ATI RN
RN Nursing Care of Children 2019 With NGN
1. The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the presenting signs?
- A. Gastrointestinal perforation may have occurred.
- B. The object may have been aspirated.
- C. The object may be lodged in the esophagus.
- D. The object may be embedded in the stomach wall.
Correct answer: C
Rationale: The symptoms of gagging and drooling suggest that the foreign object is likely lodged in the esophagus. This can cause significant discomfort and potential complications, requiring immediate medical evaluation.
2. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. What is the nurse's priority action?
- A. Administering a supplemental dose of hydrocortisone
- B. Instructing the client about coughing and deep breathing
- C. Collecting additional information from the client about his history of Addison's disease
- D. Inserting an indwelling urinary catheter
Correct answer: A
Rationale: The nurse's priority in this situation is to administer a supplemental dose of hydrocortisone. Clients with Addison's disease taking hydrocortisone are at risk of acute adrenal insufficiency during times of stress such as surgery. Administering supplemental doses of hydrocortisone helps prevent acute adrenal insufficiency (adrenal crisis) in these situations, making it the priority action to ensure the client's safety. Instructing the client about coughing and deep breathing is important postoperatively but not the priority at this time. Collecting additional information about the client's history of Addison's disease is important but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority in this situation.
3. A client with tuberculosis is receiving a new prescription for isoniazid (INH). The nurse should instruct the client to report which of the following findings as an adverse effect of the medication?
- A. You might notice yellowing of your skin.
- B. You might experience pain in your joints.
- C. You might notice tingling of your hands.
- D. You might experience loss of appetite.
Correct answer: You might notice tingling of your hands.
Rationale: Tingling of the hands is a common adverse effect of isoniazid (INH) due to its potential to cause peripheral neuropathy. This sensation can be an early sign of nerve damage, and thus, the client should be instructed to report it promptly to the healthcare provider for further evaluation and management.
4. A 30-year-old male was diagnosed with HIV. Which of the following treatments would be most effective?
- A. Reverse transcriptase inhibitors
- B. Protease inhibitors
- C. Entrance inhibitors
- D. Highly active antiretroviral therapy
Correct answer: D
Rationale: The correct answer is D: Highly active antiretroviral therapy (HAART). HAART involves a combination of different classes of antiretroviral drugs, which can effectively suppress the HIV virus, reduce the viral load, and improve the immune function. While choices A, B, and C are also used in HIV treatment, the most effective approach is a combination therapy like HAART due to its ability to target the virus at different stages of its life cycle, reducing the risk of drug resistance and improving treatment outcomes.
5. A healthcare professional is preparing to remove a client’s clogged NG tube prior to re-inserting a new tube. Which of the following actions should the healthcare professional take first?
- A. Assist the client in blowing their nose.
- B. Ask the client to take a deep breath and hold it.
- C. Pinch the proximal end of the tube.
- D. Disconnect the tube from the suction source.
Correct answer: D
Rationale: Correct Answer: Disconnecting the tube from the suction source is the first step in safely removing a clogged NG tube. This action helps prevent any suction-related complications and ensures a smooth transition when removing the tube. Choice A, assisting the client to blow their nose, is not necessary in this situation. Choice B, asking the client to take a deep breath and hold it, is unrelated to the process of removing a clogged NG tube. Choice C, pinching the proximal end of the tube, should only be done after disconnecting the tube from the suction source to prevent the contents from leaking.
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