ATI RN
RN Nursing Care of Children 2019 With NGN
1. The mother of a child with type 1 diabetes asks the nurse why her child cannot avoid all those ‘shots’ and take pills like an uncle does. How should the nurse respond?
- A. The pills work with adult pancreases only.
- B. Your child needs insulin replaced, and the oral hypoglycemic only add to an existing supply of insulin.
- C. The drugs affect fat and protein metabolism, not sugar.
- D. Perhaps when your child is older the pancreas will produce its own insulin, and then your child can take oral hypoglycemic agents.
Correct answer: B
Rationale: The correct answer is B. Children with type 1 diabetes require insulin replacement because their pancreas produces little or no insulin. Oral hypoglycemics used in type 2 diabetes work by improving the effectiveness of insulin the body already makes, which is not sufficient in type 1 diabetes. Choice A is incorrect because the issue is not about the pancreas being adult or child-specific but rather the type of diabetes. Choice C is incorrect because it misstates the mechanism of action of the medications. Choice D is incorrect because it provides inaccurate information about the potential for the child's pancreas to produce insulin in the future, which is unlikely in type 1 diabetes.
2. When teaching a mother how to administer eye drops, where should the nurse tell her to place them?
- A. At the lacrimal duct
- B. On the sclera while the child looks to the outside
- C. In the conjunctival sac when the lower eyelid is pulled down
- D. Carefully under the eyelid while it is gently pulled upward
Correct answer: C
Rationale: Eye drops should be placed in the conjunctival sac, which allows the medication to be absorbed properly without causing irritation. Placing drops directly on the sclera or near the lacrimal duct is less effective and can cause discomfort.
3. Which is the most frequently used test for measuring visual acuity?
- A. Snellen letter chart
- B. Ishihara vision test
- C. Allen picture card test
- D. Denver eye screening test
Correct answer: A
Rationale: The Snellen letter chart is the most commonly used test for measuring visual acuity, particularly in school-age children and adults.
4. When caring for a child with an intravenous (IV) infusion, what is an appropriate nursing action?
- A. Change the insertion site every 24 hours.
- B. Check the insertion site frequently for signs of infiltration.
- C. Use a macrodropper to facilitate reaching the prescribed flow rate.
- D. Avoid restraining the child to prevent undue emotional stress.
Correct answer: B
Rationale: Frequent monitoring of the IV site for signs of infiltration is crucial to prevent tissue damage, especially in pediatric patients. Changing the site every 24 hours is unnecessary unless complications arise, and using a macrodropper is not specific to pediatric care.
5. A 12-month-old infant has been diagnosed with failure to thrive (FTT). Which assessment findings does the nurse expect to be documented with this infant?
- A. Fear of strangers
- B. Minimal smiling
- C. Avoidance of eye contact
- D. All of the above
Correct answer: D
Rationale: These behaviors are consistent with FTT and indicate social withdrawal, which is often observed in infants who are not thriving. A wide-eyed gaze and avoidance of eye contact can also indicate developmental delays or emotional disturbances.
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