ATI RN
RN Nursing Care of Children 2019 With NGN Questions
Question 1 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 2 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.
Question 3 of 5
The nurse is caring for a child with acute renal failure. What laboratory findings should the nurse expect to find? (Select all that apply.)
Correct Answer: C
Rationale: In caring for a child with acute renal failure, the nurse should expect to find several specific laboratory findings. The correct answer, option C (All are applicable), is the most appropriate choice because acute renal failure typically presents with a constellation of abnormalities, including hyponatremia, hyperkalemia, and elevated blood urea nitrogen (BUN) levels. Hyponatremia is common in renal failure due to the impaired excretion of water and sodium. Hyperkalemia results from the kidneys' inability to excrete potassium effectively, leading to dangerous cardiac effects. An elevated BUN level indicates decreased kidney function and impaired filtration of waste products. Options A, B, and D are incorrect because they do not encompass the comprehensive range of laboratory findings typically associated with acute renal failure in a child. Understanding these specific laboratory abnormalities is crucial for nurses caring for pediatric patients with renal issues, as prompt recognition and management are essential for positive outcomes.
Question 4 of 5
What signs and symptoms are indicative of a urinary tract disorder in the infancy period (1-24 months)? (Select all that apply.)
Correct Answer: A
Rationale: In infants (1-24 months), signs and symptoms of a urinary tract disorder can be subtle and challenging to identify. The correct answer is option A, which includes all the listed symptoms: poor feeding, hypothermia, and frequent urination. Poor feeding can be a sign of a urinary tract disorder due to associated discomfort or pain while feeding. Hypothermia can result from sepsis associated with a urinary tract infection. Frequent urination in infants may indicate irritation or infection in the urinary tract. Option B, poor feeding, is correct as explained above. Option C, hypothermia, is indicative of a systemic response to infection but may not always be present in urinary tract disorders. Option D, frequent urination, is a common symptom of urinary tract infections in older children but may not always be significant in infants. Educationally, it is crucial for nurses to be able to recognize these subtle signs in infants to provide early intervention. Understanding these symptoms helps in prompt diagnosis and treatment of urinary tract disorders in this vulnerable population, preventing complications like sepsis or renal damage. Nurses play a key role in advocating for infants who cannot verbalize their discomfort, making accurate assessment vital in pediatric care.
Question 5 of 5
A child is hospitalized in acute renal failure and has a serum potassium greater than 7 mEq/L. What temporary measures that will produce a rapid but transient effect to reduce the potassium should the nurse expect to be prescribed? (Select all that apply.)
Correct Answer: A
Rationale: In the context of a child hospitalized with acute renal failure and severely elevated serum potassium levels, the correct temporary measure to rapidly reduce potassium is dialysis. Dialysis is the most effective method to quickly lower potassium levels by removing excess potassium from the bloodstream. This intervention is crucial in preventing life-threatening complications such as cardiac arrhythmias associated with hyperkalemia. The other options listed are not appropriate for rapidly reducing potassium levels in this critical situation. Sodium bicarbonate is used to correct metabolic acidosis but does not directly lower potassium levels. Glucose 50% and insulin therapy temporarily shifts potassium into the intracellular space but is not as rapid or effective as dialysis in severe cases. This method also carries a risk of hypoglycemia, especially in pediatric patients. Educationally, understanding the rationale behind choosing dialysis over other interventions in the management of hyperkalemia is essential for nurses caring for pediatric patients with renal issues. It emphasizes the importance of prompt and appropriate interventions to prevent complications associated with electrolyte imbalances. Nurses must be knowledgeable about the most effective treatments to ensure positive patient outcomes in critical situations like acute renal failure.