ATI Pediatrics Test Bank

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A 62-year old client diagnosed with pyelonephritis and possible septicemia has had five urinary tract infections over the past 2 years. She's fatigued from lack of sleep; urinates frequently, even during the night, and has lost weight recently. Tests reveal the following: sodium level 152mEq/L, osmolarity 340mOsm/L, glucose level 125mg/dl, and potassium level of 3.8mEq/L. Which of the following nursing diagnoses is most appropriate for this client?

  • A. Deficient fluid volume related to inability to conserve water
  • B. Imbalanced nutrition: Less than body requirements related to hypermetabolic state
  • C. Deficient fluid volume related to osmotic diuresis induced by hypernatremia
  • D. Imbalanced nutrition: Less than body requirements related to catabolic effects of insulin deficiency
Correct Answer: C

Rationale: The client's elevated sodium level of 152 mEq/L indicates hypernatremia, which can lead to osmotic diuresis, causing excessive urination and subsequent fluid loss. This fluid loss can result in deficient fluid volume. The client's symptoms of frequent urination, fatigue from lack of sleep, and weight loss are indicative of dehydration due to the osmotic diuresis. Therefore, the most appropriate nursing diagnosis for this client is Deficient fluid volume related to osmotic diuresis induced by hypernatremia.

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Austin, age 6 months, has six teeth. How should the nurse interpret this finding?

  • A. Normal tooth eruption
  • B. Delayed tooth eruption
  • C. Unusual and dangerous
  • D. Earlier-than-normal tooth eruption
Correct Answer: A

Rationale: The eruption of teeth in infants typically begins around 6 months of age, with the lower central incisors being the first to appear. Having six teeth at 6 months old is within the normal range of tooth eruption for infants. The average time frame for infants to have their first teeth is between 4 to 7 months, so Austin's situation falls within that range. There is no cause for concern or interpretation of the finding as unusual or dangerous in this scenario.

A 40 year old woman with aplastic anemia is prescribed estrogen with progesterone. The nurse can expect that these medications are given for which of the following reasons?

  • A. To stimulate bone growth
  • B. To enhance sodium and potassium
  • C. To regulate fluid balance absorption
  • D. To promote utilization and storage of fluids
Correct Answer: A

Rationale: Estrogen plays a crucial role in maintaining bone density and promoting bone growth in both men and women. Aplastic anemia is a condition where the bone marrow does not produce enough blood cells, leading to low blood cell counts. Estrogen therapy is often used in aplastic anemia to help stimulate bone growth and improve bone health. Additionally, estrogen can help protect against bone loss, which is important for overall bone health in individuals with this condition. Progesterone is commonly prescribed along with estrogen to provide a balanced hormonal therapy approach.

When assessing the external ear, the nurse palpates a small protrusion of the helix called a Darwin tubercle. The nurse would document this finding as which of the following?

  • A. A normal finding
  • B. An abnormal finding
  • C. A normal finding only in the older adult
  • D. An abnormal finding only in the older adult
Correct Answer: A

Rationale: A Darwin tubercle is a small, painless, hereditary nodule located on the helix of the ear. It is a normal anatomical variation and is present in varying degrees in the general population, regardless of age. Therefore, it would be documented as a normal finding during the assessment of the external ear.

When caring for a client with diabetes insipidus, the nurse expects to administer:

  • A. Vasopressin (Pitressin Synthetic)
  • B. Regular insulin
  • C. Furosemide (Lasix)
  • D. 10% dextrose
Correct Answer: A

Rationale: Diabetes insipidus is a condition characterized by the inability of the kidneys to conserve water due to reduced secretion of antidiuretic hormone (ADH), also known as vasopressin. Therefore, the treatment for diabetes insipidus typically involves administering synthetic vasopressin, such as desmopressin (DDAVP) or vasopressin (Pitressin Synthetic), to replace the deficient hormone and help the kidneys reabsorb more water. Vasopressin helps regulate water balance in the body by increasing water reabsorption in the kidneys, reducing urine output, and preventing dehydration. Therefore, the nurse would expect to administer vasopressin to a client with diabetes insipidus to help manage the condition effectively.

The lungs regulate acid-base balance b₃y⁻ all of the following except:

  • A. Excreting HCO into the blood
  • B. Controlling carbon dioxide levels
  • C. Slowing ventilation
  • D. Increasing ventilation
Correct Answer: C

Rationale: The lungs help regulate acid-base balance primarily by controlling carbon dioxide levels through ventilation. When carbon dioxide levels increase in the blood, the lungs increase ventilation to exhale more carbon dioxide and maintain the acid-base balance. Slowing ventilation (Option C) would not help in regulating the acid-base balance as it would lead to a buildup of carbon dioxide in the blood, causing respiratory acidosis. Excreting HCO into the blood (Option A) helps maintain acid-base balance by regulating bicarbonate levels, and increasing ventilation (Option D) is the mechanism through which the lungs primarily adjust acid-base balance.

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