ATI RN
Human Growth and Development Exam 1
1. When Mateo was born prematurely to Yvonne, a cocaine addict, what can his caregivers expect?
- A. He will be very attentive to the environment
- B. His cries will be abnormally shrill and piercing
- C. He will overcome the harmful effects of drug exposure by age 3
- D. His motor development will be especially rapid during the first year
Correct answer: B
Rationale: Mateo, being born prematurely to a cocaine-addicted mother, is at risk for several health issues. One common effect of prenatal drug exposure is a higher likelihood of sensory and regulatory problems, such as having abnormally shrill and piercing cries. This is a potential outcome that Mateo's caregivers can expect due to his circumstances. Choice A is incorrect as there is no direct correlation between being born prematurely to a cocaine-addicted mother and being very attentive to the environment. Choice C is incorrect as overcoming harmful effects of drug exposure by age 3 is overly optimistic and may not be the case for all children exposed to drugs prenatally. Choice D is incorrect as rapid motor development is not typically associated with prenatal drug exposure.
2. A patient who had a total hip replacement had an intraoperative hemorrhage 14 hours ago. Which laboratory test result would the nurse expect?
- A. Hematocrit of 46%
- B. Hemoglobin of 13.8 g/dL
- C. Elevated reticulocyte count
- D. Decreased white blood cell (WBC) count
Correct answer: C
Rationale: The correct answer is C: Elevated reticulocyte count. Hemorrhage leads to the release of reticulocytes (immature red blood cells) from the bone marrow into circulation as a compensatory mechanism to replenish lost red blood cells. This response helps in restoring the oxygen-carrying capacity of the blood. Choices A and B, hematocrit of 46% and hemoglobin of 13.8 g/dL, may not reflect the immediate response to hemorrhage within 14 hours. Choice D, decreased white blood cell (WBC) count, is not directly related to the body's response to hemorrhage.
3. The client is on dobutamine. Adverse effects of Dobutrex (dobutamine) include the following: Select all that apply.
- A. Heart failure
- B. Bradycardia
- C. Tachycardia
- D. Respiratory distress
Correct answer: C
Rationale: The correct answer is C: Tachycardia. Dobutamine is a medication that primarily increases heart rate (tachycardia) and blood pressure. Therefore, the adverse effects of dobutamine include tachycardia. Choices A, B, and D are incorrect. Heart failure is not an adverse effect of dobutamine; in fact, it is used to treat heart failure by increasing heart contractility. Bradycardia (slow heart rate) is not an expected adverse effect of dobutamine, as it usually increases heart rate. Respiratory distress is not a common adverse effect of dobutamine.
4. A client is receiving intermittent tube feedings and is at risk for aspiration. What should the nurse identify as a risk factor?
- A. A residual of 65mL 1 hour postprandial.
- B. History of gastroesophageal reflux disease.
- C. Receiving a high-osmolarity formula.
- D. Receiving a feeding in a supine position.
Correct answer: B
Rationale: The correct answer is B: History of gastroesophageal reflux disease. Gastroesophageal reflux disease increases the risk of aspiration due to the potential for regurgitation of stomach contents into the esophagus and airways. Choices A, C, and D are not directly related to an increased risk of aspiration. A residual of 65mL 1 hour postprandial may indicate delayed gastric emptying but is not a direct risk factor for aspiration. Receiving a high-osmolarity formula or receiving a feeding in a supine position are not specific risk factors for aspiration unless they contribute to reflux or other related issues.
5. The nurse notes that the fall might also cause a possible head injury. The patient will be observed for signs of increased intracranial pressure which include:
- A. Narrowing of the pulse pressure
- B. Vomiting
- C. Periorbital edema
- D. A positive Kernig's sign
Correct answer: C
Rationale: Periorbital edema is a sign of increased intracranial pressure. It is caused by fluid accumulation around the eyes due to compromised drainage. Narrowing of the pulse pressure is more indicative of shock than increased intracranial pressure. While vomiting can be a sign of increased intracranial pressure, it is not as specific as periorbital edema. A positive Kernig's sign is associated with meningitis, not increased intracranial pressure.
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