ATI RN
ATI Nursing Care of Children
1. 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.
2. What type of dehydration occurs when the electrolyte deficit exceeds the water deficit?
- A. Isotonic dehydration
- B. Hypotonic dehydration
- C. Hypertonic dehydration
- D. Hyperosmotic dehydration
Correct answer: B
Rationale: Hypotonic dehydration occurs when the loss of electrolytes exceeds the loss of water, leading to a decrease in plasma osmolarity. This often occurs when sodium loss is greater than water loss, as in diarrhea or vomiting.
3. Which physiological acid-base balance complication would be most important for the nurse to assess in a patient with diarrhea?
- A. High serum pH
- B. Normal serum pH
- C. Metabolic alkalosis
- D. Metabolic acidosis
Correct answer: D
Rationale: The correct answer is metabolic acidosis. Diarrhea can lead to the loss of bicarbonate, causing an imbalance in the acid-base status of the body, specifically resulting in metabolic acidosis. High serum pH (choice A) is incorrect as diarrhea-induced bicarbonate loss would lower pH, not increase it. Normal serum pH (choice B) is not the best answer as diarrhea can disrupt the acid-base balance. Metabolic alkalosis (choice C) is an alkaline state, which is less likely to be caused by diarrhea.
4. The child is admitted with acute abdominal pain and possible appendicitis. What intervention is appropriate to relieve the abdominal discomfort during the evaluation?
- A. Place the child in the Trendelenburg position.
- B. Apply moist heat to the abdomen.
- C. Allow the child to assume a position of comfort.
- D. Administer a saline enema to cleanse the bowel.
Correct answer: C
Rationale: Allowing the child to assume a position of comfort is appropriate as it helps alleviate discomfort without the risk of complications. Placing the child in the Trendelenburg position could increase intra-abdominal pressure and worsen the condition. Applying moist heat may lead to vasodilation and potential perforation in case of appendicitis. Administering a saline enema can be harmful if the appendix is inflamed or perforated.
5. When should the dressing change for a post-op pediatric patient that is expected to be very painful and frightening be performed?
- A. In the patient’s room
- B. In the treatment room
- C. After discharge when the patient is at home
- D. In the playroom
Correct answer: B
Rationale: The correct answer is B: 'In the treatment room.' Performing painful procedures in the treatment room helps the child associate their own room with safety and comfort, not pain. Choice A is incorrect because performing the dressing change in the patient’s room may create a negative association with their safe space. Choice C is incorrect as it is important to ensure proper wound care and pain management before discharge. Choice D is incorrect as the playroom may not be equipped for a sterile dressing change.
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