ATI RN
Nursing Care of Children Final ATI
1. As the primary caregiver for a 5-month-old baby, according to Maslow’s hierarchy of basic needs, which intervention takes the highest priority?
- A. Feeding every four hours
- B. Protection from harm
- C. Providing stimulation
- D. Providing love
Correct answer: A
Rationale: The correct answer is A: Feeding every four hours. According to Maslow’s hierarchy of needs, physiological needs, such as food, water, and warmth, take the highest priority. Ensuring that the baby is fed regularly is crucial for survival and overall health. Choice B, protection from harm, relates more to safety needs which come after physiological needs. Choice C, providing stimulation, is associated with higher-level needs like belongingness and esteem. Choice D, providing love, corresponds to esteem and self-actualization needs, which are higher in the hierarchy than physiological needs.
2. While caring for a client taking Propylthiouracil, for which of the following adverse effects should the nurse monitor?
- A. Bradycardia
- B. Insomnia
- C. Heat intolerance
- D. Weight loss
Correct answer: A
Rationale: When a client is taking Propylthiouracil, the nurse should monitor for bradycardia as it is an adverse effect of this medication. Propylthiouracil can lead to a decrease in heart rate, which is known as bradycardia. Monitoring for this adverse effect is crucial to ensure the client's safety and well-being while on this medication. The other options, such as insomnia, heat intolerance, and weight loss, are not commonly associated adverse effects of Propylthiouracil. Therefore, they are incorrect choices for monitoring while the client is on this medication.
3. What is the most appropriate action when a patient experiences chest pain?
- A. Administer aspirin
- B. Administer nitroglycerin
- C. Reposition the patient
- D. Prepare for surgery
Correct answer: A
Rationale: Administering aspirin is the correct initial action when a patient experiences chest pain. Aspirin helps reduce the risk of clot formation and is a standard first-line treatment for chest pain related to possible cardiac issues. Administering nitroglycerin may be appropriate based on the underlying cause of chest pain, but aspirin is typically administered first. Repositioning the patient is not the primary intervention for chest pain, and preparing for surgery is not the immediate action required unless indicated by a healthcare provider after assessment.
4. What is the best intervention for a patient experiencing hypoxia?
- A. Administer oxygen
- B. Reposition the patient
- C. Provide humidified air
- D. Provide chest physiotherapy
Correct answer: A
Rationale: The best intervention for a patient experiencing hypoxia is to administer oxygen. Oxygen therapy helps improve oxygenation levels in the blood, addressing the underlying cause of hypoxia. Repositioning the patient, providing humidified air, and chest physiotherapy may be beneficial in certain situations but are not the primary interventions for hypoxia. Administering oxygen is crucial to quickly alleviate hypoxia and support the patient's respiratory function.
5. The nurse is caring for clients on a cardiac floor. Which client should the nurse assess first?
- A. The client with three (3) unifocal PVCs in a minute
- B. The client diagnosed with coronary artery disease who wants to ambulate
- C. The client diagnosed with mitral valve prolapse with an audible S3
- D. The client diagnosed with pericarditis who is in normal sinus rhythm
Correct answer: C
Rationale: The correct answer is C because an audible S3 in a client with mitral valve prolapse could indicate heart failure and requires immediate assessment. Choice A is not as urgent as an audible S3 in mitral valve prolapse. Choice B, a client with coronary artery disease wanting to ambulate, does not present an immediate concern compared to a potential heart failure indicated by an audible S3. Choice D, a client with pericarditis in normal sinus rhythm, is stable and does not require immediate attention when compared to a potential heart failure situation signified by an audible S3 in mitral valve prolapse.