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ATI Nursing Care of Children 2019 B
1. For a child with Kawasaki disease, which symptom is most indicative of the acute phase?
- A. Strawberry tongue
- B. Joint pain
- C. Rash
- D. Peeling skin
Correct answer: A
Rationale: The correct answer is A: Strawberry tongue. In Kawasaki disease, a 'strawberry tongue' is most indicative of the acute phase. This refers to the tongue appearing red and swollen with enlarged fungiform papillae, giving it a strawberry-like appearance. Joint pain (Choice B) is more commonly associated with other conditions like rheumatoid arthritis. Rash (Choice C) and peeling skin (Choice D) are also seen in Kawasaki disease but are not as specific to the acute phase as the presence of a strawberry tongue.
2. What amount of fluid loss occurs with moderate dehydration?
- A. <50 ml/kg
- B. 50 to 90 ml/kg
- C. <5% total body weight
- D. >15% total body weight
Correct answer: B
Rationale: Moderate dehydration is typically defined as a loss of 50 to 90 mL/kg of body weight. This amount reflects significant fluid loss that requires medical attention but is not yet severe.
3. What is the primary concern in a child with nephrotic syndrome?
- A. Hypotension
- B. Hyperkalemia
- C. Hyperlipidemia
- D. Hypocalcemia
Correct answer: C
Rationale: The correct answer is C: Hyperlipidemia. Children with nephrotic syndrome often present with hyperlipidemia due to altered lipid metabolism, making it a primary concern in these patients. Hypotension (choice A) is not a primary concern in nephrotic syndrome. Hyperkalemia (choice B) and hypocalcemia (choice D) are not typically associated with nephrotic syndrome and are less likely to be primary concerns in these patients.
4. According to Erikson’s theory of psychosocial development, the school-age child is in which stage?
- A. Industry vs. inferiority
- B. Autonomy vs. shame and doubt
- C. Identity vs. role diffusion
- D. Trust vs. mistrust
Correct answer: A
Rationale: The correct answer is A: 'Industry vs. inferiority.' According to Erikson’s theory, school-age children (approximately 6-12 years old) are in the stage of industry vs. inferiority. In this stage, children focus on developing a sense of competence and productivity. Choice B, 'Autonomy vs. shame and doubt,' is incorrect as it refers to the stage that occurs during early childhood (1-3 years old). Choice C, 'Identity vs. role diffusion,' pertains to adolescence (12-18 years old). Choice D, 'Trust vs. mistrust,' is related to the stage of infancy (0-1 year old). Therefore, option A is the most appropriate stage for school-age children in Erikson's theory.
5. A child diagnosed with aplastic anemia is admitted to the hospital. The parents ask the nurse what aplastic anemia is. Which response by the nurse is accurate?
- A. Aplastic anemia causes a proliferation of white blood cells.
- B. Aplastic anemia is characterized by abnormally shaped red blood cells.
- C. Aplastic anemia is caused by the bone marrow producing inadequate cells.
- D. Aplastic anemia is a disorder that occurs after a viral illness.
Correct answer: C
Rationale: Aplastic anemia is a condition where the bone marrow fails to produce sufficient red blood cells, white blood cells, and platelets, leading to pancytopenia. This can result in fatigue, infections, and bleeding tendencies. It is not characterized by abnormal red blood cell shapes, but rather by a reduction in the production of blood cells. Therefore, the accurate response is that aplastic anemia is caused by the bone marrow producing inadequate cells. Choices A and B are incorrect as aplastic anemia does not cause a proliferation of white blood cells or involve abnormally shaped red blood cells. Choice D is incorrect as aplastic anemia is not typically a disorder that occurs after a viral illness.
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