ATI RN
ATI Nursing Care of Children 2019 B
1. The nurse is preparing to admit a 10-year-old child with appendicitis. What clinical manifestations should the nurse expect to observe?
- A. Fever
- B. Vomiting
- C. Tachycardia
- D. All of the above
Correct answer: D
Rationale: Correct! Typical signs of appendicitis include fever, vomiting, and tachycardia due to infection and inflammation. These clinical manifestations are commonly observed in patients with appendicitis. Hyperactive bowel sounds are not typically associated with appendicitis, so they are not expected findings in this situation. Therefore, the correct answer is 'All of the above.'
2. A nurse is teaching a client who is at 10 weeks gestation about the amniocentesis procedure. Which of the following statements should the nurse make?
- A. This test will confirm whether your baby has a genetic disorder.
- B. Amniocentesis is used to assess your baby's lung maturity.
- C. You should not feel any pain during this procedure.
- D. This test will assess the amount of amniotic fluid around your baby.
Correct answer: A
Rationale: The correct answer is A because amniocentesis is a procedure that confirms genetic disorders by analyzing the amniotic fluid surrounding the baby. Choice B is incorrect because amniocentesis is not used to assess lung maturity. Choice C is incorrect because some discomfort or pain may be felt during the procedure. Choice D is incorrect because amniocentesis does not primarily assess the amount of amniotic fluid around the baby.
3. A nurse is assessing the skin of an immobilized patient. What will the nurse do?
- A. Use a standardized tool such as the Braden Scale.
- B. Limit the amount of fluid intake.
- C. Have special times for inspection so as not to interrupt routine care.
- D. Assess the skin every 4 hours.
Correct answer: A
Rationale: The correct answer is A. When assessing the skin of an immobilized patient, it is essential to use a standardized tool such as the Braden Scale to identify patients at high risk for impaired skin integrity. This tool helps in early identification and appropriate intervention. Choice B, limiting fluid intake, is not directly related to skin assessment. Choice C, having special times for inspection, may not ensure timely identification of skin issues. Choice D, assessing the skin every 4 hours, lacks specificity regarding the use of a validated tool for risk assessment.
4. A client is receiving daily doses of Oprelvekin. Which of the following laboratory values should the nurse monitor to determine the effectiveness of this medication?
- A. Hemoglobin
- B. Absolute neutrophil count
- C. Platelet count
- D. Total white blood cell count
Correct answer: C
Rationale: The nurse should monitor the platelet count to determine the effectiveness of Oprelvekin. The expected outcome for this medication is a platelet count greater than 50,000/mm^3. Oprelvekin is a medication used to stimulate platelet production, making platelet count a crucial parameter to assess its effectiveness. Monitoring hemoglobin, absolute neutrophil count, or total white blood cell count is not specifically related to the action or effectiveness of Oprelvekin.
5. What is the traditional cutoff in diagnosing intellectual disability?
- A. IQ score below 80
- B. IQ score below 70
- C. IQ score below 60
- D. IQ score below 50
Correct answer: B
Rationale: The traditional cutoff for diagnosing intellectual disability is an IQ score below 70. An IQ score below 70 is generally considered as the threshold for diagnosing intellectual disability. Choices A, C, and D are incorrect as they do not reflect the commonly accepted cutoff point for diagnosing intellectual disability.
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