ATI RN
ATI Nursing Care of Children 2019 B
1. Which of the following is a hallmark sign of intussusception in children?
- A. Bilious vomiting
- B. "Currant jelly" stools
- C. Abdominal distention
- D. Constipation
Correct answer: B
Rationale: "Currant jelly" stools, consisting of mucus and blood, are characteristic of intussusception in children. It occurs due to the telescoping of a segment of the intestine into an adjacent segment, leading to obstruction and subsequent mucosal ischemia, causing the passage of bloody mucus in the stool. Bilious vomiting can be seen in other conditions like bowel obstruction, abdominal distention can be present but is not as specific, and constipation is less likely in the presentation of intussusception.
2. Which of the following statements about time management is true?
- A. Time management is not important in nursing
- B. Writing goals will increase stress
- C. Effective time management reduces stress
- D. Setting goals is a time waster
Correct answer: C
Rationale: The correct answer is C: Effective time management reduces stress. Proper time management allows nurses to prioritize tasks, allocate sufficient time for each activity, and reduce the feeling of being overwhelmed. This, in turn, helps in reducing stress levels and increasing productivity. Choices A, B, and D are incorrect. Time management is crucial in nursing to ensure efficient patient care and task completion. Writing goals helps in providing direction and motivation, reducing stress rather than increasing it. Setting goals is not a time waster; it is a fundamental aspect of effective time management.
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. The nurse is preparing to administer medications to a client with osteoarthritis. What is the goal of medication therapy?
- A. Eradicate the disease
- B. Reduce pain and inflammation
- C. Turn on the immune system
- D. Manage weight loss
Correct answer: Reduce pain and inflammation
Rationale:
5. The nurse is assessing a 3-day-old breastfed newborn who weighed 3400 g (7 pounds, 8 oz) at birth. The infant’s mother is now concerned because the infant weighs 3147 g (6 pounds, 15 oz). The most appropriate nursing intervention is what?
- A. Recommend supplemental feedings of formula.
- B. Explain that this weight loss is within normal limits.
- C. Assess the child further to determine the cause of excessive weight loss.
- D. Encourage the mother to express breast milk for bottle-feeding the infant.
Correct answer: B
Rationale: A neonate normally loses about 10% of the birth weight by age 3 to 4 days. The birth weight is usually regained by the 10th day of life. In this case, the weight loss from 3400 g to 3147 g is within the expected range. Therefore, the most appropriate action is to explain to the mother that this weight loss is within normal limits. Choice A is incorrect because supplemental feedings of formula are not indicated for this expected weight loss in a breastfed newborn. Choice C is incorrect as there is no evidence to suggest excessive weight loss at this point. Choice D is unnecessary at this stage and may not align with the current situation of normal weight loss post-birth.
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