ATI RN
RN Nursing Care of Children 2019 With NGN
1. What signs and symptoms are indicative of a urinary tract disorder in the infancy period (1-24 months)? (Select all that apply.)
- A. All below
- B. Poor feeding
- C. Hypothermia
- D. Frequent urination
Correct answer: A
Rationale: In infants, urinary tract disorders may present with poor feeding, hypothermia, and frequent urination. Pallor can be associated with other conditions but is less specific to urinary tract disorders.
2. Latex allergy is suspected in a child with spina bifida. What are appropriate nursing interventions to include in care of this patient?
- A. Avoid using any latex product.
- B. Use only non-allergenic latex products.
- C. Teach the family about long-term management of asthma.
- D. Administer medication for long-term desensitization.
Correct answer: A
Rationale: The correct answer is A: 'Avoid using any latex product.' In the case of a suspected latex allergy, it is crucial to prevent exposure to latex products to avoid allergic reactions. Choice B is incorrect because there are no truly non-allergenic latex products. Choice C is irrelevant to the situation described in the question, as the child does not have asthma. Choice D is also incorrect because desensitization is not an immediate option for managing a suspected latex allergy.
3. The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination?
- A. The United States is ranked last among 27 countries
- B. The United States is ranked similar to 20 other developed countries
- C. The United States is ranked in the middle of 20 other developed countries
- D. The United States is ranked highest among 27 other industrialized countries
Correct answer: A
Rationale: The United States is ranked last among developed countries with similar populations in terms of infant mortality rates, highlighting a significant public health concern.
4. An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Postoperative nursing care would include what?
- A. Monitor closely for signs of infection.
- B. Place the child with the operative side of the head up.
- C. Avoid pumping the shunt reservoir to maintain patency.
- D. Avoid maintaining a Trendelenburg position to decrease pressure on the shunt.
Correct answer: A
Rationale: Postoperative nursing care for an infant with hydrocephalus who underwent ventriculoperitoneal shunt placement includes monitoring closely for signs of infection, as infection is the greatest hazard in the postoperative period. Signs of cerebrospinal fluid infection to watch for include elevated temperature, poor feeding, vomiting, decreased responsiveness, and seizure activity. The child should be placed with the operative side of the head up to reduce pressure on the valve. The shunt reservoir should not be pumped to maintain patency, as this can disrupt its function. Maintaining a Trendelenburg position to decrease pressure on the shunt is contraindicated as it can lead to increased intracranial pressure and compromise the shunt's effectiveness.
5. A school-age child with cancer is being prepared for a procedure. The child says, “I have had one of these before. They hurt.” The nurse bases her response on what knowledge related to pain in this patient?
- A. Often misrepresent experiencing pain
- B. Tolerate pain better than adults
- C. Become accustomed to painful procedures
- D. Commonly experience treatment-related moderate to severe pain when they have cancer
Correct answer: D
Rationale: The correct answer is D. Pain is frequently reported by children with cancer, with around 84% experiencing it. Most children report moderate to severe pain, with about half finding it highly distressing. There is no evidence to suggest that children often misrepresent their pain experiences. Pain tolerance is not solely based on age but is a complex phenomenon. Children do not become accustomed to painful procedures, as each experience of pain is unique.
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