ATI RN
ATI Nursing Care of Children 2019 B
1. What is the primary concern in a child with nephrotic syndrome?
- A. Hypotension
- B. Hyperkalemia
- C. Hyperlipidemia
- D. Hypocalcemia
Correct answer: C
Rationale: The correct answer is C: Hyperlipidemia. Children with nephrotic syndrome often present with hyperlipidemia due to altered lipid metabolism, making it a primary concern in these patients. Hypotension (choice A) is not a primary concern in nephrotic syndrome. Hyperkalemia (choice B) and hypocalcemia (choice D) are not typically associated with nephrotic syndrome and are less likely to be primary concerns in these patients.
2. An anxious 12-year-old child receives an injection from the nurse and sighs with relief when it is done. After a moment of reflection, the girl asks the nurse, 'Is it hard to give someone an injection?' This child’s question is evidence that the child has developed which cognitive skill?
- A. Conservation
- B. Accommodation
- C. Decentering
- D. Class inclusion
Correct answer: C
Rationale: The correct answer is C: Decentering. Decentering is the ability to consider multiple aspects of a situation, which the child's question demonstrates. In this scenario, the child's question shows that she is thinking beyond her own experience and considering the difficulty or complexity of giving an injection from the nurse's perspective. Choices A, B, and D are incorrect. Conservation refers to understanding that certain properties of an object remain the same despite changes in its appearance. Accommodation is the process of adjusting existing knowledge or creating new mental categories to incorporate new information. Class inclusion involves understanding the relationship between a whole set and its subsets, which is not demonstrated in the child's question.
3. 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.
4. A nurse is evaluating the effectiveness of teaching regarding care of a child with minimal change nephrotic syndrome (MCNS) that is in remission after the administration of prednisone. The nurse realizes further teaching is required if the parents state what?
- A. We will keep our child away from anyone who is ill.
- B. We will be sure to administer the prednisone as ordered.
- C. We will encourage our child to eat a balanced diet, but we will watch his salt intake.
- D. We understand our child will not be able to attend school, so we will arrange for homeschooling.
Correct answer: D
Rationale: Children with MCNS who are in remission can usually attend school and participate in normal activities with precautions to avoid infections. Home schooling may not be necessary, and this indicates a misunderstanding of the condition's management.
5. When should the nurse instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux?
- A. At bedtime
- B. With a meal
- C. Midmorning
- D. 30 minutes before breakfast
Correct answer: D
Rationale: Proton pump inhibitors (PPIs) like omeprazole or lansoprazole are most effective when given 30 minutes before breakfast. This timing allows the medication to inhibit the proton pumps in the stomach that produce acid, providing better symptom control throughout the day. Administering the PPI at bedtime (choice A) may not be as effective as giving it before breakfast due to the timing of peak acid production during the day. Giving it with a meal (choice B) might affect the absorption and effectiveness of the medication. Midmorning administration (choice C) is not the recommended time for optimal PPI efficacy.
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