ATI RN
RN Nursing Care of Children 2019 With NGN
1. The mother of a child with type 1 diabetes asks the nurse why her child cannot avoid all those ‘shots’ and take pills like an uncle does. How should the nurse respond?
- A. The pills work with adult pancreases only.
- B. Your child needs insulin replaced, and the oral hypoglycemic only add to an existing supply of insulin.
- C. The drugs affect fat and protein metabolism, not sugar.
- D. Perhaps when your child is older the pancreas will produce its own insulin, and then your child can take oral hypoglycemic agents.
Correct answer: B
Rationale: The correct answer is B. Children with type 1 diabetes require insulin replacement because their pancreas produces little or no insulin. Oral hypoglycemics used in type 2 diabetes work by improving the effectiveness of insulin the body already makes, which is not sufficient in type 1 diabetes. Choice A is incorrect because the issue is not about the pancreas being adult or child-specific but rather the type of diabetes. Choice C is incorrect because it misstates the mechanism of action of the medications. Choice D is incorrect because it provides inaccurate information about the potential for the child's pancreas to produce insulin in the future, which is unlikely in type 1 diabetes.
2. What condition is the most common cause of acute renal failure in children?
- A. Pyelonephritis
- B. Tubular destruction
- C. Severe dehydration
- D. Upper tract obstruction
Correct answer: C
Rationale: Severe dehydration is the most common cause of acute renal failure in children, as it leads to prerenal azotemia, which can progress to renal failure if not corrected. Other causes like pyelonephritis and tubular destruction are less common and usually secondary to other conditions.
3. What statement is descriptive of renal transplantation in children?
- A. It is an acceptable means of treatment after age 10 years.
- B. Children can receive kidneys only from other children.
- C. It is the preferred means of renal replacement therapy in children.
- D. The decision for transplantation is difficult because a relatively normal lifestyle is not possible.
Correct answer: C
Rationale: Renal transplantation is the preferred method of treatment for children with end-stage renal disease, as it offers the best chance for a normal lifestyle compared to long-term dialysis. Transplantation can be performed at any age, and kidneys can come from adult donors as well.
4. The nurse is performing an oral examination on a preschool child. Which strategies should the nurse use to encourage the child to open the mouth for the examination? (Select all that apply.)
- A. Lightly brush the palate with a cotton swab
- B. Perform the examination in front of a mirror
- C. Let the child examine someone else's mouth first
- D. All of the above
Correct answer: D
Rationale: Using a cotton swab, allowing the child to observe, and demonstrating on someone else are effective ways to encourage a preschooler to open their mouth for examination.
5. What changes could the school nurse implement at the school to help reduce students’ risk for developing type 2 diabetes?
- A. Increase the amount of daily physical activity.
- B. Decrease the amount of daily physical activity.
- C. Test each child’s urine monthly.
- D. Teach parents to avoid administering aspirin to their child.
Correct answer: A
Rationale: Increasing physical activity helps improve insulin sensitivity and can prevent or delay the onset of type 2 diabetes in children. Regular physical activity is a key component in managing weight and reducing the risk of chronic diseases. Decreasing physical activity (Choice B) would not be beneficial in reducing the risk of type 2 diabetes. Testing each child’s urine monthly (Choice C) is not directly related to preventing type 2 diabetes. Teaching parents to avoid administering aspirin to their child (Choice D) is important for Reye's syndrome prevention but not directly related to reducing the risk of type 2 diabetes.