ATI RN
RN Nursing Care of Children Online Practice 2019 A Questions
Question 1 of 5
What is the most frequent cause of hypovolemic shock in children?
Correct Answer: B
Rationale: In children, the most frequent cause of hypovolemic shock is blood loss. This is because children have a smaller blood volume compared to adults, so even a relatively small amount of blood loss can quickly lead to significant hypovolemia and shock. Sepsis (option A) can also cause shock, but it is not as common a cause in children as blood loss. Anaphylaxis (option C) is more likely to cause distributive shock rather than hypovolemic shock. Heart failure (option D) can lead to cardiogenic shock, not hypovolemic shock. Educationally, understanding the primary causes of hypovolemic shock in children is crucial for nurses caring for pediatric patients. Recognizing the signs and symptoms of hypovolemic shock, along with its common causes, allows nurses to intervene promptly and effectively to stabilize the child's condition. This knowledge is essential for providing safe and competent care to pediatric patients in various healthcare settings.
Question 2 of 5
What clinical manifestation(s) should the nurse expect to see as shock progresses in a child and becomes decompensated shock?
Correct Answer: D
Rationale: In the context of pediatric shock, the correct answer is D) Confusion and somnolence because as shock progresses and becomes decompensated, the child's body is no longer able to compensate for the inadequate tissue perfusion. This leads to a decreased level of consciousness, confusion, and eventually somnolence as the brain becomes severely hypoperfused. Option A) Thirst is an early sign of shock, not a late manifestation seen in decompensated shock. Option B) Irritability and C) Apprehension are also early signs of shock due to sympathetic nervous system activation, but as shock worsens, the child's mental status shifts from agitation to confusion and eventually somnolence. Educationally, understanding the progression of shock symptoms is crucial for nurses caring for pediatric patients. Recognizing the signs of decompensated shock promptly is essential to initiate appropriate interventions and prevent further deterioration. Monitoring for changes in mental status, along with vital signs and perfusion parameters, is vital in the assessment and management of pediatric patients in shock.
Question 3 of 5
The nurse is preparing a presentation on compensated, decompensated, and irreversible shock in children. What clinical manifestations related to decompensated shock should the nurse include? (Select all that apply.)
Correct Answer: A
Rationale: In the context of pediatric shock, understanding the clinical manifestations of decompensated shock is crucial for nurses to provide timely and effective interventions. Option A, "All below," is the correct choice because decompensated shock is characterized by a progression of symptoms that indicate the body's inability to maintain adequate perfusion. These can include oliguria, confusion, and pale extremities. Oliguria is a sign of decreased renal perfusion, confusion may indicate cerebral hypoperfusion, and pale extremities reflect poor peripheral perfusion. Option B, "Oliguria," is a key manifestation of decompensated shock as decreased urine output is a late sign of renal compromise due to poor perfusion. Option C, "Confusion," is also indicative of decompensated shock as cerebral hypoperfusion affects neurological function, leading to altered mental status. Option D, "Pale extremities," is a hallmark sign of poor peripheral perfusion seen in decompensated shock, as the body shunts blood to vital organs, resulting in pallor in the extremities. Educationally, understanding these manifestations helps nurses recognize the progression of shock in children and intervene promptly to prevent further deterioration. Recognizing decompensated shock is vital in providing timely treatment to stabilize the child's condition and prevent irreversible harm.
Question 4 of 5
In what condition should the nurse be alert for altered fluid requirements in children? (Select all that apply.)
Correct Answer: D
Rationale: In pediatric nursing, understanding fluid requirements is crucial as children's bodies have unique needs. The correct answer, option D, "All above," is the most comprehensive choice because all the conditions listed (oliguric renal failure, increased intracranial pressure, mechanical ventilation) can lead to altered fluid requirements in children. Oliguric renal failure can result in decreased urine output, requiring close monitoring of fluid intake and output to prevent fluid overload or dehydration. Increased intracranial pressure can lead to cerebral edema, necessitating careful management of fluid balance to prevent further brain swelling. Children on mechanical ventilation may have increased insensible water loss, requiring adjustments in their fluid intake to maintain hydration. Option A, oliguric renal failure, is correct because it directly affects the kidneys' ability to regulate fluid balance. Option B, increased intracranial pressure, is correct as changes in fluid levels can impact intracranial dynamics. Option C, mechanical ventilation, is correct as it can affect respiratory function and fluid balance. Understanding these relationships is essential for pediatric nurses to provide safe and effective care to children with complex health needs. By recognizing these conditions and their implications for fluid balance, nurses can intervene promptly to prevent complications related to fluid imbalances.
Question 5 of 5
The nurse is caring for a child with hypernatremia. The nurse evaluates the child for which signs and symptoms of hypernatremia? (Select all that apply.)
Correct Answer: A
Rationale: In caring for a child with hypernatremia, the nurse must be able to recognize the signs and symptoms associated with this condition. The correct answer is option A, which includes all the signs and symptoms mentioned. Lethargy is a common symptom of hypernatremia due to the effects of electrolyte imbalances on the nervous system. Oliguria, or decreased urine output, is another common manifestation of hypernatremia as the body tries to conserve water. Intense thirst is also a classic symptom as the body attempts to correct the imbalance by increasing fluid intake. Option A is correct because all these signs and symptoms are commonly seen in hypernatremia. Options B, C, and D are incorrect because they do not cover the comprehensive range of manifestations associated with hypernatremia. Educationally, understanding these signs and symptoms of hypernatremia is crucial for nurses caring for children as prompt recognition and intervention are essential in managing electrolyte imbalances effectively to prevent further complications. This knowledge helps nurses provide appropriate care, monitor the child's condition, and collaborate with the healthcare team to ensure optimal outcomes for the child.