ATI RN
RN Nursing Care of Children Online Practice 2019 A
1. In which type of cancer are the urinary excretion of the breakdown products of catecholamines, especially vanillylmandelic acid (VMA) and homovanillic acid (HVA), detected?
- A. Neuroblastoma
- B. Nephroblastoma
- C. Leukemia
- D. Osteosarcoma
Correct answer: A
Rationale: The correct answer is A: Neuroblastoma. Neuroblastoma, a cancer that arises from nerve tissue, is associated with increased levels of catecholamine metabolites, including VMA and HVA, in the urine. Nephroblastoma (Wilms tumor) is a type of kidney cancer and is not typically associated with elevated levels of catecholamine breakdown products. Leukemia is a cancer of the blood and bone marrow and does not lead to increased VMA and HVA excretion in urine. Osteosarcoma is a bone cancer and is not linked to elevated levels of catecholamine metabolites in the urine.
2. In children with Type 1 diabetes, what is a common early sign of hypoglycemia?
- A. Irritability
- B. Rapid heartbeat
- C. Confusion
- D. Sweating
Correct answer: D
Rationale: Sweating is indeed one of the earliest signs of hypoglycemia in children with Type 1 diabetes. When blood sugar levels drop too low, the body releases stress hormones like adrenaline, which can lead to sweating. While irritability, rapid heartbeat, and confusion can also be seen in hypoglycemia, sweating is particularly common as a quick indicator of low blood sugar levels in children with Type 1 diabetes.
3. The nurse is discussing toddler development with a parent. Which intervention will foster the achievement of autonomy?
- A. Help the toddler complete tasks
- B. Encourage the toddler to do things for themselves when capable
- C. Provide opportunities for the toddler to play with other children
- D. Help the toddler learn the difference between right and wrong
Correct answer: B
Rationale: Encouraging the toddler to do things for themselves when capable is the correct intervention to foster autonomy. This approach helps the toddler develop independence, self-confidence, and a sense of achievement. Choice A is incorrect as it focuses on assisting rather than encouraging independence. Choice C is incorrect as playing with other children primarily fosters social skills, not necessarily autonomy. Choice D is incorrect as learning the difference between right and wrong is related to moral development, not autonomy.
4. 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.
5. A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child?
- A. It is unnecessary because of child’s age.
- B. It is essential because it will be an adjustment.
- C. Preparation is not needed because the colostomy is temporary.
- D. Preparation is important because the child needs to deal with negative body image.
Correct answer: B
Rationale: Preparation is essential even for a young child, as they need to adjust to the temporary colostomy and understand the changes to their body, which can be confusing and distressing without proper explanation.
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