ATI RN
Nursing Care of Children Final ATI
1. Which assessment findings should the nurse expect in a child with sickle cell anemia experiencing an acute vaso-occlusive crisis?
- A. Circulatory collapse, hypovolemia
- B. Cardiomegaly, systolic murmur
- C. Hepatomegaly, intrahepatic cholestasis
- D. Painful swelling of joints in hands and feet, tissue engorgement
Correct answer: D
Rationale: The correct answer is D. Vaso-occlusive crises in sickle cell anemia are characterized by painful swelling of the joints in the hands and feet (hand-foot syndrome) and tissue engorgement due to the obstruction of blood flow by sickled cells. Choices A, B, and C are incorrect because circulatory collapse, hypovolemia, cardiomegaly, systolic murmur, hepatomegaly, and intrahepatic cholestasis are not typically associated with an acute vaso-occlusive crisis in sickle cell anemia.
2. What is the MOST COMMON cause of vaginal bleeding immediately after birth?
- A. Uterine atony
- B. Genital lacerations
- C. Abnormal clotting mechanisms
- D. Endometritis
Correct answer: A
Rationale: Vaginal bleeding immediately after birth is most commonly due to uterine atony. Uterine atony is the failure of the uterine muscle to contract adequately after childbirth, leading to postpartum hemorrhage. This condition is more frequent than genital lacerations, abnormal clotting mechanisms, or endometritis as a cause of immediate postpartum bleeding.
3. A client has a new prescription for Sucralfate to treat a duodenal ulcer. Which of the following instructions should be included?
- A. Take the medication with meals.
- B. Swallow the tablet whole.
- C. Take the medication 1 hour before meals.
- D. Chew the tablet before swallowing.
Correct answer: C
Rationale: The correct instruction for taking Sucralfate is to take it 1 hour before meals. This timing allows the medication to coat the stomach lining, providing a protective barrier against stomach acid, which aids in healing the duodenal ulcer. Option A is incorrect as it contradicts the correct timing for taking Sucralfate. Option B is not necessary as it does not pertain to how the medication should be taken in relation to meals. Option D is incorrect as chewing the tablet before swallowing is not the correct administration method for Sucralfate.
4. The nurse is reviewing the medication record of a client with acute gastritis. Which medication, if noted on the client’s record, would the nurse question?
- A. Digoxin (Lanoxin)
- B. Indomethacin (Indocin)
- C. Furosemide (Lasix)
- D. Propranolol hydrochloride (Inderal)
Correct answer: B
Rationale: Indomethacin (Indocin) is an NSAID that can aggravate acute gastritis and should be questioned.
5. When educating a client with a new prescription for Losartan, which instruction should the nurse provide?
- A. Avoid consuming grapefruit juice.
- B. Take this medication with a full glass of water.
- C. Take this medication with food.
- D. Monitor for signs of dehydration.
Correct answer: D
Rationale: The correct answer is to instruct the client to monitor for signs of dehydration when taking Losartan. Losartan can lead to dehydration, so it is crucial for the client to watch out for symptoms like dry mouth, increased thirst, and reduced urine output. Monitoring for these signs can help prevent complications associated with dehydration while taking this medication. Choices A, B, and C are incorrect because Losartan is not known to have interactions with grapefruit juice, does not require a specific amount of water for intake, and can be taken with or without food.