ATI RN
RN Nursing Care of Children 2019 With NGN
1. A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this child?
- A. Stimulate appetite
- B. Detect evidence of edema
- C. Minimize risk of infection
- D. Promote adherence to the antibiotic regimen
Correct answer: C
Rationale: Prednisone, an immunosuppressant, increases the child's susceptibility to infections, making infection prevention a critical nursing goal. Detecting edema and stimulating appetite are important but secondary to preventing potentially life-threatening infections.
2. The nurse is preparing to admit a 6-month-old child with gastroesophageal reflux disease. What clinical manifestations should the nurse expect to observe?
- A. Spitting up
- B. Bilious vomiting
- C. Failure to thrive
- D. All of the above
Correct answer: D
Rationale: The correct answer is D, as gastroesophageal reflux disease (GERD) in infants typically presents with symptoms such as spitting up, failure to thrive, excessive crying, and respiratory problems due to aspiration. Bilious vomiting is not a common symptom of GERD in infants and may indicate a different or more severe condition, such as intestinal obstruction or other gastrointestinal issues. Therefore, choices A, B, and C are all expected clinical manifestations of GERD in a 6-month-old child, making option D the correct answer.
3. Which electrolyte imbalance is a common concern in children with severe diarrhea?
- A. Hypernatremia
- B. Hypokalemia
- C. Hypercalcemia
- D. Hypomagnesemia
Correct answer: B
Rationale: Hypokalemia is the correct answer because it is a common concern in children with severe diarrhea. Diarrhea can lead to significant potassium loss, resulting in hypokalemia. Hypernatremia (Choice A) is less common in diarrhea as sodium concentration is usually diluted by the fluid loss. Hypercalcemia (Choice C) is not typically associated with severe diarrhea. Hypomagnesemia (Choice D) can occur but is not as common as hypokalemia in this scenario.
4. The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child's mother says she has rubbed the edge of a coin on her child's oiled skin. The nurse should recognize this as what?
- A. Child abuse
- B. Cultural practice to rid the body of disease
- C. Cultural practice to treat enuresis or temper tantrums
- D. Child discipline measure common in the Vietnamese culture
Correct answer: B
Rationale: This practice, known as "coining," is a cultural method believed to rid the body of illness and is not indicative of child abuse.
5. The nurse is preparing to administer an intramuscular injection to a toddler-age client. Which is the most appropriate statement by the nurse prior to this procedure?
- A. "We will give you your shot when your mommy comes back."
- B. "I will wipe your skin with a magic wipe and then hold the needle like this and say one, two, three, go and give you your shot. Are you ready?"
- C. "It is all right to cry. After we are done, you can go to the box and pick out your favorite sticker."
- D. "This is a magic sword that will give you your medicine and make you all better."
Correct answer: C
Rationale: The correct answer is C because it acknowledges the child's feelings, provides clear instructions, and offers comfort and rewards to help the child cope with the procedure. Choice A is not appropriate as it may create anxiety about the injection. Choice B uses the term 'magic,' which may confuse the child and lead to fear. Choice D introduces a fantasy element that may not be beneficial in preparing the child for the injection.
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