ATI RN
RN Nursing Care of Children Online Practice 2019 A
1. Physiologically, the child compensates for fluid volume losses by which mechanism?
- A. Inhibition of aldosterone secretion
- B. Hemoconcentration to reduce cardiac workload
- C. Fluid shift from interstitial space to intravascular space
- D. Vasodilation of peripheral arterioles to increase perfusion
Correct answer: C
Rationale: In response to dehydration, the body compensates by shifting fluids from the interstitial spaces to the intravascular space to maintain blood pressure and perfusion to vital organs. Hemoconcentration and vasoconstriction are other compensatory mechanisms but are less immediate.
2. What clinical manifestation should be the most suggestive of acute appendicitis?
- A. Rebound tenderness
- B. Bright red or dark red rectal bleeding
- C. Abdominal pain that is relieved by eating
- D. Colicky, cramping abdominal pain around the umbilicus
Correct answer: D
Rationale: The correct answer is D: Colicky, cramping abdominal pain around the umbilicus. This type of pain is a common early sign of acute appendicitis. Rebound tenderness, choice A, is a later sign seen in the physical examination of a patient with appendicitis. Rectal bleeding, as described in choice B, is not typically associated with appendicitis. Abdominal pain that is relieved by eating, as mentioned in choice C, is more indicative of peptic ulcer disease rather than appendicitis.
3. The Denver II is a test used to assess children. What does it evaluate?
- A. Behavior problems
- B. Developmental status
- C. Body mass index
- D. Infection likelihood
Correct answer: B
Rationale: The Denver II Developmental Screening Test is used to assess a child's development in four areas: personal-social, fine motor-adaptive, language, and gross motor skills. It helps identify children who may need further evaluation. Choice A, behavior problems, is incorrect as the Denver II primarily focuses on developmental milestones rather than behavior. Choice C, body mass index, is unrelated to the assessment of child development. Choice D, infection likelihood, is also not evaluated by the Denver II test.
4. The mother of an infant diagnosed with bronchiolitis asks the nurse what causes the disease. How should the nurse respond?
- A. Respiratory syncytial virus (RSV)
- B. Haemophilus influenzae
- C. Parainfluenza
- D. Rotavirus
Correct answer: A
Rationale: The correct answer is A: Respiratory syncytial virus (RSV). RSV is the most common cause of bronchiolitis, especially in infants. Bronchiolitis is characterized by inflammation of the small airways in the lungs. Choice B, Haemophilus influenzae, is a bacterium that can cause respiratory infections but is not the primary cause of bronchiolitis. Choice C, Parainfluenza, is a common viral infection that can cause croup and other respiratory illnesses but is not the main cause of bronchiolitis. Choice D, Rotavirus, is a virus that primarily affects the gastrointestinal system, causing diarrhea and vomiting, and is not associated with bronchiolitis.
5. What is the most consistent and commonly used indicator of pain in infants?
- A. Increased respirations
- B. Increased heart rate
- C. Thrashing of arms and legs
- D. Facial expression of discomfort
Correct answer: D
Rationale: Facial expression has consistently been validated as an indicator of pain in infants. Behavioral pain measures are most reliable for sharp procedural pain in infants. Increased heart rate and respirations are indicative of a generalized and complex response to stress, not specific for pain in infants. Thrashing of arms and legs is a reliable indicator in young children, not specifically in infants.
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