density lipoprotein (LDL; i.e., foam cells) in the intima
- B. accumulation of lipids in the intima (i.e., fatty streak)
- C. accumulation of proteins such as collagen and elastin (i.e., fibrous cap)
- D. development of calcium and a necrotic lipid core
Correct answer: macrophages full of oxidized low-density lipoprotein (LDL; i.e., foam cells) in the intima
Rationale: The correct answer is A. In the early stages of atheroma development, macrophages accumulate oxidized low-density lipoprotein (LDL) and transform into foam cells, leading to the formation of fatty streaks in the intima of blood vessels. This process is a hallmark of the initial stages of atherosclerosis. Choice B is incorrect as it describes the accumulation of lipids in the intima, which is a later event following foam cell formation. Choice C is also incorrect as it refers to the accumulation of proteins forming the fibrous cap, which occurs at a later stage to stabilize the atheroma. Choice D is incorrect as it describes the development of calcium and a necrotic lipid core, typically seen in advanced atherosclerosis rather than the early stages.
4. A nurse is teaching a client who has a new prescription for Atenolol. Which of the following adverse effects should the nurse instruct the client to monitor?
- A. Tachycardia
- B. Hypoglycemia
- C. Bradycardia
- D. Hypertension
Correct answer: C
Rationale: Atenolol is a beta-blocker that can cause bradycardia as an adverse effect. The client should monitor their pulse regularly and report any significant decreases.
5. The belief that effort will lead to a specific performance level in an individual is known as:
- A. Rewards.
- B. Expectancy.
- C. Valence.
- D. Instrumentality.
Correct answer: B
Rationale: The correct answer is B: Expectancy. Expectancy refers to the perceived probability that effort will lead to a specific performance level. This aligns with the concept of expectancy theory in psychology, which emphasizes the importance of individuals' beliefs regarding the link between effort and outcomes. Choices A, C, and D are incorrect. Rewards (choice A) typically refer to incentives given after achieving a goal, valence (choice C) is the value a person places on a particular outcome, and instrumentality (choice D) is the belief that a particular outcome is contingent on achieving a specific level of performance.