ATI RN
RN Nursing Care of Children 2019 With NGN
1. The nurse is caring for a child with a urinary tract infection who is on trimethoprim-sulfamethoxazole (Bactrim). What side effects of this medication should the nurse teach to the parents and the child? (Select all that apply.)
- A. Rash
- B. Urticaria
- C. All are applicable
- D. Photosensitivity
Correct answer: C
Rationale: Trimethoprim-sulfamethoxazole (Bactrim) can cause side effects like rash, urticaria, and photosensitivity. Parents and the child should be educated on these potential side effects to ensure prompt recognition and management.
2. The mother of a 3-month-old breastfed infant asks about giving her baby water because it is summer and very warm. What should the nurse tell her?
- A. Fluids in addition to breast milk are not needed.
- B. Water should be given if the infant seems to nurse longer than usual.
- C. Clear juices are better than water to promote adequate fluid intake.
- D. Water once or twice a day will make up for losses resulting from environmental temperature.
Correct answer: A
Rationale: Breast milk provides adequate hydration, even in warm weather, so additional fluids like water are not necessary and can interfere with breastfeeding.
3. Which congenital heart defect causes a "boot-shaped" heart on a chest x-ray?
- A. Tetralogy of Fallot
- B. Coarctation of the aorta
- C. Transposition of the great arteries
- D. Ventricular septal defect
Correct answer: A
Rationale: The correct answer is A: Tetralogy of Fallot. Tetralogy of Fallot, a congenital heart defect with four distinct abnormalities, often presents with a "boot-shaped" heart on chest x-ray due to right ventricular hypertrophy. This characteristic finding is due to the specific combination of defects in this condition. Coarctation of the aorta (choice B), Transposition of the great arteries (choice C), and Ventricular septal defect (choice D) do not typically result in a "boot-shaped" heart on a chest x-ray like Tetralogy of Fallot does.
4. 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.
5. A 10-month-old infant is diagnosed with gastroesophageal reflux. An esophageal (pH) probe monitor is ordered. What explanation for the purpose of the esophageal probe should the nurse provide to the parents?
- A. Assist in the passage of formula through the esophagus
- B. Identify the number of reflux episodes that are occurring
- C. Determine the time it takes for the stomach to empty its contents
- D. Monitor the pH within the stomach
Correct answer: B
Rationale: The correct answer is B. The esophageal pH probe is used to identify the frequency and severity of reflux episodes by measuring the pH in the esophagus. Choice A is incorrect because the probe does not assist in the passage of formula through the esophagus. Choice C is incorrect as determining the time it takes for the stomach to empty its contents would require a different procedure. Choice D is incorrect as the esophageal pH probe monitors the pH in the esophagus, not the stomach.
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