ATI RN
RN Nursing Care of Children 2019 With NGN
1. The nurse is caring for a child with Beta Thalassemia. Which child is in a group most at risk for Beta Thalassemia?
- A. A three-year-old girl of Mediterranean descent.
- B. A ten-year-old boy of Hispanic descent.
- C. A young girl of African descent.
- D. A baby of European descent.
Correct answer: A
Rationale: Corrected Rationale: Beta Thalassemia is most common in individuals of Mediterranean descent, such as those from Italy, Greece, and the Middle East. This genetic disorder affects hemoglobin production and can lead to severe anemia. Choice A is the correct answer as individuals of Mediterranean descent are at the highest risk for Beta Thalassemia. Choices B, C, and D are incorrect as they do not belong to the population group most at risk for this genetic disorder.
2. Two 3-year-old clients are playing together in a hospital playroom. One is working on a puzzle, while the other is stacking blocks. Which type of play is this?
- A. Cooperative play
- B. Solitary play
- C. Parallel play
- D. Associative play
Correct answer: C
Rationale: The correct answer is C, parallel play. Parallel play is observed when children play alongside each other but do not directly interact. In this scenario, each child is engaged in their own activity without engaging or influencing each other's play, which characterizes parallel play. Cooperative play (choice A) involves children playing together towards a common goal, which is not evident in the given situation. Solitary play (choice B) is when a child plays alone, unrelated to the presence of others. Associative play (choice D) involves more interaction and sharing of toys between children, which is not happening in the described play scenario.
3. Which assessment findings should the nurse expect in a child with sickle cell anemia experiencing an acute vaso-occlusive crisis?
- A. Circulatory collapse, hypovolemia
- B. Cardiomegaly, systolic murmur
- C. Hepatomegaly, intrahepatic cholestasis
- D. Painful swelling of joints in hands and feet, tissue engorgement
Correct answer: D
Rationale: The correct answer is D. Vaso-occlusive crises in sickle cell anemia are characterized by painful swelling of the joints in the hands and feet (hand-foot syndrome) and tissue engorgement due to the obstruction of blood flow by sickled cells. Choices A, B, and C are incorrect because circulatory collapse, hypovolemia, cardiomegaly, systolic murmur, hepatomegaly, and intrahepatic cholestasis are not typically associated with an acute vaso-occlusive crisis in sickle cell anemia.
4. What is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)?
- A. Reduce blood pressure
- B. Lower serum protein levels
- C. Minimize excretion of urinary protein
- D. Increase the ability of tissue to retain fluid
Correct answer: C
Rationale: The primary objective in managing MCNS is to minimize the excretion of urinary protein, which is responsible for the hypoalbuminemia and subsequent edema in these patients.
5. What findings would the nurse consider normal in assessing the anterior fontanel of a neonate?
- A. Closed anterior fontanel
- B. Sunken anterior fontanel
- C. Bulging anterior fontanel
- D. Pulsating anterior fontanel
Correct answer: D
Rationale: The correct answer is D: Pulsating anterior fontanel. The fontanel should feel flat, firm, and well demarcated. Pulsations are frequently visible at the anterior fontanel, which is a normal finding in a neonate. A closed anterior fontanel, as mentioned, is a potential sign of a major abnormality. A sunken or bulging fontanel (when the infant is quiet) may be indicative of distress or a major abnormality. Therefore, options A, B, and C are considered abnormal findings when assessing the anterior fontanel of a neonate.
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