ATI RN
Nursing Care of Children Final ATI
1. The nurse is using a bulb syringe to suction a neonate after delivery. What is an important consideration?
- A. Compress the bulb before insertion.
- B. Clear the mouth and pharynx before the nasal passages.
- C. Use two bulb syringes, one for the mouth and pharynx and one for the nasal passages.
- D. Continue using a bulb syringe until secretions are removed as mechanical suction is contraindicated.
Correct answer: B
Rationale: The correct consideration when using a bulb syringe to suction a neonate after delivery is to clear the mouth and pharynx before the nasal passages to prevent aspiration of amniotic fluid. Compressing the bulb syringe before insertion is important to create suction. Using two bulb syringes is unnecessary, as one is sufficient for both the mouth/pharynx and nasal passages. It is not recommended to continue using a bulb syringe until all secretions are removed; instead, mechanical suction can be employed if more forceful removal of secretions is required.
2. What is the most frequent cause of hypovolemic shock in children?
- A. Sepsis
- B. Blood loss
- C. Anaphylaxis
- D. Heart failure
Correct answer: B
Rationale: Hypovolemic shock in children is most frequently caused by blood loss, which can result from trauma, surgery, or gastrointestinal bleeding. Sepsis and anaphylaxis can lead to different types of shock (septic and anaphylactic), and heart failure is related to cardiogenic shock.
3. The mother of a child with type 1 diabetes asks the nurse why her child cannot avoid all those ‘shots’ and take pills like an uncle does. How should the nurse respond?
- A. The pills work with adult pancreases only.
- B. Your child needs insulin replaced, and the oral hypoglycemic only add to an existing supply of insulin.
- C. The drugs affect fat and protein metabolism, not sugar.
- D. Perhaps when your child is older the pancreas will produce its own insulin, and then your child can take oral hypoglycemic agents.
Correct answer: B
Rationale: The correct answer is B. Children with type 1 diabetes require insulin replacement because their pancreas produces little or no insulin. Oral hypoglycemics used in type 2 diabetes work by improving the effectiveness of insulin the body already makes, which is not sufficient in type 1 diabetes. Choice A is incorrect because the issue is not about the pancreas being adult or child-specific but rather the type of diabetes. Choice C is incorrect because it misstates the mechanism of action of the medications. Choice D is incorrect because it provides inaccurate information about the potential for the child's pancreas to produce insulin in the future, which is unlikely in type 1 diabetes.
4. A child with acute glomerulonephritis is in the playroom and experiences blurred vision and a headache. What action should the nurse take?
- A. Check the urine to see if hematuria has increased.
- B. Obtain the child's blood pressure and notify the healthcare provider.
- C. Obtain serum electrolytes and send urinalysis to the laboratory.
- D. Reassure the child and encourage bed rest until the headache improves.
Correct answer: B
Rationale: Blurred vision and headache in a child with acute glomerulonephritis may indicate severe hypertension, which requires immediate assessment and intervention. Blood pressure should be checked, and the healthcare provider notified.
5. The nurse is providing anticipatory guidance to the parent of a 9-month-old infant during a well-baby visit. Which topic would be most appropriate?
- A. Cautioning about putting the infant in a walker
- B. Advising how to create a toddler-safe home
- C. Instructing on safety procedures during baths
- D. Warning about leaving small objects on the floor
Correct answer: D
Rationale: The correct answer is D because at 9 months, infants become more mobile, increasing the risk of choking hazards from small objects left on the floor. Cautioning about putting the infant in a walker (Choice A) is not as crucial at this age as warning about choking hazards. While advising how to create a toddler-safe home (Choice B) is essential, the most critical concern at 9 months is small objects. Instructing on safety procedures during baths (Choice C) is important but does not address the immediate risk of choking hazards associated with small objects.
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