ATI RN
RN Nursing Care of Children 2019 With NGN
1. The nurse is preparing to admit a child to the hospital with a diagnosis of minimal change nephrotic syndrome. The nurse understands that the peak age at onset for this disease is what?
- A. 2 to 3 years
- B. 4 to 5 years
- C. 6 to 7 years
- D. 8 to 9 years
Correct answer: B
Rationale: The peak age for the onset of minimal change nephrotic syndrome (MCNS) is typically between 4 and 5 years old. MCNS is the most common cause of nephrotic syndrome in children, particularly within this age range.
2. The nurse has just started assessing a young child who is febrile and appears ill. There is hyperextension of the child's head (opisthotonos) with pain on flexion. Which is the most appropriate action?
- A. Ask the parent when the neck was injured
- B. Refer for immediate medical evaluation
- C. Continue assessment to determine the cause of the neck pain
- D. Record head lag on the assessment record and continue the assessment of the child
Correct answer: B
Rationale: Opisthotonos with pain on flexion is a sign of possible meningitis or other serious neurological conditions, requiring immediate medical evaluation.
3. Parents of a hospitalized toddler ask the nurse, "What is meant by family-centered care?" The nurse should respond with which statement?
- A. Family-centered care reduces the effect of cultural diversity on the family
- B. Family-centered care encourages family dependence on the health care system
- C. Family-centered care recognizes that the family is the constant in a child’s life
- D. Family-centered care avoids expecting families to be part of the decision-making process
Correct answer: C
Rationale: Family-centered care emphasizes the importance of the family as the constant in a child's life, involving them in all aspects of care and decision-making.
4. Frequent urine tests for specific gravity are required on a 6-month-old infant. What method is the most appropriate way to collect small amounts of urine for these tests?
- A. Apply a urine collection bag to the perineal area.
- B. Tape a small medicine cup inside of the diaper.
- C. Aspirate urine from cotton balls inside the diaper with a syringe without a needle.
- D. Use a syringe without a needle to aspirate urine from a superabsorbent disposable diaper.
Correct answer: C
Rationale: Aspirating urine from cotton balls inside the diaper is a minimally invasive method and effective for collecting small amounts of urine. Using a collection bag can be more cumbersome, and other methods are not as effective for this age.
5. What disease should be suspected in a 3-day-old infant presenting with abdominal distention, vomiting, and failure to pass meconium?
- A. Pyloric stenosis
- B. Intussusception
- C. Hirschsprung disease
- D. Celiac disease
Correct answer: C
Rationale: Hirschsprung disease should be suspected in a newborn with abdominal distention, vomiting, and failure to pass meconium. This condition arises from a congenital absence of nerve cells in a portion of the colon, leading to severe constipation and intestinal obstruction. Pyloric stenosis typically presents with non-bilious projectile vomiting in the first few weeks of life. Intussusception classically manifests with sudden onset of colicky abdominal pain and currant jelly stools. Celiac disease may present with chronic diarrhea, failure to thrive, and abdominal distention but is less likely in this scenario.
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