ATI RN
Nursing Care of Children Final ATI
1. The nurse is caring for a child with acute postinfectious glomerulonephritis. Which of the following best describes the pathophysiology of acute postinfectious glomerulonephritis?
- A. Occurs after a urinary tract infection
- B. Occurs after a streptococcal infection
- C. Associated with renal vascular disorders
- D. Is caused by E. coli
Correct answer: B
Rationale: The correct answer is B: 'Occurs after a streptococcal infection.' Acute postinfectious glomerulonephritis often occurs after an infection with certain strains of streptococcus bacteria, specifically group A streptococcus. The body’s immune response to the infection leads to inflammation and damage in the kidneys. Choices A, C, and D are incorrect because acute postinfectious glomerulonephritis is primarily associated with streptococcal infections, not urinary tract infections, renal vascular disorders, or E. coli.
2. The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination?
- A. The United States is ranked last among 27 countries
- B. The United States is ranked similar to 20 other developed countries
- C. The United States is ranked in the middle of 20 other developed countries
- D. The United States is ranked highest among 27 other industrialized countries
Correct answer: A
Rationale: The United States is ranked last among developed countries with similar populations in terms of infant mortality rates, highlighting a significant public health concern.
3. What is the primary treatment for Kawasaki disease?
- A. Corticosteroids
- B. Intravenous immunoglobulin
- C. Antibiotics
- D. Antivirals
Correct answer: B
Rationale: The correct answer is B, Intravenous immunoglobulin (IVIG). IVIG is the primary treatment for Kawasaki disease, an acute vasculitis that mainly affects children under 5 years old. Early administration of IVIG is crucial as it helps reduce the risk of coronary artery aneurysms, which is the most serious complication of Kawasaki disease. Corticosteroids (Choice A) are not the primary treatment for Kawasaki disease and are not recommended due to potential adverse effects. Antibiotics (Choice C) are not indicated for the treatment of Kawasaki disease as it is not caused by a bacterial infection. Antivirals (Choice D) are also not part of the standard treatment for Kawasaki disease, as it is not caused by a viral infection.
4. When should the nurse instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux?
- A. At bedtime
- B. With a meal
- C. Midmorning
- D. 30 minutes before breakfast
Correct answer: D
Rationale: Proton pump inhibitors (PPIs) like omeprazole or lansoprazole are most effective when given 30 minutes before breakfast. This timing allows the medication to inhibit the proton pumps in the stomach that produce acid, providing better symptom control throughout the day. Administering the PPI at bedtime (choice A) may not be as effective as giving it before breakfast due to the timing of peak acid production during the day. Giving it with a meal (choice B) might affect the absorption and effectiveness of the medication. Midmorning administration (choice C) is not the recommended time for optimal PPI efficacy.
5. A teenager is accompanied by his mother to the annual physical examination. The nurse is aware of privacy issues related to the teenager. While the mother is in the room, which topic should the nurse avoid?
- A. School performance
- B. Seatbelt use
- C. Cigarette smoking
- D. School friends
Correct answer: C
Rationale: The correct answer is C: Cigarette smoking. Discussing sensitive topics like cigarette smoking in the presence of a parent may inhibit the teenager's willingness to be open and honest. It's important to provide an opportunity for the teenager to speak privately with the healthcare provider. Choices A, B, and D are more general topics that can be discussed openly in front of the parent without compromising the teenager's privacy or comfort.
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