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RN Nursing Care of Children Online Practice 2019 A
1. What laboratory finding should the nurse expect in a child with an excess of water?
- A. Decreased hematocrit
- B. High serum osmolality
- C. High urine specific gravity
- D. Increased blood urea nitrogen (BUN)
Correct answer: A
Rationale: Water excess typically leads to hemodilution, resulting in a decreased hematocrit. High serum osmolality and specific gravity would indicate dehydration, while elevated BUN could suggest renal impairment or dehydration, not fluid overload.
2. Which finding suggests fluid volume deficit in an infant presenting with vomiting and diarrhea for 2 days?
- A. Increased blood pressure
- B. A sunken fontanel
- C. Decreased pulse rate
- D. Low urine specific gravity
Correct answer: B
Rationale: A sunken fontanel is a classic sign of dehydration in infants, indicating a fluid volume deficit. In dehydration, the fontanel sinks due to decreased fluid volume in the body. Increased blood pressure (Choice A) is not typically associated with dehydration in infants. Decreased pulse rate (Choice C) is not a common finding in fluid volume deficit, as the body tries to increase the heart rate to compensate for decreased volume. Low urine specific gravity (Choice D) may be seen in dehydration, but it is not as specific or as easily observable as a sunken fontanel.
3. At what stage can infants raise their heads and gain control of their trunks before walking due to which directional pattern of development?
- A. Cephalocaudal
- B. Anterior to posterior
- C. Proximodistal
- D. Normal growth curve charts
Correct answer: A
Rationale: The correct answer is A: Cephalocaudal. The cephalocaudal pattern of development means that growth and motor control proceed from the head downward through the body. This explains why infants can raise their heads before they can sit and gain control of their trunks before walking. Choices B, C, and D are incorrect. Anterior to posterior refers to development from the front to the back, while proximodistal refers to development from the center of the body outward. Normal growth curve charts are used to track physical growth over time and are not directly related to the directional pattern of development in infants.
4. What is the most common cause of bronchiolitis in infants?
- A. Adenovirus
- B. Influenza virus
- C. Respiratory syncytial virus
- D. Parainfluenza virus
Correct answer: C
Rationale: The correct answer is C, Respiratory syncytial virus (RSV). RSV is the leading cause of bronchiolitis, a common respiratory condition in infants that results in inflammation of the small airways in the lung. It is highly contagious and can cause severe respiratory distress in young children, particularly those under 2 years old. Choice A, Adenovirus, is not the most common cause of bronchiolitis in infants. Choice B, Influenza virus, may cause respiratory infections but is not the primary cause of bronchiolitis. Choice D, Parainfluenza virus, can cause croup and other upper respiratory infections but is not the main cause of bronchiolitis in infants.
5. What is the typical presentation of pyloric stenosis in infants?
- A. Bilious vomiting
- B. Projectile vomiting
- C. Blood in stools
- D. Failure to thrive
Correct answer: B
Rationale: The correct answer is B: Projectile vomiting. Pyloric stenosis in infants typically presents with projectile vomiting, which is forceful and projective in nature. This occurs due to the obstruction at the pylorus, leading to the stomach being unable to empty properly. Choices A, C, and D are incorrect. Bilious vomiting is more commonly associated with intestinal obstruction, blood in stools can occur in conditions such as necrotizing enterocolitis or allergic colitis, and failure to thrive is a nonspecific finding that can be seen in various pediatric conditions.
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