what physiologic states produces the clinical manifestations of nervous system stimulation and excitement such as overexcitability nervousness and tet
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Nursing Elites

ATI RN

RN Nursing Care of Children Online Practice 2019 A

1. What physiologic state(s) produces the clinical manifestations of nervous system stimulation and excitement, such as overexcitability, nervousness, and tetany?

Correct answer: D

Rationale: Both metabolic and respiratory alkalosis can cause overexcitability and nervous system stimulation due to a decrease in ionized calcium levels, which can cause symptoms such as tetany and paresthesias. Acidosis typically has the opposite effect, leading to depression of the nervous system.

2. When should a child receive the first dose of the hepatitis B virus (HBV) vaccine if the mother is hepatitis B surface antigen (HBsAg) negative?

Correct answer: B

Rationale: If the mother is HBsAg negative, it is recommended that the child receives the first dose of the hepatitis B vaccine at birth before discharge from the hospital. This is to provide early protection against the hepatitis B virus. The second dose of the vaccine is typically given at the first well-child visit, and the third dose is usually administered at a later date. The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention and the Committee on Infectious Diseases of the American Academy of Pediatrics govern the recommendations for immunization, including the hepatitis B virus vaccine. Choice A is incorrect as the first dose should ideally be given at birth. Choice C is incorrect as waiting until 6 months of age may leave the child vulnerable to infection during the early months of life. Choice D is incorrect as the hepatitis B vaccine is recommended for all newborns, especially if the mother is HBsAg negative, to prevent transmission of the virus.

3. A preschool-age boy presents to the outpatient clinic for a sore throat. In the child’s mind, which is the most likely cause for the sore throat?

Correct answer: D

Rationale: The correct answer is D. Preschool-age children often attribute illness to their actions, like yelling at a sibling or not following instructions. They may not understand medical causes such as exposure to infections like strep throat (choice A), dietary factors (choice B), or vitamin deficiencies (choice C). It is common for young children to connect symptoms to recent behaviors or events within their limited understanding.

4. What condition is often associated with severe diarrhea?

Correct answer: A

Rationale: Severe diarrhea can lead to a loss of bicarbonate, resulting in metabolic acidosis. This is a common complication of prolonged or severe diarrhea, especially in children.

5. What is the leading cause of morbidity and mortality in children with cystic fibrosis?

Correct answer: A

Rationale: Respiratory infections are the leading cause of morbidity and mortality in children with cystic fibrosis. Cystic fibrosis primarily affects the respiratory system, leading to thick mucus buildup in the lungs, which predisposes these children to recurrent respiratory infections. Malnutrition and diabetes are common comorbidities in cystic fibrosis but are not the leading causes of morbidity and mortality in affected children. Liver disease can occur in cystic fibrosis but is less common than respiratory complications.

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