ATI RN
ATI Nursing Care of Children 2019 B
1. Which of the following conditions is characterized by a 'machine-like' murmur in children?
- A. Patent ductus arteriosus
- B. Ventricular septal defect
- C. Atrial septal defect
- D. Coarctation of the aorta
Correct answer: A
Rationale: The correct answer is A, Patent ductus arteriosus. This condition is characterized by a continuous 'machine-like' murmur due to abnormal blood flow between the aorta and pulmonary artery. Ventricular septal defect (choice B) is characterized by a harsh holosystolic murmur, atrial septal defect (choice C) typically presents with a fixed split S2 and a pulmonary flow murmur, and coarctation of the aorta (choice D) is associated with a systolic murmur in the back and bilateral lower extremities.
2. A child diagnosed with aplastic anemia is admitted to the hospital. The parents ask the nurse what aplastic anemia is. Which response by the nurse is accurate?
- A. Aplastic anemia causes a proliferation of white blood cells.
- B. Aplastic anemia is characterized by abnormally shaped red blood cells.
- C. Aplastic anemia is caused by the bone marrow producing inadequate cells.
- D. Aplastic anemia is a disorder that occurs after a viral illness.
Correct answer: C
Rationale: Aplastic anemia is a condition where the bone marrow fails to produce sufficient red blood cells, white blood cells, and platelets, leading to pancytopenia. This can result in fatigue, infections, and bleeding tendencies. It is not characterized by abnormal red blood cell shapes, but rather by a reduction in the production of blood cells. Therefore, the accurate response is that aplastic anemia is caused by the bone marrow producing inadequate cells. Choices A and B are incorrect as aplastic anemia does not cause a proliferation of white blood cells or involve abnormally shaped red blood cells. Choice D is incorrect as aplastic anemia is not typically a disorder that occurs after a viral illness.
3. A 14-year-old with chronic renal failure suddenly becomes non-compliant with the medication regimen. Which nursing intervention would most likely improve compliance?
- A. Give the child a computer-animated game that presents information on the management of chronic renal failure.
- B. Set up a meeting with some older teens who have chronic renal failure and have been managing their disease effectively.
- C. Arrange for a physician to sit down and talk to the child about the risks related to noncompliance with medications.
- D. Discuss with the child’s parents that privileges, such as a cell phone, can be taken away if compliance fails to improve.
Correct answer: B
Rationale: Adolescents often seek guidance and support from their peers. Setting up a meeting with older teens who are effectively managing chronic renal failure can provide the 14-year-old with motivation, encouragement, and practical advice on how to handle their treatment regimen. This peer support can positively influence the non-compliant adolescent, making choice B the most likely intervention to improve compliance. Choices A and C may not address the peer influence aspect of adolescent behavior, while choice D focuses on punitive measures rather than addressing the underlying reasons for non-compliance.
4. What diagnostic test allows visualization of renal parenchyma and renal pelvis without exposure to external-beam radiation or radioactive isotopes?
- A. Renal ultrasonography
- B. Computed tomography
- C. Intravenous pyelography
- D. Voiding cystourethrography
Correct answer: A
Rationale: Renal ultrasonography provides imaging of the renal parenchyma and pelvis without the risks associated with radiation or radioactive isotopes, making it a safer option, especially for children.
5. What is a suitable nutritional goal for a preschool-aged child?
- A. Minimize messiness and spills.
- B. Introduce new foods gradually and provide variety.
- C. Finish all the food on the plate.
- D. Allow the child to eat only preferred foods.
Correct answer: B
Rationale: Introducing new foods gradually and offering a variety of options is a suitable nutritional goal for preschool-aged children as it helps in providing essential nutrients and expanding their palate. Choice A is incorrect as reducing messiness and spills is more related to behavior than nutrition. Choice C is incorrect as forcing a child to finish all the food on the plate may override their natural hunger and fullness cues. Choice D is incorrect as allowing a child to eat only preferred foods may lead to an imbalanced diet lacking in essential nutrients.
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