ATI RN
RN Nursing Care of Children 2019 With NGN Questions
Question 1 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 2 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 3 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 4 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 5 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.