ATI RN
RN Nursing Care of Children 2019 With NGN
1. When should a child receive the first dose of the hepatitis B virus (HBV) vaccine if the mother is hepatitis B surface antigen (HBsAg) negative?
- A. 2 months of age, before hospital discharge.
- B. Birth before discharge from the hospital.
- C. 6 months of age, at the third well-child visit.
- D. No time (this vaccine is not currently recommended).
Correct answer: B
Rationale: If the mother is HBsAg negative, it is recommended that the child receives the first dose of the hepatitis B vaccine at birth before discharge from the hospital. This is to provide early protection against the hepatitis B virus. The second dose of the vaccine is typically given at the first well-child visit, and the third dose is usually administered at a later date. The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention and the Committee on Infectious Diseases of the American Academy of Pediatrics govern the recommendations for immunization, including the hepatitis B virus vaccine. Choice A is incorrect as the first dose should ideally be given at birth. Choice C is incorrect as waiting until 6 months of age may leave the child vulnerable to infection during the early months of life. Choice D is incorrect as the hepatitis B vaccine is recommended for all newborns, especially if the mother is HBsAg negative, to prevent transmission of the virus.
2. Which teaching point should the nurse include when providing education to an adolescent client who participates in soccer regarding the plan of care for diabetes mellitus?
- A. Decreased food intake
- B. Increased doses of insulin
- C. Increased food intake
- D. Decreased doses of insulin
Correct answer: C
Rationale: The correct teaching point the nurse should include is to advise the adolescent client who participates in soccer to increase food intake. Physical activity increases glucose utilization, so adolescents with diabetes need to consume additional carbohydrates to prevent hypoglycemia during and after exercise. Choice A (Decreased food intake) is incorrect because the adolescent needs extra carbohydrates to support the increased physical activity. Choice B (Increased doses of insulin) is incorrect as the focus should be on adjusting food intake rather than insulin doses. Choice D (Decreased doses of insulin) is also incorrect as the insulin doses should be adjusted based on the increased food intake and physical activity level.
3. Which term best describes the sharing of common characteristics that differentiate one group from other groups in a society?
- A. Race
- B. Culture
- C. Ethnicity
- D. Superiority
Correct answer: C
Rationale: Ethnicity refers to the shared characteristics such as nationality, culture, language, and beliefs that differentiate one group from another.
4. The nurse is taking vital signs on a group of assigned preschool-aged children. Which assessment finding would indicate the need for further action?
- A. Respiratory rate of 20 breaths per minute
- B. Heart rate of 89 beats per minute
- C. Heart rate of 120 beats per minute
- D. Respiratory rate of 24 breaths per minute
Correct answer: C
Rationale: A heart rate of 120 beats per minute is high for a preschool-aged child and may indicate an underlying issue that requires further assessment. A respiratory rate of 20 breaths per minute (choice A) is within the normal range for preschool children. Similarly, a heart rate of 89 beats per minute (choice B) falls within the expected range. A respiratory rate of 24 breaths per minute (choice D) is slightly elevated but may not be as concerning as a heart rate of 120 beats per minute.
5. The nurse is caring for a child with Meckel diverticulum. What type of stool does the nurse expect to observe?
- A. Steatorrhea
- B. Clay-colored
- C. Currant jelly-like
- D. Loose stools with undigested food
Correct answer: C
Rationale: Corrected Rationale: Currant jelly-like stools, which contain blood and mucus, are characteristic of Meckel diverticulum. This symptom occurs due to the bleeding from the ectopic gastric mucosa present in the diverticulum. Steatorrhea (choice A) is not typically associated with Meckel diverticulum. Clay-colored stools (choice B) are seen in conditions affecting the biliary system. Loose stools with undigested food (choice D) may indicate malabsorption issues, but it is not specifically linked to Meckel diverticulum.
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