ATI RN
RN Nursing Care of Children Online Practice 2019 A
1. Following treatment for iron deficiency anemia, the physician orders lab tests. Which lab value would indicate an improvement in the child’s condition?
- A. Low hemoglobin
- B. Normal platelet count
- C. High reticulocyte count
- D. Low hematocrit
Correct answer: C
Rationale: A high reticulocyte count indicates that the bone marrow is producing more red blood cells, which is a sign of recovery from anemia as the body replenishes its iron stores and increases hemoglobin levels. Low hemoglobin (Choice A) would indicate ongoing anemia rather than improvement. A normal platelet count (Choice B) and low hematocrit (Choice D) are not specific indicators of improvement in iron deficiency anemia.
2. The nurse is caring for an infant who was born 24 hr ago to a mother who received no prenatal care. The infant is a poor feeder but sucks avidly on his hands. Clinical manifestations also include hyperactive reflexes, tremors, sneezing, and a high-pitched shrill cry. What does the nurse consider as a possible diagnosis for this infant?
- A. Seizure disorder
- B. Narcotic withdrawal
- C. Placental insufficiency
- D. Meconium aspiration syndrome
Correct answer: B
Rationale: In this case, the infant's symptoms are consistent with narcotic withdrawal. Infants exposed to drugs in utero may display withdrawal symptoms starting around 12 to 24 hours post-birth. The presentation often includes hyperactive reflexes, tremors, sneezing, high-pitched shrill cry, poor feeding, and sucking avidly on hands. Signs such as loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating are common. These symptoms are not indicative of a seizure disorder. Placental insufficiency typically leads to a small-for-gestational-age child, which is not mentioned in the scenario. Meconium aspiration syndrome primarily presents with respiratory distress, not the symptoms described in this case.
3. When teaching a discipline class for parents of pre-schoolers, the nurse will be guided by which principle?
- A. Using the strictest form of punishment at the time of infraction is most effective
- B. Punishment increases unwanted behavior
- C. Discipline is to teach and gradually shift control from parents to child, promoting self-discipline
- D. Discipline and punishment are the same
Correct answer: C
Rationale: The correct principle to guide the nurse when teaching a discipline class for parents of pre-schoolers is that discipline is meant to teach and gradually shift control from parents to the child, promoting self-discipline. This approach focuses on educating children on appropriate behavior rather than solely relying on punishment. Choice A is incorrect because using the strictest punishment is not the most effective method for discipline. Choice B is incorrect because punishment can reinforce unwanted behavior if not used appropriately. Choice D is incorrect because discipline and punishment are not synonymous; discipline involves a broader aspect of teaching and guiding behavior.
4. Why are neonates predisposed to problems with thermoregulation?
- A. Renal function is not fully developed.
- B. Flexed posture favors heat loss.
- C. A large body surface area favors heat loss to the environment.
- D. A thick layer of subcutaneous fat provides excellent insulation.
Correct answer: C
Rationale: Neonates have a large surface area relative to their weight, which makes them prone to heat loss to the environment, leading to thermoregulation issues. The underdeveloped kidney affecting urine concentration (Choice A) is unrelated to the thermal regulation process. While a flexed posture can help retain heat (Choice B), it does not outweigh the impact of the large body surface area in neonates. Although subcutaneous fat (Choice D) provides insulation, in neonates, the large body surface area is more significant in contributing to heat loss than the fat's insulating properties.
5. Ongoing fluid losses can overwhelm the child’s ability to compensate, resulting in shock. What early clinical sign precedes shock?
- A. Tachycardia
- B. Slow respirations
- C. Warm, flushed skin
- D. Decreased blood pressure
Correct answer: A
Rationale: Tachycardia is an early sign of shock as the body tries to maintain cardiac output in the face of declining circulatory volume. Blood pressure often remains normal until late in the progression, at which point decompensated shock is occurring.