ATI RN
Nursing Care of Children ATI
1. Which medication should the nurse expect to administer to a child with an acute sickle cell pain crisis?
- A. Meperidine (Demerol)
- B. Morphine
- C. Acetaminophen (Tylenol)
- D. Ibuprofen (Motrin)
Correct answer: B
Rationale: In the management of acute sickle cell pain crisis in children, morphine is the preferred medication due to its effectiveness in providing pain relief. Meperidine (Demerol) is less commonly used in this scenario because of its potential for neurotoxicity with repeated doses. Acetaminophen (Tylenol) and Ibuprofen (Motrin) are not typically sufficient for managing the severe pain associated with sickle cell crises and are not the first-line treatment options.
2. A 5-year-old has patient-controlled analgesia (PCA) for pain management after abdominal surgery. What information does the nurse include in teaching the parents about the PCA?
- A. The child may not be pain-free.
- B. The parents or nurse may push the button for a bolus if needed.
- C. The pump allows for a continuous basal rate to deliver a constant amount of medication for pain control.
- D. Monitoring is required every 1 to 2 hours to assess patient response.
Correct answer: C
Rationale: The correct answer is C because the PCA pump can be programmed to deliver a continuous basal rate of pain medication to maintain pain control. While the goal of PCA is effective pain relief, it does not guarantee a pain-free state. In the case of a 5-year-old child, the parents or nurse can administer boluses if necessary since the child may not fully comprehend using the PCA button. Monitoring every 1 to 2 hours for patient response is adequate and there is no need for monitoring every 15 minutes, as stated in choice D, unless specific circumstances dictate more frequent monitoring.
3. A father calls the clinic because he found his young daughter squirting Visine eyedrops into her mouth. What is the most appropriate nursing action?
- A. Reassure the father that Visine is harmless.
- B. Direct him to seek immediate medical treatment.
- C. Recommend inducing vomiting with ipecac.
- D. Advise him to dilute Visine by giving his daughter several glasses of water to drink.
Correct answer: B
Rationale: Visine is not harmless when ingested, and immediate medical treatment is necessary due to the risk of toxicity. Vomiting should not be induced without medical advice, and dilution with water is not an appropriate treatment.
4. A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. What should the therapeutic plan initially include?
- A. Bowel cleansing
- B. Dietary modification
- C. Structured toilet training
- D. Behavior modification
Correct answer: B
Rationale: Dietary modification is often the first step in managing chronic constipation in children, focusing on increasing fiber and fluid intake. Other interventions like bowel cleansing and toilet training may follow if dietary changes are insufficient.
5. What type of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks, which may occur with drug or latex allergy?
- A. Neurogenic shock
- B. Cardiogenic shock
- C. Hypovolemic shock
- D. Anaphylactic shock
Correct answer: D
Rationale: Anaphylactic shock is a severe allergic reaction that causes massive vasodilation and increased capillary permeability, leading to rapid fluid shifts and circulatory collapse if not treated promptly. Neurogenic, cardiogenic, and hypovolemic shocks have different etiologies.