ATI RN
RN Nursing Care of Children Online Practice 2019 A
1. Nurses should be alert for increased fluid requirements in which circumstance?
- A. Fever
- B. Mechanical ventilation
- C. Congestive heart failure
- D. Increased intracranial pressure
Correct answer: A
Rationale: Fever increases metabolic rate, leading to insensible water loss, thus requiring increased fluid intake. Mechanical ventilation, CHF, and increased intracranial pressure generally require fluid restriction rather than increased fluid intake.
2. According to Erikson, when parents are over- or undercontrolling, the outcome is a child who __________.
- A. feels forced and shamed
- B. acts competently on his own
- C. asserts his independence
- D. feels self-confident
Correct answer: A
Rationale: According to Erikson, when parents are over- or undercontrolling, the outcome is a child who feels forced and shamed. This is because overly controlling parents can make the child feel inadequate, leading to a sense of shame and doubt. Choice B, 'acts competently on his own,' is incorrect because overcontrolling parents hinder the child's ability to act independently. Choice C, 'asserts his independence,' is incorrect because overcontrolling parents can actually suppress the child's independence. Choice D, 'feels self-confident,' is incorrect because overcontrolling parenting can undermine the child's confidence and lead to feelings of inadequacy.
3. Which sign is indicative of developmental dysplasia of the hip in infants?
- A. Ortolani sign
- B. Romberg sign
- C. Trendelenburg sign
- D. Gower's sign
Correct answer: A
Rationale: The Ortolani sign is a specific maneuver used during physical examination to detect hip instability or dislocation in infants. A positive Ortolani sign, where the hip is felt to slip back into the socket, is indicative of developmental dysplasia of the hip, a condition that can lead to long-term disability if not treated early. Romberg sign is used to assess sensory ataxia, Trendelenburg sign indicates weakness of the hip abductor muscles, and Gower's sign is seen in children with proximal muscle weakness climbing up their own body from a supine position due to conditions like muscular dystrophy.
4. A woman has been prescribed Climara, a transdermal estradiol patch. Which of the following should she be instructed by the nurse regarding the administration?
- A. Avoid prolonged sun exposure at the patch site due to increased plasma concentrations.
- B. The application of heat at the patch site will decrease effectiveness and result in pregnancy.
- C. The medication, when exposed to sunlight, can increase the risk of breast cancer.
- D. Exposure of the medication to occasional cold will increase effectiveness with application.
Correct answer: A
Rationale: The correct answer is A. The Climara patch delivers estradiol transdermally, and patients should be instructed to avoid prolonged sun exposure at the patch site due to increased plasma concentrations. Sun exposure can accelerate the absorption of the medication, leading to higher systemic levels than intended. Choices B, C, and D are incorrect because heat at the patch site does not result in pregnancy but may alter absorption rates, there is no direct link between sunlight exposure and breast cancer risk related to this medication, and exposure to cold does not increase effectiveness of the transdermal patch.
5. Prior to performing percussion, vibration, and postural drainage on an adolescent client with pneumonia, which of the following nursing actions should the nurse complete first?
- A. Auscultate lung fields
- B. Assess pulse and respirations
- C. Assess characteristics of the sputum
- D. Instruct the client to slowly exhale with pursed lips
Correct answer: Auscultate lung fields
Rationale: Before initiating percussion, vibration, and postural drainage, the nurse should first auscultate the lung fields to assess the baseline lung sounds and identify areas of congestion or abnormality. This initial assessment helps the nurse to tailor the percussion and drainage techniques effectively. Assessing pulse and respirations, sputum characteristics, and providing instructions to the client for exhalation are important steps in the procedure but should follow the initial auscultation to ensure a comprehensive and individualized care approach.
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