ATI RN
ATI Nursing Care of Children 2019 B
1. One of the major differences in clinical presentation between Crohn disease (CD) and ulcerative colitis (UC) is that UC is more likely to cause which clinical manifestation?
- A. Pain
- B. Rectal bleeding
- C. Perianal lesions
- D. Growth retardation
Correct answer: B
Rationale: Rectal bleeding is more commonly associated with ulcerative colitis (UC) than with Crohn disease (CD). While both conditions can cause abdominal pain and growth issues, bleeding is a hallmark of UC due to its superficial mucosal inflammation. Perianal lesions are more characteristic of CD, and growth retardation is typically not a direct clinical manifestation of either CD or UC.
2. A child with acetaminophen (Tylenol) poisoning has been admitted to the emergency department. What antidote does the nurse anticipate being prescribed?
- A. Carnitine (Carnitor)
- B. Fomepizole (Antizol)
- C. Deferoxamine (Desferal)
- D. N-acetylcysteine (Mucomyst)
Correct answer: D
Rationale: N-acetylcysteine is the specific antidote for acetaminophen poisoning, working by replenishing glutathione and preventing liver damage. The other options are antidotes for different types of poisoning (e.g., Fomepizole for methanol or ethylene glycol poisoning).
3. The nurse is admitting a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the doctor to order initially to replace fluids?
- A. 0.9% normal saline
- B. D5 0.2% (1/4) normal saline
- C. D5W
- D. Albumin
Correct answer: A
Rationale: In the case of severe isotonic dehydration, the initial fluid of choice is 0.9% normal saline. This solution is preferred because it helps to restore both fluids and electrolytes effectively. Options B, C, and D are not suitable for the initial management of severe isotonic dehydration. D5 0.2% (1/4) normal saline (Choice B) is a hypotonic solution and might worsen the imbalance. D5W (Choice C) is a hypotonic solution that does not contain electrolytes essential for rehydration. Albumin (Choice D) is a colloid solution used for specific indications like hypoproteinemia or hypoalbuminemia, not for initial rehydration in severe dehydration.
4. When planning care for a child with a urinary tract infection, the nurse should give priority to which treatment measure?
- A. Provide adequate nutrition to prevent dehydration.
- B. Administer ordered antibiotics on schedule.
- C. Prevent enuresis.
- D. Restrict fluid.
Correct answer: B
Rationale: Administering antibiotics on schedule is crucial in treating a UTI effectively and preventing complications. Antibiotics help to eliminate the infection-causing bacteria from the urinary tract. While maintaining adequate nutrition and hydration are important aspects of care, the priority in a UTI is to target the infection with antibiotics. Preventing enuresis (bedwetting) is not directly related to the treatment of the infection. Fluid restriction is not recommended in the management of a UTI; in fact, encouraging adequate fluid intake helps flush out bacteria from the urinary tract.
5. What is the most consistent and commonly used indicator of pain in infants?
- A. Increased respirations
- B. Increased heart rate
- C. Thrashing of arms and legs
- D. Facial expression of discomfort
Correct answer: D
Rationale: Facial expression has consistently been validated as an indicator of pain in infants. Behavioral pain measures are most reliable for sharp procedural pain in infants. Increased heart rate and respirations are indicative of a generalized and complex response to stress, not specific for pain in infants. Thrashing of arms and legs is a reliable indicator in young children, not specifically in infants.
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