ATI RN
RN Nursing Care of Children 2019 With NGN
1. A child is admitted in acute renal failure (ARF). Therapeutic management to rapidly provoke a flow of urine includes the administration of what medication?
- A. Propranolol (Inderal)
- B. Calcium gluconate
- C. Mannitol (Osmitrol) or furosemide (Lasix)
- D. Sodium, chloride, and potassium
Correct answer: C
Rationale: Mannitol and furosemide are diuretics commonly used to induce diuresis in acute renal failure, helping to provoke urine flow and manage fluid overload. Calcium gluconate and electrolyte supplementation are used for other specific conditions and not primarily for diuresis.
2. The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which?
- A. 50th percentile
- B. 75th percentile
- C. 80th percentile
- D. 95th percentile
Correct answer: D
Rationale: A child with a BMI greater than the 95th percentile is classified as obese, according to standard growth charts used in pediatric practice.
3. A thorough systemic physical assessment is necessary in the extremely low-birth-weight (ELBW) infant to detect what?
- A. Weight gain reflective of fluid retention
- B. Difficulties in maternal-child attachment
- C. Subtle changes that may be indicative of an underlying problem
- D. Changes in Apgar score over the first 24 hours of life
Correct answer: C
Rationale: In extremely low-birth-weight (ELBW) infants, a thorough systemic physical assessment is crucial to detect subtle changes that may indicate an underlying problem. These infants are highly vulnerable and may show signs of stress through changes in feeding behavior, activity, color, oxygen saturation, or vital signs. Monitoring weight in ELBW infants primarily reflects genitourinary function rather than fluid retention. Difficulties in maternal-child attachment are important but are usually assessed during parental visits and are not the primary focus of a systemic physical assessment. Changes in the Apgar score are used immediately after birth to assess the transition to extrauterine life and are not as relevant in the following 24 hours to detect ongoing subtle issues.
4. Which is considered a block to effective communication?
- A. Using silence
- B. Using clichés
- C. Directing the focus
- D. Defining the problem
Correct answer: B
Rationale: Using clichés is a communication block because it can come across as dismissive or insincere, hindering meaningful dialogue.
5. Why does the nurse have a 2-year-old boy sit in a “tailor” position while palpating for the presence of the testes?
- A. It prevents the cremasteric reflex
- B. Undescended testes can be palpated
- C. The child has an inguinal hernia
- D. The child does not yet have a need for privacy
Correct answer: A
Rationale: The tailor position stretches the muscle responsible for the cremasteric reflex, preventing it from contracting and pulling the testes into the pelvic cavity. This position helps accurately palpate the testes. Choice B is incorrect because the position does not facilitate the palpation of undescended testes specifically. Choice C is incorrect as it does not relate to the rationale behind the tailor position. Choice D is incorrect as the reason for using the tailor position is not related to the child's need for privacy.
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