ATI RN
ATI Nursing Care of Children 2019 B
1. The nurse is caring for a child with Meckel diverticulum. What type of stool does the nurse expect to observe?
- A. Steatorrhea
- B. Clay-colored
- C. Currant jelly-like
- D. Loose stools with undigested food
Correct answer: C
Rationale: Corrected Rationale: Currant jelly-like stools, which contain blood and mucus, are characteristic of Meckel diverticulum. This symptom occurs due to the bleeding from the ectopic gastric mucosa present in the diverticulum. Steatorrhea (choice A) is not typically associated with Meckel diverticulum. Clay-colored stools (choice B) are seen in conditions affecting the biliary system. Loose stools with undigested food (choice D) may indicate malabsorption issues, but it is not specifically linked to Meckel diverticulum.
2. 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.
3. Which type of breath sound is normally heard over the entire surface of the lungs except for the upper intrascapular area and the area beneath the manubrium?
- A. Vesicular
- B. Bronchial
- C. Adventitious
- D. Bronchovesicular
Correct answer: A
Rationale: Vesicular breath sounds are normally heard over most of the lung fields, except near the trachea and main bronchi, where bronchial or bronchovesicular sounds may be heard.
4. During a well-child checkup, the parent of a 5-year-old child reports the child seems much smaller than the 2 older siblings did at this same age. A review of the medical record reveals that the child is 44 inches tall and weighs 42 pounds. What information should be included in the response by the nurse?
- A. The weight of your child at this time is within normal limits for this age but the child is moderately taller than other children this age.
- B. Your child is within the acceptable range for height but the child is significantly smaller in weight for this age.
- C. Your child is within normal limits for weight but the child is slightly shorter in stature than other children this age.
- D. Your child is slightly taller than other children this age but the child’s weight is normal.
Correct answer: D
Rationale: The correct answer is D. The child is slightly taller than average, but the weight is within normal limits. This information should be reassuring to the parent and provides insights into normal growth patterns. Choice A is incorrect as it inaccurately states that the child is taller than other children this age. Choice B is incorrect because the child's weight is actually within normal limits. Choice C is incorrect as it inaccurately states that the child is shorter in stature than other children this age.
5. Which immunization is recommended for all newborns?
- A. Hepatitis A vaccine
- B. Hepatitis B vaccine
- C. Hepatitis C vaccine
- D. Hepatitis A, B, and C vaccines
Correct answer: B
Rationale: The correct answer is B, the Hepatitis B vaccine. This vaccine is recommended for all newborns to prevent Hepatitis B infection, which can lead to chronic liver disease and liver cancer. The Hepatitis B vaccine is a crucial part of the routine immunization schedule for infants. Choices A, C, and D are incorrect because the recommended vaccine for newborns is specifically Hepatitis B, not Hepatitis A, Hepatitis C, or a combination of Hepatitis A, B, and C vaccines.
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