ATI RN
RN Nursing Care of Children 2019 With NGN Questions
Question 1 of 5
What are signs and symptoms of a possible kidney transplant rejection in a child? (Select all that apply.)
Correct Answer: B
Rationale: In the context of kidney transplant rejection in a child, hypotension is a key sign to recognize. This is because rejection leads to decreased kidney function, resulting in decreased blood flow, which can manifest as hypotension. Fever is a non-specific symptom that can occur with various conditions, not specific to transplant rejection. Swelling and tenderness in the graft area are more indicative of infection or surgical complications rather than rejection. Educationally, understanding the signs of kidney transplant rejection is crucial for nurses caring for pediatric patients post-transplant. Recognizing these signs promptly can lead to early intervention and improved outcomes for the child. Hypotension specifically is a critical sign to monitor closely as it can indicate a serious decline in kidney function. Nurses must be vigilant in assessing and monitoring these signs to provide optimal care for pediatric transplant recipients.
Question 2 of 5
A toddler's mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurse's response should be based on which premise?
Correct Answer: B
Rationale: The correct answer is B) The location needs to be confirmed by radiographic examination. In the case of a suspected ingestion of a button battery by a toddler, prompt assessment is crucial to determine the exact location of the battery. Radiographic examination, such as an X-ray, is necessary to confirm the presence and location of the battery within the gastrointestinal tract. This information is vital for guiding further management and intervention. Option A, an emergency laparotomy, is not the initial course of action unless there are signs of severe complications like perforation or obstruction, which would be confirmed through imaging studies. Option C, stating that surgery will be necessary if the battery has not passed in the stool in 48 hours, is not accurate as the presence of the battery in the GI tract requires careful monitoring and intervention based on location and symptoms. Option D is incorrect as the ingestion of a button battery is detectable through radiographic imaging, and careful observation alone is not sufficient due to the potential life-threatening complications associated with battery ingestion. Educationally, this question highlights the importance of immediate assessment and appropriate diagnostic procedures in cases of suspected foreign body ingestion in pediatric patients. It emphasizes the significance of accurate and timely interventions based on diagnostic findings to prevent complications and ensure the child's safety and well-being.
Question 3 of 5
The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the presenting signs?
Correct Answer: C
Rationale: In this scenario, the correct answer is option C: The object may be lodged in the esophagus. When a child with cognitive impairment presents with gagging and drooling after a suspected foreign body ingestion, the most likely physiologic occurrence is the object being stuck in the esophagus. This is because individuals with cognitive impairment may have difficulty chewing and swallowing properly, leading to an increased risk of objects getting lodged in their esophagus. Option A, gastrointestinal perforation, is incorrect in this case because the symptoms of gagging and drooling are more indicative of an obstruction rather than a perforation. Option B, aspiration of the object, would typically present with different symptoms like coughing and wheezing. Option D, the object being embedded in the stomach wall, is less likely due to the nature of the symptoms described. Educationally, understanding the unique challenges faced by children with cognitive impairments in terms of feeding and swallowing is crucial for nurses caring for this population. Prompt recognition and appropriate intervention in cases of foreign body ingestion can prevent complications and ensure the safety and well-being of these vulnerable patients.
Question 4 of 5
What is a high-fiber food that the nurse should recommend for a child with chronic constipation?
Correct Answer: B
Rationale: In this scenario, the correct answer is B) Popcorn. Popcorn is a high-fiber food that can aid in relieving constipation in children. Fiber helps to add bulk to the stool, making it easier to pass through the digestive tract. Popcorn, specifically the whole-grain variety, is a good source of dietary fiber, promoting regular bowel movements and preventing constipation. Now, let's discuss why the other options are incorrect: A) White rice: White rice is a low-fiber food that may contribute to constipation rather than alleviate it. C) Fruit juice: While some fruit juices may contain fiber, many are low in fiber content and can even worsen constipation due to their high sugar content and lack of sufficient fiber. D) Ripe bananas: While bananas are a good source of fiber, ripe bananas are lower in fiber content compared to when they are slightly unripe. Therefore, they may not be as effective in treating chronic constipation in children. Educationally, it is crucial for nurses to understand the importance of dietary fiber in managing constipation in children. By recommending high-fiber foods like popcorn, nurses can help promote gastrointestinal health and alleviate constipation issues in pediatric patients. It is also essential to educate caregivers on the significance of a balanced diet rich in fiber for maintaining overall digestive health in children.
Question 5 of 5
A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. What should the therapeutic plan initially include?
Correct Answer: B
Rationale: In caring for a 2-year-old child with chronic constipation, the initial therapeutic plan should include dietary modification (Option B). This is the correct answer because dietary interventions play a crucial role in managing constipation in children. Increasing fiber intake through fruits, vegetables, and whole grains can help soften stools and promote regular bowel movements in young children. It is important to address dietary factors first before considering other interventions. Option A, bowel cleansing, is not appropriate as the initial step in managing chronic constipation in a child. Bowel cleansing procedures can be invasive and are typically reserved for specific situations under medical supervision. Option C, structured toilet training, may not be effective for a 2-year-old with chronic constipation. Toilet training is more relevant for addressing issues related to potty training readiness and may not directly address the underlying cause of constipation. Option D, behavior modification, is also not the initial step in managing chronic constipation in a child. While behavior modification strategies can be helpful in some cases, addressing dietary factors is typically the first line of treatment in pediatric constipation management. Educationally, understanding the importance of dietary modifications in managing constipation in children is essential for nursing care of pediatric patients. By prioritizing dietary interventions, nurses can help promote optimal bowel health and prevent complications associated with chronic constipation in young children.