ATI RN
ATI Nursing Care of Children 2019 B
1. Which electrolyte imbalance is a common concern in children with severe diarrhea?
- A. Hypernatremia
- B. Hypokalemia
- C. Hypercalcemia
- D. Hypomagnesemia
Correct answer: B
Rationale: Hypokalemia is the correct answer because it is a common concern in children with severe diarrhea. Diarrhea can lead to significant potassium loss, resulting in hypokalemia. Hypernatremia (Choice A) is less common in diarrhea as sodium concentration is usually diluted by the fluid loss. Hypercalcemia (Choice C) is not typically associated with severe diarrhea. Hypomagnesemia (Choice D) can occur but is not as common as hypokalemia in this scenario.
2. At which age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?
- A. 1 month
- B. 2 months
- C. 3 months
- D. 4 months
Correct answer: B
Rationale: Infants typically begin to smile in response to pleasurable stimuli by 2 months, which is an early sign of social interaction and emotional development.
3. What test is used to screen for carbohydrate malabsorption?
- A. Stool pH
- B. Urine ketones
- C. C urea breath test
- D. ELISA stool assay
Correct answer: A
Rationale: Stool pH testing is used to screen for carbohydrate malabsorption. A low pH indicates the presence of unabsorbed carbohydrates, which are fermented by bacteria, leading to acidic stool.
4. A child has a central venous access device for intravenous (IV) fluid administration. A blood sample is needed for a complete blood count, hemogram, and electrolytes. What is the appropriate procedure to implement for this blood sample?
- A. Perform a new venipuncture to obtain the blood sample.
- B. Interrupt the IV fluid and withdraw the blood sample needed.
- C. Withdraw a blood sample equal to the amount of fluid in the device, discard, and then withdraw the sample needed.
- D. Flush the line and central venous device with saline and then aspirate the required amount of blood for the sample.
Correct answer: C
Rationale: Withdrawing and discarding a sample equal to the amount of fluid in the device ensures that the blood drawn is not diluted by the IV fluids, providing accurate lab results.
5. What is the most critical physiologic change required of newborns at birth?
- A. Transition from fetal to neonatal breathing
- B. Body temperature maintenance
- C. Stabilization of fluid and electrolytes
- D. Closure of fetal shunts in the heart
Correct answer: A
Rationale: The correct answer is A: Transition from fetal to neonatal breathing. The onset of breathing is the most immediate and critical physiologic change required for the transition to extrauterine life. Factors that interfere with this normal transition increase fetal asphyxia, which is a condition of hypoxemia, hypercapnia, and acidosis. While body temperature maintenance, stabilization of fluid and electrolytes, and closure of fetal shunts in the heart are crucial changes in the transition to extrauterine life, breathing and the exchange of oxygen for carbon dioxide must take precedence as they are essential for newborn survival.
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