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RN Nursing Care of Children Online Practice 2019 A
1. Physiologically, the child compensates for fluid volume losses by which mechanism?
- A. Inhibition of aldosterone secretion
- B. Hemoconcentration to reduce cardiac workload
- C. Fluid shift from interstitial space to intravascular space
- D. Vasodilation of peripheral arterioles to increase perfusion
Correct answer: C
Rationale: In response to dehydration, the body compensates by shifting fluids from the interstitial spaces to the intravascular space to maintain blood pressure and perfusion to vital organs. Hemoconcentration and vasoconstriction are other compensatory mechanisms but are less immediate.
2. An infant has been diagnosed with bladder obstruction. What do symptoms of this disorder include?
- A. Renal colic
- B. Strong urinary stream
- C. Urinary tract infections
- D. Post urination dribbling
Correct answer: D
Rationale: Post-urination dribbling is a symptom of bladder obstruction due to the incomplete emptying of the bladder. A strong urinary stream is typically absent in such cases. UTIs are common, but dribbling is more directly related to the obstruction.
3. A 12-month-old child presents to the clinic for a well visit after missing several appointments. The child began her immunization schedule but has missed several follow-up appointments and doses of immunizations. What is the most appropriate nursing intervention?
- A. Administer initial immunizations from the beginning of the schedule.
- B. The child cannot receive missed immunizations if the schedule is not followed and will not be vaccinated.
- C. The child should only receive the missed doses of immunizations based on the catch-up schedule.
- D. The child should receive double-strength immunizations at this well visit.
Correct answer: C
Rationale: Children who began primary immunization at the recommended age but fail to receive all the doses do not need to begin the series again but should receive only the missed doses. The child may receive missed vaccinations on a catch-up schedule per CDC guidelines.
4. What should preoperative care of a newborn with an anorectal malformation include?
- A. Frequent suctioning
- B. Gastrointestinal decompression
- C. Feedings with sterile water only
- D. Supine position with head elevated
Correct answer: C
Rationale: Preoperative care for a newborn with an anorectal malformation should include feedings with sterile water only. This approach is important to avoid complications before surgery. Gastrointestinal decompression is necessary to prevent abdominal distention and potential aspiration, making choice B incorrect. Frequent suctioning and placing the newborn in a supine position with the head elevated are not typically part of the preoperative care protocol for an anorectal malformation, thus choices A and D are incorrect.
5. The nurse is discussing development and play activities with the parent of a 2-month-old boy. Which statement by the parent would indicate a correct understanding of the teaching?
- A. I can give my baby a ball of yarn to pull apart or different textured fabrics to feel
- B. I can use a music box and soft mobiles as appropriate play activities for my baby
- C. I should introduce a cup and spoon or push-pull toys for my baby at this age
- D. I do not have to worry about appropriate play activities at this age
Correct answer: B
Rationale: At 2 months, infants are most stimulated by visual and auditory activities, such as a music box or soft mobiles. These activities help in sensory development and are appropriate for this age.
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