ATI RN
RN Nursing Care of Children Online Practice 2019 A
1. The nurse is admitting a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the doctor to order initially to replace fluids?
- A. 0.9% normal saline
- B. D5 0.2% (1/4) normal saline
- C. D5W
- D. Albumin
Correct answer: A
Rationale: In the case of severe isotonic dehydration, the initial fluid of choice is 0.9% normal saline. This solution is preferred because it helps to restore both fluids and electrolytes effectively. Options B, C, and D are not suitable for the initial management of severe isotonic dehydration. D5 0.2% (1/4) normal saline (Choice B) is a hypotonic solution and might worsen the imbalance. D5W (Choice C) is a hypotonic solution that does not contain electrolytes essential for rehydration. Albumin (Choice D) is a colloid solution used for specific indications like hypoproteinemia or hypoalbuminemia, not for initial rehydration in severe dehydration.
2. What is the appropriate action when a patient experiences an allergic reaction to a medication?
- A. Administer epinephrine
- B. Discontinue the medication
- C. Administer corticosteroids
- D. Administer antihistamines
Correct answer: A
Rationale: The correct answer is to administer epinephrine. Epinephrine is the first-line treatment for a severe allergic reaction as it helps to constrict blood vessels, increase heart rate, and open airways, thereby improving breathing and circulation. Discontinuing the medication may not be sufficient to manage a severe allergic reaction as the allergen is already in the patient's system. Corticosteroids and antihistamines can be considered as complementary treatments but are not the primary immediate intervention required for a severe allergic reaction.
3. A nurse is providing nutritional education to a client who is obese. The nurse should include in the information that which of the following gastrointestinal disorders is commonly associated with obesity?
- A. Peptic ulcer disease
- B. Gastroesophageal reflux disease
- C. Celiac disease
- D. Crohn’s disease
Correct answer: B
Rationale: Gastroesophageal reflux disease (GERD) is commonly associated with obesity due to increased abdominal pressure and other factors.
4. The RDA for iron is higher in premenopausal women than for men or postmenopausal women because of the blood loss during menstruation.
- A. Both the statement and the reason are correct and related.
- B. Both the statement and the reason are correct but are not related.
- C. The statement is correct, but the reason is not correct.
- D. The statement is not correct, but the reason is correct.
Correct answer: A
Rationale: Both the statement and the reason are correct and related. The Institute of Medicine (IOM) recommends 18 mg of iron per day for women 19 to 50 years old, 8 mg/day for women 51 years old and older, and men 19 years old and older. During menstruation, women lose blood containing iron, leading to a higher iron requirement in premenopausal women compared to men or postmenopausal women. This increased demand aims to replenish the iron lost during this physiological process. Therefore, the statement and reason are directly linked, explaining why the RDA for iron is higher in premenopausal women than in men or postmenopausal women. Choices B, C, and D are incorrect as they do not accurately assess the relationship between the statement and the reason provided in the question.
5. A patient in the emergency department complains of back pain and difficulty breathing 15 minutes after a transfusion of packed red blood cells is started. The nurse's first action should be to
- A. administer oxygen therapy at a high flow rate
- B. obtain a urine specimen to send to the laboratory
- C. notify the healthcare provider about the symptoms
- D. disconnect the transfusion and infuse normal saline
Correct answer: D
Rationale: The patient's symptoms, back pain, and difficulty breathing after the transfusion indicate a possible acute hemolytic reaction, a severe transfusion reaction. The priority action in this situation is to discontinue the transfusion immediately to prevent further complications. Infusing normal saline helps maintain the patient's intravascular volume and prevent renal damage. Administering oxygen or obtaining a urine specimen is not the most urgent action and could delay essential treatment. Notifying the healthcare provider is important but should come after ensuring the patient's safety by stopping the blood transfusion.