ATI RN
RN Nursing Care of Children 2019 With NGN
1. What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis?
- A. Infarction of renal vessels
- B. Immune complex formation and glomerular deposition
- C. Bacterial endotoxin deposition on and destruction of glomeruli
- D. Embolization of glomeruli by bacteria and fibrin from endocardial vegetation
Correct answer: B
Rationale: Postinfectious glomerulonephritis is typically caused by immune complex deposition in the glomeruli following a streptococcal infection. This immune response leads to inflammation and impaired kidney function.
2. The nurse is caring for a child with acute postinfectious glomerulonephritis. Which of the following best describes the pathophysiology of acute postinfectious glomerulonephritis?
- A. Occurs after a urinary tract infection
- B. Occurs after a streptococcal infection
- C. Associated with renal vascular disorders
- D. Is caused by E. coli
Correct answer: B
Rationale: The correct answer is B: 'Occurs after a streptococcal infection.' Acute postinfectious glomerulonephritis often occurs after an infection with certain strains of streptococcus bacteria, specifically group A streptococcus. The body’s immune response to the infection leads to inflammation and damage in the kidneys. Choices A, C, and D are incorrect because acute postinfectious glomerulonephritis is primarily associated with streptococcal infections, not urinary tract infections, renal vascular disorders, or E. coli.
3. According to Erikson’s developmental theory, toddlers need to be encouraged to become independent to successfully complete which developmental challenge?
- A. Trust vs. mistrust
- B. Industry vs. inferiority
- C. Autonomy vs. shame and doubt
- D. Initiative vs. guilt
Correct answer: C
Rationale: The correct answer is C: Autonomy vs. shame and doubt. Erikson's developmental stage for toddlers focuses on the conflict between developing a sense of independence (autonomy) and feelings of inadequacy (shame and doubt). Encouraging toddlers to explore their environment and make choices helps them build self-confidence and independence. Choices A, B, and D are incorrect because trust vs. mistrust relates to infancy, industry vs. inferiority is associated with school-age children, and initiative vs. guilt is linked to preschoolers.
4. A parent of a school-age child tells the school nurse that the parents are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as what?
- A. Indicative of maladjustment
- B. A common reaction to divorce
- C. Suggestive of a lack of adequate parenting
- D. An unusual response that indicates a need for referral
Correct answer: B
Rationale: Poor academic performance and sleep disturbances are common reactions in children going through their parents' divorce, reflecting stress and adjustment challenges.
5. A 14-month-old child is admitted to the hospital with laryngotracheobronchitis (LTB). Which assessment findings should the nurse expect?
- A. Cyanosis and dyspnea
- B. Productive cough and high fever
- C. Barking cough and inspiratory stridor
- D. Pale laryngeal and dyspnea
Correct answer: C
Rationale: The correct answer is C: 'Barking cough and inspiratory stridor.' Classic signs of laryngotracheobronchitis (LTB) include a barking cough, often described as a seal-like cough, and inspiratory stridor, which is a high-pitched sound heard during inspiration. These symptoms occur due to inflammation and narrowing of the upper airway. Choices A, B, and D are incorrect as they do not align with the typical assessment findings of LTB. Cyanosis and dyspnea (Choice A) may occur in severe cases but are not specific to LTB. Productive cough and high fever (Choice B) are more indicative of lower respiratory tract infections. Pale laryngeal and dyspnea (Choice D) are not characteristic findings of LTB.
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