ATI RN
ATI Nursing Care of Children 2019 B
1. What is the most appropriate action for a healthcare provider if a child presents with suspected meningitis?
- A. Administer antibiotics immediately
- B. Perform a lumbar puncture
- C. Isolate the child
- D. Obtain a complete blood count
Correct answer: C
Rationale: Isolating the child is a priority to prevent the spread of infection until meningitis is confirmed or ruled out. Meningitis, particularly bacterial, is highly contagious and can lead to outbreaks if not properly managed. Isolation and prompt treatment are critical in preventing serious complications. Administering antibiotics immediately without confirmation of the diagnosis can be harmful if the cause is viral or non-infectious. Performing a lumbar puncture is a diagnostic procedure that should be done by a healthcare provider but is not the initial action when suspecting meningitis. Obtaining a complete blood count may be part of the diagnostic workup but is not the most appropriate initial action in suspected meningitis.
2. A four-year-old child has a history of repeated otitis media despite antibiotic treatment. Which treatment measure should the nurse discuss with the parents?
- A. Antibiotic treatment
- B. Adenoidectomy
- C. The insertion of tympanostomy (pressure equalizing) tubes
- D. Tonsillectomy
Correct answer: C
Rationale: The correct answer is C: The insertion of tympanostomy (pressure equalizing) tubes. This treatment measure is appropriate for a child with recurrent otitis media as it helps drain fluid from the middle ear and prevent further infections. Adenoidectomy (choice B) involves the removal of the adenoids, which may not directly address the ear infections. Antibiotic treatment (choice A) has already been ineffective in this case, so alternative measures are necessary. Tonsillectomy (choice D) is not typically indicated for otitis media unless there are specific reasons such as enlarged tonsils contributing to the condition.
3. What is the primary concern in a child with nephrotic syndrome?
- A. Hypotension
- B. Hyperkalemia
- C. Hyperlipidemia
- D. Hypocalcemia
Correct answer: C
Rationale: The correct answer is C: Hyperlipidemia. Children with nephrotic syndrome often present with hyperlipidemia due to altered lipid metabolism, making it a primary concern in these patients. Hypotension (choice A) is not a primary concern in nephrotic syndrome. Hyperkalemia (choice B) and hypocalcemia (choice D) are not typically associated with nephrotic syndrome and are less likely to be primary concerns in these patients.
4. Which nursing intervention should be included in the postoperative care of a child following a tonsillectomy?
- A. Encourage the child to blow the nose gently
- B. Notify the physician if mucus is observed in the emesis
- C. Position the child supine in the immediate postoperative period
- D. Avoid giving citrus juice
Correct answer: D
Rationale: The correct answer is D: 'Avoid giving citrus juice.' Citrus juice can irritate the throat after a tonsillectomy, so it should be avoided. Choice A is incorrect because blowing the nose gently is not a recommended intervention following a tonsillectomy. Choice B is incorrect as mucus in emesis is not uncommon postoperatively and does not necessarily require physician notification. Choice C is incorrect as positioning the child supine immediately postoperatively can increase the risk of airway obstruction and should be avoided.
5. What is the most effective way to prevent the spread of hand, foot, and mouth disease in a daycare setting?
- A. Handwashing
- B. Isolating sick children
- C. Disinfecting toys
- D. Encouraging vaccination
Correct answer: A
Rationale: Handwashing is indeed the most effective way to prevent the spread of hand, foot, and mouth disease in children. Proper hand hygiene helps in removing and killing germs that can cause infections. While isolating sick children and disinfecting toys are important measures to prevent the spread of diseases, they are not as effective as handwashing. Encouraging vaccination, in this case, is not relevant since there is no specific vaccine available for hand, foot, and mouth disease.
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