ATI RN
RN Nursing Care of Children Online Practice 2019 A
1. The nurse is teaching the family of a child with a long-term central venous access device about signs and symptoms of bacteremia. What finding indicates the presence of bacteremia?
- A. Hypertension
- B. Pain at the entry site
- C. Fever and general malaise
- D. Redness and swelling at the entry site
Correct answer: C
Rationale: Fever and general malaise are systemic signs of bacteremia, indicating that the infection may have spread beyond the local entry site. Localized pain, redness, and swelling are signs of a localized infection but do not necessarily indicate bacteremia.
2. A client with asthma is taking fluticasone. The nurse should monitor the client for which of the following adverse effects?
- A. Hypoglycemia
- B. Hypertension
- C. Polyuria
- D. Oral candidiasis
Correct answer: D: Oral candidiasis
Rationale: Fluticasone is a corticosteroid often used to manage asthma. One of the common adverse effects associated with inhaled corticosteroids like fluticasone is oral candidiasis, also known as thrush. This fungal infection can develop in the mouth and throat due to the steroid's local immunosuppressive effects. Patients should be advised to rinse their mouths after using inhaled corticosteroids to reduce the risk of oral candidiasis. Monitoring for symptoms such as white patches, sore throat, or difficulty swallowing is essential to detect and manage this adverse effect promptly.
3. An emergency department nurse is triaging a 77-year-old man who presents with uncharacteristic fatigue as well as back and rib pain. The patient denies any recent injuries. The nurse should recognize the need for this patient to be assessed for what health problem?
- A. Hodgkin disease
- B. Non-Hodgkin lymphoma
- C. Multiple myeloma
- D. Acute thrombocythemia
Correct answer: C
Rationale: The correct answer is multiple myeloma (choice C). Back pain is a common presenting symptom in multiple myeloma, especially in older patients. This malignancy can lead to bone pain due to bone destruction and fractures. Hodgkin disease (choice A) and Non-Hodgkin lymphoma (choice B) typically present with symptoms like painless lymph node enlargement, fever, and weight loss. Acute thrombocythemia (choice D) is characterized by an increase in platelet count but is not typically associated with the symptoms described by the patient.
4. The client has orders for a nasogastric (NG) tube insertion. During the procedure, instructions that will assist in the insertion would be:
- A. Instruct the client to tilt his head back for insertion in the nostril, then flex his neck for the final insertion
- B. After insertion into the nostril, instruct the client to extend his neck
- C. Introduce the tube with the client’s head tilted back, then instruct him to keep his head upright for final insertion
- D. Instruct the client to hold his chin down, then back for insertion of the tube
Correct answer: A
Rationale: Instructing the client to tilt his head back for insertion in the nostril, then flex his neck for the final insertion helps facilitate the NG tube insertion.
5. What is the condition where a blood clot blocks an artery in the lungs, causing shortness of breath, chest pain, and other symptoms?
- A. Pulmonary embolism
- B. Pneumothorax
- C. Pleural effusion
- D. Aneurysm
Correct answer: A
Rationale: The correct answer is Pulmonary embolism. Pulmonary embolism occurs when a blood clot blocks an artery in the lungs, leading to symptoms like shortness of breath and chest pain. This condition is life-threatening and requires prompt treatment. Choices B, C, and D are incorrect as they refer to different medical conditions: Pneumothorax is a collapsed lung, Pleural effusion is an abnormal accumulation of fluid around the lungs, and an Aneurysm is a bulge in a blood vessel.
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