ATI RN
RN Nursing Care of Children 2019 With NGN Questions
Question 1 of 5
A child with acute glomerulonephritis is in the playroom and experiences blurred vision and a headache. What action should the nurse take?
Correct Answer: B
Rationale: In this scenario, the correct action for the nurse to take is option B: Obtain the child's blood pressure and notify the healthcare provider. Blurred vision and headache in a child with acute glomerulonephritis could indicate a rise in blood pressure, which is a common complication of this condition. Monitoring blood pressure is crucial in managing acute glomerulonephritis to prevent hypertensive crisis and further kidney damage. Option A is incorrect because checking urine for increased hematuria does not address the immediate concern of elevated blood pressure and potential hypertensive crisis. Option C, obtaining serum electrolytes and sending urinalysis to the laboratory, is not the priority when dealing with acute symptoms like blurred vision and headache. Option D is also incorrect as reassuring the child and encouraging bed rest do not address the potential medical emergency of hypertension. It is essential for nurses caring for children with acute glomerulonephritis to promptly assess and address signs of increasing blood pressure to prevent complications. Educationally, understanding the relationship between acute glomerulonephritis and hypertension is vital for nurses caring for pediatric patients. This rationale highlights the importance of timely assessment, intervention, and collaboration with the healthcare team to provide safe and effective care for children with renal conditions.
Question 2 of 5
The nurse is preparing to admit a child to the hospital with a diagnosis of minimal change nephrotic syndrome. The nurse understands that the peak age at onset for this disease is what?
Correct Answer: B
Rationale: In the case of minimal change nephrotic syndrome, the peak age at onset is typically between 4 to 5 years old. This is because minimal change nephrotic syndrome is more commonly seen in preschool and early school-aged children. At this age, the immune system is still developing, making children more susceptible to this condition. Option A (2 to 3 years) is incorrect because minimal change nephrotic syndrome is less commonly seen in younger children due to their immune system still maturing. Option C (6 to 7 years) is incorrect because while children in this age range can develop minimal change nephrotic syndrome, the peak age of onset is earlier, around 4 to 5 years old. Option D (8 to 9 years) is incorrect as minimal change nephrotic syndrome typically presents before this age range. Understanding the peak age of onset for diseases in children is crucial for nurses caring for pediatric patients as it helps in early recognition, prompt treatment, and better outcomes. By knowing the typical age range for minimal change nephrotic syndrome, nurses can provide appropriate care and support to children and their families facing this condition.
Question 3 of 5
The nurse is admitting a 9-year-old child with hemolytic uremic syndrome. What clinical manifestations should the nurse expect to observe? (Select all that apply.)
Correct Answer: A
Rationale: In the context of hemolytic uremic syndrome (HUS) in children, the correct manifestations to expect include anorexia, hypertension, and purpura. Anorexia is common due to gastrointestinal symptoms associated with the condition. Hypertension is a significant finding in HUS, reflecting renal involvement and potential complications. Purpura, which is characterized by purple spots on the skin caused by bleeding under the skin, can be present due to thrombocytopenia in HUS. Option A is correct because all these manifestations are commonly seen in children with HUS. Option B, anorexia, is a valid symptom as mentioned earlier. Option C, hypertension, is also a common finding in HUS due to renal involvement. Option D, purpura, is associated with the thrombotic microangiopathy that occurs in HUS. Understanding the clinical manifestations of HUS in children is crucial for nurses caring for pediatric patients. Recognizing these signs early can lead to prompt intervention and improved outcomes. Nurses should be vigilant in assessing and monitoring these symptoms in children admitted with suspected or diagnosed HUS to provide timely and appropriate care.
Question 4 of 5
The nurse is caring for a child with a urinary tract infection who is on intravenous gentamicin (Garamycin). What interventions should the nurse plan for this child with regard to this medication? (Select all that apply.)
Correct Answer: D
Rationale: In caring for a child with a urinary tract infection on IV gentamicin, it is crucial for the nurse to plan specific interventions related to this medication. Encouraging fluids is essential because gentamicin is nephrotoxic, and adequate hydration helps to protect the kidneys. Monitoring urinary output is important to assess renal function and ensure the drug is being excreted properly. Monitoring sodium serum levels is not directly related to gentamicin therapy but is important for overall electrolyte balance in the body. The correct answer is D, as all the interventions are relevant to the safe administration of gentamicin in a child with a UTI. Encouraging fluids helps maintain renal perfusion, monitoring urinary output aids in assessing renal function and drug excretion, and checking sodium levels ensures overall electrolyte balance. These interventions are vital in preventing nephrotoxicity and optimizing therapeutic outcomes. Options A, B, and C are explained in the context of the child's condition and the medication being administered. Understanding the rationale behind each intervention is crucial for safe and effective nursing care, especially when managing medications that can have potentially serious side effects like gentamicin. This question highlights the importance of comprehensive nursing care and medication management in pediatric patients with urinary tract infections.
Question 5 of 5
The nurse is caring for a child with a urinary tract infection who is on trimethoprim-sulfamethoxazole (Bactrim). What side effects of this medication should the nurse teach to the parents and the child? (Select all that apply.)
Correct Answer: C
Rationale: In this scenario, the correct answer is C) All are applicable. Trimethoprim-sulfamethoxazole (Bactrim) is an antibiotic commonly used to treat urinary tract infections in children. Teaching the parents and child about the potential side effects of this medication is crucial for their safety and well-being. Rationales for each option: - A) Rash: Bactrim can cause skin reactions, including rashes, which may indicate an allergic reaction and the need to discontinue the medication. - B) Urticaria: Urticaria, also known as hives, is another skin reaction that can occur as a side effect of Bactrim. - C) All are applicable: Given the nature of Bactrim as an antibiotic, all the listed side effects (rash, urticaria, and photosensitivity) are potential risks that the nurse should educate the parents and child about. - D) Photosensitivity: Bactrim can make the skin more sensitive to sunlight, leading to sunburn or skin damage with minimal sun exposure. This risk highlights the importance of sun protection while on this medication. Educational context: Teaching parents and children about medication side effects empowers them to recognize and report adverse reactions promptly, ensuring timely intervention and preventing potential complications. It also promotes medication adherence and fosters a collaborative approach to healthcare between the healthcare team and the family.