ATI RN
RN Nursing Care of Children Online Practice 2019 A
1. What factor predisposes an infant to fluid imbalances?
- A. Decreased surface area
- B. Lower metabolic rate
- C. Immature kidney functioning
- D. Decreased daily exchange of extracellular fluid
Correct answer: C
Rationale: Infants have immature kidneys that are less efficient at concentrating urine, making them more susceptible to fluid imbalances. Their higher surface area to volume ratio also contributes to greater insensible fluid losses.
2. Which of the following should be included in a discussion of advance directives with new nurse graduates?
- A. According to the Patient Self-Determination Act, nurses are required to inform clients of their right to create an advance directive.
- B. The advance directive designates an individual who will make financial decisions for the client if he or she is unable to do so.
- C. A living will designates who will make health-care decisions for an individual in the event the individual is unable or incompetent to make his or her own decisions.
- D. The advance directive designates a health-care surrogate who will make known the client�s wishes regarding medical treatment if the client is unable to do so.
Correct answer: A
Rationale: According to the Patient Self-Determination Act, nurses are required to inform clients of their right to create an advance directive.
3. A nurse is reviewing the laboratory results of a female client who has hypovolemia. Which of the following laboratory results would be a priority for the nurse to report to the provider?
- A. BUN 21 mg/dL (10 to 20 mg/dL)
- B. Potassium 5.8 mEq/L (3.5 to 5 mEq/L)
- C. Creatinine 1.4 mg/dL (0.5 to 1.1 mg/dL)
- D. Sodium 132 mEq/L (136 to 145 mEq/L)
Correct answer: B
Rationale: In a client with hypovolemia, the nurse should prioritize reporting the elevated potassium level of 5.8 mEq/L to the provider. Hypovolemia can lead to electrolyte imbalances, and hyperkalemia (potassium level above 5.0 mEq/L) is a serious condition that can result in cardiac arrhythmias and requires immediate attention. The other laboratory results, BUN, creatinine, and sodium, are also important in assessing renal function and fluid balance, but the priority in this case is the elevated potassium level due to its potential life-threatening complications.
4. Which laboratory value at the time of diagnosis should the nurse anticipate would determine the worst prognosis for a child with leukemia?
- A. Slow response to chemotherapy
- B. Platelets of 150,000/mcL
- C. Leukocytes less than 10,000/mcL
- D. Leukocytes of 275,000/mcL
Correct answer: D
Rationale: A high white blood cell count (leukocytes of 275,000/mcL) at diagnosis is associated with a worse prognosis in leukemia because it indicates a more aggressive disease with a higher tumor burden. Slow response to chemotherapy (choice A) is a consequence of the aggressive disease and not a determining factor at diagnosis. Platelets of 150,000/mcL (choice B) and leukocytes less than 10,000/mcL (choice C) are within normal ranges and not indicative of a worse prognosis in leukemia.
5. Which type of diet is recommended for patients with diverticulitis during an acute flare-up?
- A. High-fiber
- B. Low-residue
- C. Low-fat
- D. High-protein
Correct answer: B
Rationale: During an acute flare-up of diverticulitis, a low-residue diet is recommended. This diet helps reduce bowel movements and minimizes irritants in the colon, which can help alleviate symptoms and promote healing. High-fiber diets, like choice A, are typically recommended for diverticulosis prevention but may exacerbate symptoms during a flare-up due to increased bulk in the stool. Low-fat (choice C) and high-protein (choice D) diets are not specifically indicated for diverticulitis flare-ups.
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