ATI RN
RN Nursing Care of Children Online Practice 2019 A
1. What laboratory finding should the nurse expect in a child with an excess of water?
- A. Decreased hematocrit
- B. High serum osmolality
- C. High urine specific gravity
- D. Increased blood urea nitrogen (BUN)
Correct answer: A
Rationale: Water excess typically leads to hemodilution, resulting in a decreased hematocrit. High serum osmolality and specific gravity would indicate dehydration, while elevated BUN could suggest renal impairment or dehydration, not fluid overload.
2. Why are neonates predisposed to problems with thermoregulation?
- A. Renal function is not fully developed.
- B. Flexed posture favors heat loss.
- C. A large body surface area favors heat loss to the environment.
- D. A thick layer of subcutaneous fat provides excellent insulation.
Correct answer: C
Rationale: Neonates have a large surface area relative to their weight, which makes them prone to heat loss to the environment, leading to thermoregulation issues. The underdeveloped kidney affecting urine concentration (Choice A) is unrelated to the thermal regulation process. While a flexed posture can help retain heat (Choice B), it does not outweigh the impact of the large body surface area in neonates. Although subcutaneous fat (Choice D) provides insulation, in neonates, the large body surface area is more significant in contributing to heat loss than the fat's insulating properties.
3. What is the most appropriate intervention for a child with suspected acute appendicitis?
- A. Administer antibiotics
- B. Apply heat to the abdomen
- C. Encourage oral fluids
- D. Prepare for surgery
Correct answer: D
Rationale: The correct answer is D: Prepare for surgery. Acute appendicitis is a surgical emergency that requires prompt removal of the appendix to prevent complications like rupture and peritonitis. Administering antibiotics (choice A) may be part of the treatment plan but should not delay surgical intervention. Applying heat to the abdomen (choice B) is not recommended as it can worsen the inflammation of the appendix. Encouraging oral fluids (choice C) is generally beneficial, but the priority in acute appendicitis is surgical intervention.
4. In terms of gross motor development, what should the nurse expect an infant age 5 months to do?
- A. Sit erect without support
- B. Roll from the back to the abdomen
- C. Turn from the abdomen to the back
- D. Move from a prone to a sitting position
Correct answer: C
Rationale: At 5 months, infants typically can turn from their abdomen to their back. Rolling from back to abdomen and sitting erect without support occur later.
5. Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?
- A. Codeine sulfate (Codeine)
- B. Morphine (Roxanol)
- C. Methadone (Dolophine)
- D. Meperidine (Demerol)
Correct answer: B
Rationale: Morphine is the drug of choice for PCA in children because of its efficacy, safety profile, and rapid onset of action for pain management.
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