ATI RN
Nursing Care of Children Final ATI
1. The nurse is caring postoperatively for an 8-year-old child with multiple fractures and other traumatic injuries from a motor vehicle crash. The child is experiencing severe pain. What is an important consideration in managing the child’s pain?
- A. Give only an opioid analgesic at this time.
- B. Increase the dosage of analgesic until the child is adequately sedated.
- C. Plan a preventive schedule of pain medication around the clock.
- D. Give the child a clock and explain when they can have pain medications.
Correct answer: C
Rationale: For severe postoperative pain, a preventive around-the-clock schedule is necessary to prevent decreased plasma levels of medications. Providing only an opioid analgesic at this time may not be sufficient for effective pain management. Increasing the dosage without an order is unsafe and may lead to oversedation. Planning a preventive schedule of pain medication around the clock ensures consistent pain relief and better management. Giving the child a clock and explaining when they can have pain medications may increase the child's focus on waiting for relief rather than addressing the pain promptly, making it a less effective strategy.
2. What procedure uses a catheter to open blocked coronary arteries and improve blood flow to the heart muscle?
- A. Angioplasty
- B. Stent placement
- C. Coronary artery bypass graft (CABG)
- D. Valve replacement
Correct answer: A
Rationale: The correct answer is A, Angioplasty. Angioplasty is a procedure where a catheter is used to open blocked coronary arteries and may involve the insertion of a stent to improve blood flow to the heart muscle. Stent placement (B) is a related procedure but specifically refers to the insertion of a stent. Coronary artery bypass graft (CABG) (C) is a surgical procedure that uses blood vessels to bypass blocked coronary arteries. Valve replacement (D) is a different procedure that involves replacing a heart valve, not opening blocked coronary arteries.
3. What is a cause of the crystallization within the synovial fluid of the joint affected by gouty arthritis?
- A. Destruction of proteoglycans
- B. Underexcretion of uric acid
- C. Overexcretion of uric acid
- D. Increased absorption of uric acid
Correct answer: B
Rationale: The correct answer is B: Underexcretion of uric acid. In gouty arthritis, the crystallization within the synovial fluid of the affected joint is caused by the underexcretion of uric acid, leading to the accumulation and subsequent crystallization of urate crystals. Choice A, destruction of proteoglycans, is incorrect as it is not directly related to the crystallization process in gouty arthritis. Choice C, overexcretion of uric acid, is incorrect because gout is primarily associated with underexcretion or decreased excretion of uric acid rather than overexcretion. Choice D, increased absorption of uric acid, is also incorrect as the primary issue in gouty arthritis is the body's inability to properly eliminate uric acid.
4. In the 5th substage of sensorimotor development, what does Piaget refer to as 'experimentation,' where the infant tries out new ways of playing with or manipulating objects?
- A. Short-term memory
- B. Working memory
- C. Core memories
- D. Long-term memory
Correct answer: D
Rationale: The correct answer is D, 'Long-term memory.' In the 5th substage of sensorimotor development, Piaget refers to 'experimentation' as tertiary circular reactions, where the infant tries out new ways of playing with or manipulating objects. This stage involves exploring and testing different ways of interacting with the world to understand cause and effect relationships. Choices A, B, and C are incorrect as they do not align with Piaget's concept of tertiary circular reactions and experimentation in the sensorimotor stage of development.
5. A nurse is providing teaching to a client who is at 36 weeks of gestation and is scheduled for a nonstress test. Which of the following instructions should the nurse include?
- A. The test will last about 30 minutes.
- B. You should drink a full glass of water prior to the test.
- C. You will need to have your bladder full for this test.
- D. This test measures how well your baby's heart responds to movement.
Correct answer: D
Rationale: The correct answer is D. A nonstress test measures the fetal heart's response to movement, helping to assess fetal well-being. Choice A is incorrect as the duration of the test can vary, and it is not always precisely 30 minutes. Choice B is incorrect as drinking water is not necessary for a nonstress test. Choice C is incorrect as having a full bladder is not required for this test.