ATI RN
RN Nursing Care of Children 2019 With NGN
1. The parents of a 2-year-old boy who had a repair of exstrophy of the bladder at birth ask when they can begin toilet training their son. The nurse replies based on what knowledge?
- A. Most boys in the United States can be toilet trained at age 3 years.
- B. Training can begin when he has sufficient bladder capacity.
- C. Additional surgery may be necessary to achieve continence.
- D. They should begin now because he will require additional time.
Correct answer: B
Rationale: Toilet training should begin when the child has sufficient bladder capacity and control, which may be delayed in children who have undergone surgical repairs for conditions like bladder exstrophy. Premature training can lead to frustration and setbacks.
2. A healthcare provider is caring for a client who has been diagnosed with sepsis. Which of the following laboratory results indicates that the client is developing disseminated intravascular coagulation (DIC)?
- A. Elevated hemoglobin
- B. Elevated white blood cell count
- C. Decreased fibrinogen level
- D. Decreased platelet count
Correct answer: D
Rationale: The correct answer is D, decreased platelet count. In disseminated intravascular coagulation (DIC), there is widespread activation of clotting factors leading to the formation of multiple blood clots throughout the body, which can deplete platelets. A decreased platelet count is a hallmark of DIC. Elevated hemoglobin (choice A) and elevated white blood cell count (choice B) are not specific indicators of DIC. While fibrinogen levels (choice C) can be decreased in DIC due to consumption, a decreased platelet count is a more specific and early sign of DIC development.
3. Gail is scheduled for a cholecystectomy. After completion of preoperative teaching, Gail states,”If I lie still and avoid turning after the operation, I’ll avoid pain. Do you think this is a good idea?” What is the best response?
- A. You’ll need to turn from side to side every 2 hours.
- B. It’s always a good idea to rest quietly after surgery.
- C. The doctor will probably order you to lie flat for 24 hours.
- D. Why don’t you decide about activity after you return from the recovery room?
Correct answer: A
Rationale: The best response to Gail is to inform her that she will need to turn from side to side every 2 hours to prevent complications.
4. A healthcare professional is assessing a patient's fluid balance. What is the most reliable indicator of fluid status?
- A. Monitor the patient's vital signs.
- B. Check the patient's weight daily.
- C. Measure the patient's intake and output.
- D. Monitor the patient's urine color.
Correct answer: B
Rationale: Checking the patient's weight daily is the most reliable indicator of fluid status because weight changes can directly reflect fluid retention or loss. Monitoring vital signs (Choice A) can provide some information but is not as specific as weight changes. Measuring intake and output (Choice C) is crucial but may not always accurately reflect fluid balance. Monitoring urine color (Choice D) can give some insights into hydration levels, but it is not as reliable as daily weight checks for assessing overall fluid status.
5. A nurse is caring for a client with hypertension who asks about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients with a history of which of the following conditions?
- A. Asthma
- B. Glaucoma
- C. Depression
- D. Migraines
Correct answer: A
Rationale: Corrected Rationale: Propranolol is contraindicated in clients with a history of asthma because it can cause bronchospasms due to its non-selective beta-blocking properties. By blocking beta-2 receptors in the lungs, propranolol can lead to bronchoconstriction, potentially triggering asthma symptoms and exacerbating respiratory issues. Asthma patients should avoid medications like propranolol that can worsen their condition. Choices B, C, and D are incorrect as propranolol is not contraindicated in clients with glaucoma, depression, or migraines. In fact, propranolol is sometimes used in the treatment of migraines and certain types of glaucoma.
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