ATI RN
RN Nursing Care of Children 2019 With NGN
1. The nurse is admitting a 9-year-old child with hemolytic uremic syndrome. What clinical manifestations should the nurse expect to observe? (Select all that apply.)
- A. All are correct
- B. Anorexia
- C. Hypertension
- D. Purpura
Correct answer: A
Rationale: Hemolytic uremic syndrome (HUS) typically presents with hematuria, anorexia, hypertension, and purpura due to the hemolytic anemia, thrombocytopenia, and renal failure that characterize this condition.
2. At which age do most infants begin to fear strangers?
- A. 2 months
- B. 4 months
- C. 6 months
- D. 12 months
Correct answer: C
Rationale: Fear of strangers typically begins around 6 months as infants start recognizing familiar and unfamiliar faces, which is part of their social development.
3. A teen with asthma asks the nurse why it is hard to breathe during an asthma attack. The nurse explains that exposure to a “trigger†results in which of these manifestations?
- A. Bronchodilation, muscle relaxation, and decreased mucus production
- B. Air trapping and hypo-inflation of the alveoli
- C. Air trapping and decreased blood flow to the upper airway
- D. Bronchoconstriction, airway inflammation, and excess mucus production
Correct answer: D
Rationale: The correct answer is D. Asthma triggers cause bronchoconstriction, airway inflammation, and increased mucus production, leading to difficulty breathing. This combination of manifestations results in narrowing of the airways, making it hard for the individual to breathe effectively. Choices A, B, and C are incorrect because during an asthma attack, bronchodilation, muscle relaxation, and decreased mucus production do not occur. Instead, the airways constrict, become inflamed, and produce excess mucus, contributing to the breathing difficulties experienced by individuals with asthma.
4. An infant is brought to the emergency department with the following clinical manifestations: poor skin turgor, weight loss, lethargy, tachycardia, and tachypnea. This is suggestive of which situation?
- A. Water excess
- B. Sodium excess
- C. Water depletion
- D. Potassium excess
Correct answer: C
Rationale: These symptoms are indicative of dehydration or water depletion, which is common in infants and can rapidly lead to severe consequences if not addressed promptly.
5. The nurse is caring for a child with a urinary tract infection who is on trimethoprim-sulfamethoxazole (Bactrim). What side effects of this medication should the nurse teach to the parents and the child? (Select all that apply.)
- A. Rash
- B. Urticaria
- C. All are applicable
- D. Photosensitivity
Correct answer: C
Rationale: Trimethoprim-sulfamethoxazole (Bactrim) can cause side effects like rash, urticaria, and photosensitivity. Parents and the child should be educated on these potential side effects to ensure prompt recognition and management.
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