ATI RN
RN Nursing Care of Children Online Practice 2019 A
1. While making rounds, the nurse observes the following client behaviors. Which child should the nurse further evaluate for postoperative pain?
- A. The 6-month-old in deep sleep
- B. The 2-year-old who is cooperative when the nurse takes vital signs
- C. The 4-year-old who is actively watching cartoons
- D. The 14-month-old who is screaming and thrashing his arms and legs
Correct answer: D
Rationale: The correct answer is D because screaming and thrashing his arms and legs are indicative behaviors of discomfort or pain in young children. The child's actions suggest a higher likelihood of experiencing postoperative pain and necessitate further evaluation. Choices A, B, and C do not exhibit overt signs of distress or discomfort associated with pain, making them less likely candidates for postoperative pain assessment.
2. In which type of cancer are the urinary excretion of the breakdown products of catecholamines, especially vanillylmandelic acid (VMA) and homovanillic acid (HVA), detected?
- A. Neuroblastoma
- B. Nephroblastoma
- C. Leukemia
- D. Osteosarcoma
Correct answer: A
Rationale: The correct answer is A: Neuroblastoma. Neuroblastoma, a cancer that arises from nerve tissue, is associated with increased levels of catecholamine metabolites, including VMA and HVA, in the urine. Nephroblastoma (Wilms tumor) is a type of kidney cancer and is not typically associated with elevated levels of catecholamine breakdown products. Leukemia is a cancer of the blood and bone marrow and does not lead to increased VMA and HVA excretion in urine. Osteosarcoma is a bone cancer and is not linked to elevated levels of catecholamine metabolites in the urine.
3. The nurse is selecting a site to begin an intravenous infusion on a 2-year-old child. The superficial veins on his hand and arm are not readily visible. What intervention should increase the visibility of these veins?
- A. Gently tap over the site.
- B. Apply a cold compress to the site.
- C. Raise the extremity above the level of the body
- D. Use a rubber band as a tourniquet for 5 minutes.
Correct answer: A
Rationale: Gently tapping over the site helps dilate the veins and increase visibility. Applying a cold compress or raising the extremity above the body level constricts the veins, making them harder to access. Prolonged tourniquet use can cause discomfort and venous congestion.
4. An awake, alert 4-year-old child has just arrived at the emergency department after an ingestion of aspirin at home. The practitioner has ordered activated charcoal. The nurse administers charcoal in which manner?
- A. Giving half of the solution and then repeating the other half in 1 hour
- B. Mixing with a flavorful beverage in an opaque container with a straw
- C. Serving it in a clear plastic cup so the child can see how much has been drunk
- D. Administering it through a nasogastric tube because the child will not drink it because of the taste
Correct answer: B
Rationale: Mixing activated charcoal with a flavorful beverage in an opaque container can help mask the taste and encourage the child to ingest it. Using an opaque container can prevent the child from seeing the unappealing appearance of the charcoal mixture, increasing compliance.
5. A child with acetaminophen (Tylenol) poisoning has been admitted to the emergency department. What antidote does the nurse anticipate being prescribed?
- A. Carnitine (Carnitor)
- B. Fomepizole (Antizol)
- C. Deferoxamine (Desferal)
- D. N-acetylcysteine (Mucomyst)
Correct answer: D
Rationale: N-acetylcysteine is the specific antidote for acetaminophen poisoning, working by replenishing glutathione and preventing liver damage. The other options are antidotes for different types of poisoning (e.g., Fomepizole for methanol or ethylene glycol poisoning).
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