ATI LPN
Questions About the Immune System Questions
Question 1 of 5
A child is being treated for strep throat. The nurse tells the parent to report any abrupt onset of midabdominal pain along with malaise, irritability and fever. The nurse is teaching the parent signs of:
Correct Answer: B
Rationale: The correct answer is B: Acute post-streptococcal glomerulonephritis. This condition is a possible complication of strep throat caused by an immune response to the streptococcal infection affecting the glomeruli of the kidneys. The signs mentioned by the nurse (abrupt onset of midabdominal pain, malaise, irritability, and fever) are indicative of this condition. Sodium retention (choice A) is not associated with these specific signs. Hemolytic-uremic syndrome (choice C) typically presents with bloody diarrhea and kidney injury, not midabdominal pain. Renal insufficiency (choice D) may present with various symptoms but does not typically include midabdominal pain as a prominent sign.
Question 2 of 5
An infant is born with an esophageal atresia and tracheoesophageal fistula. Which preoperative nursing diagnosis is the priority for this infant?
Correct Answer: A
Rationale: The correct answer is A: Risk for Aspiration Related to Regurgitation. This is the priority because the infant with esophageal atresia and tracheoesophageal fistula is at high risk for aspiration due to the abnormal connection between the esophagus and trachea. Aspiration can lead to serious complications such as pneumonia and respiratory distress. Addressing this risk is crucial for the infant's safety and well-being. Choice B (Acute Pain) is not the priority as aspiration poses a more immediate threat to the infant's health. Choice C (Ineffective Infant Feeding Pattern) is important but addressing the risk of aspiration takes precedence. Choice D (Ineffective Tissue Perfusion) is not directly related to the immediate danger of aspiration in this case. Prioritizing the prevention of aspiration is essential for the infant's safety and effective care.
Question 3 of 5
A school-age client, recently diagnosed with asthma, also has a peanut allergy. The nurse instructs the family to not only avoid peanuts but also to carefully check food label ingredients for peanut products and to make sure dishes and utensils are adequately washed prior to food preparation. The mother asks why this is specific for her child. Based on the client’s history, the nurse knows that this client is at an increased risk for which complication?
Correct Answer: C
Rationale: The correct answer is C: Anaphylaxis. Anaphylaxis is a severe and potentially life-threatening allergic reaction that can occur rapidly in individuals with peanut allergies. The client's history of asthma and peanut allergy puts them at a higher risk for experiencing anaphylaxis when exposed to peanuts. Anaphylaxis can cause symptoms such as difficulty breathing, swelling, a drop in blood pressure, and can be fatal if not treated promptly with epinephrine. A: Urticaria is a skin rash that can occur in response to an allergic reaction, but it is not as severe or life-threatening as anaphylaxis. B: Diarrhea is not typically a common symptom of an allergic reaction to peanuts and does not pose the same level of risk as anaphylaxis. D: Headache is not a common symptom of an allergic reaction to peanuts and is not as severe as anaphylaxis.
Question 4 of 5
The mother of a 14-month-old child is concerned because the child’s appetite has decreased. The best response for the nurse to make to the mother is:
Correct Answer: B
Rationale: The correct answer is B: It is not unusual for toddlers to eat less. Toddlers often go through phases where their appetites fluctuate, and it is normal for them to eat less at times. This response reassures the mother that her child's decreased appetite is a common phenomenon among toddlers and typically not a cause for concern. Rationale: - A (It is important for your toddler to eat three meals a day and nothing in between): This answer is too rigid and may cause unnecessary stress for the mother. Toddlers may have varying eating patterns, and forcing them to adhere to a strict meal schedule can be counterproductive. - C (Be sure to increase your child’s milk consumption, which will improve nutrition): Increasing milk consumption may not necessarily improve nutrition and could lead to other issues such as iron deficiency. It is important to focus on a balanced diet rather than solely relying on milk. - D (Giving your child a multivitamin supplement daily will increase your toddler’s
Question 5 of 5
A child diagnosed with tetralogy of Fallot becomes upset, crying and thrashing around when a blood specimen is obtained. The child’s color becomes blue and respiratory rate increases to 44 bpm. Which of the following actions would the nurse do first?
Correct Answer: D
Rationale: The correct answer is D: Place the child in knee-to-chest position. This position helps improve blood flow to the lungs by reducing the amount of blood shunted away from the lungs in tetralogy of Fallot. It can help alleviate cyanosis and respiratory distress. This action should be done first to address the immediate physiological need of the child. Choice A: Obtaining sedation may be necessary, but addressing the physiological distress should take precedence. Choice B: Assessing for an irregular heart rate and rhythm is important but not the immediate priority in this situation. Choice C: Explaining to the child may be helpful for preparation, but addressing the physiological distress is the priority.