ATI RN
ATI Nursing Care of Children 2019 B
1. What is the purpose of using cimetidine (Tagamet) for gastroesophageal reflux?
- A. The medication reduces gastric acid secretion.
- B. The medication neutralizes the acid in the stomach.
- C. The medication increases the rate of gastric emptying time.
- D. The medication coats the lining of the stomach and esophagus.
Correct answer: A
Rationale: The correct answer is A. Cimetidine (Tagamet) is an H2 receptor antagonist that works by reducing gastric acid secretion. This action helps to decrease the acidity in the stomach, which in turn reduces the symptoms of gastroesophageal reflux. Choice B is incorrect because cimetidine does not neutralize acid but rather decreases its production. Choice C is incorrect as cimetidine does not affect the rate of gastric emptying time. Choice D is incorrect as cimetidine does not coat the lining of the stomach and esophagus but instead works to reduce gastric acid secretion.
2. Frequent urine tests for specific gravity are required on a 6-month-old infant. What method is the most appropriate way to collect small amounts of urine for these tests?
- A. Apply a urine collection bag to the perineal area.
- B. Tape a small medicine cup inside of the diaper.
- C. Aspirate urine from cotton balls inside the diaper with a syringe without a needle.
- D. Use a syringe without a needle to aspirate urine from a superabsorbent disposable diaper.
Correct answer: C
Rationale: Aspirating urine from cotton balls inside the diaper is a minimally invasive method and effective for collecting small amounts of urine. Using a collection bag can be more cumbersome, and other methods are not as effective for this age.
3. In which type of cancer are the urinary excretion of the breakdown products of catecholamines, especially vanillylmandelic acid (VMA) and homovanillic acid (HVA), detected?
- A. Neuroblastoma
- B. Nephroblastoma
- C. Leukemia
- D. Osteosarcoma
Correct answer: A
Rationale: The correct answer is A: Neuroblastoma. Neuroblastoma, a cancer that arises from nerve tissue, is associated with increased levels of catecholamine metabolites, including VMA and HVA, in the urine. Nephroblastoma (Wilms tumor) is a type of kidney cancer and is not typically associated with elevated levels of catecholamine breakdown products. Leukemia is a cancer of the blood and bone marrow and does not lead to increased VMA and HVA excretion in urine. Osteosarcoma is a bone cancer and is not linked to elevated levels of catecholamine metabolites in the urine.
4. What is an essential nursing care intervention for a neonate with a suspected tracheoesophageal fistula?
- A. Feed glucose water only.
- B. Elevate the patient's head for feedings.
- C. Raise the patient's head and give nothing by mouth.
- D. Avoid suctioning unless the infant is cyanotic.
Correct answer: C
Rationale: Raising the patient’s head and giving nothing by mouth is crucial in managing tracheoesophageal fistula. This intervention helps prevent aspiration and further complications until surgical correction can be performed. Feeding the neonate or suctioning could exacerbate the condition by risking aspiration. Elevating the head for feedings does not address the primary concern of preventing oral intake, making it less appropriate than the correct answer.
5. What is the primary symptom of congenital diaphragmatic hernia in a newborn?
- A. Cyanosis
- B. Bradycardia
- C. Absent breath sounds
- D. Tachypnea
Correct answer: C
Rationale: Absent breath sounds on the affected side are a primary symptom of congenital diaphragmatic hernia. Cyanosis, bradycardia, and tachypnea may also be present but are not the primary symptom. Cyanosis is a bluish discoloration of the skin due to poor oxygenation, bradycardia is a slower than normal heart rate, and tachypnea is rapid breathing.
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