Question 1

The nurse has just finished a parent teaching session on preventing heat-related illnesses for children who exercise. Which statement by a parent indicates understanding of preventive techniques taught?

A)Wearing dark clothing during exercise is recommended
B)Water is the drink of choice to replenish fluids.
C)During activity, stop for fluids every 15 to 20 minutes.
D)Hydration should occur at the end of an exercise session.

Accepted Answer

During activity, stop for fluids every 15 to 20 minutes.

Question 2

The nurse is caring for a child on bed rest who has severe edema in a left lower leg due to blocked lymphatic drainage. Which nursing diagnosis would take priority?&#10;A)Risk for impaired skin integrity&#10;B)Risk for altered body image&#10;C)Risk for imbalanced nutrition: less than body requirements&#10;D)Risk for activity intolerance&#10;

Accepted Answer

The priority nursing diagnosis would be Risk for impaired skin integrity due to the severe edema in the left lower leg. The edema can cause skin breakdown and increase the risk of infection, impairing skin integrity. A thorough skin assessment and implementing measures to prevent skin breakdown, such as using appropriate support under the affected area, repositioning the child regularly, and providing proper foot care would be important. While the other diagnoses may also be relevant, Risk for impaired skin integrity takes priority due to its potential serious consequences.

Question 3

The nurse is evaluating an infant for dehydration. Which assessment provides the most accurate information on dehydration?&#10;A)Urine output&#10;B)Urine specific gravity&#10;C)The infant's vital signs&#10;D)Weight loss&#10;

Accepted Answer

Weight loss is the most accurate assessment for dehydration in infants as it is a direct indicator of fluid loss. Urine output and specific gravity can be affected by other factors such as fluid intake and medication administration. The infant's vital signs may be affected by dehydration, but they are not specific to indicating dehydration.

Question 4

The nurse is assessing an infant brought to the clinic because of diarrhea. The infant is alert but has dry mucous membranes. Which other sign indicates the infant is still in the early to moderate stage of dehydration?

A)Bradycardia
B)Tachycardia
C)Increased blood pressure
D)Normal fontanels

Accepted Answer

Tachycardia is a typical sign of early to moderate dehydration in infants. Dry mucous membranes are also an indication of dehydration, but do not indicate the stage. Bradycardia, increased blood pressure, and normal fontanels are not typical signs of dehydration in infants.

Question 5

In the morning, a nurse receives a report on four pediatric clients, each of whom has some form of fluid-volume excess. Which of the children should the nurse see first?&#10;A)The child with tachypnea and pulmonary congestion&#10;B)The child with hepatomegaly and normal respiratory rate&#10;C)The child with dependent and sacral edema and regular pulse&#10;D)The child with periorbital edema and normal respiratory rate&#10;

Accepted Answer

The child with tachypnea and pulmonary congestion may indicate worsening fluid-volume excess leading to respiratory distress and should be seen first. The other symptoms, such as hepatomegaly, dependent/sacral edema, and periorbital edema, are also concerning but do not indicate immediate respiratory compromise.

Question 6

A nurse is planning care for a child with hyponatremia. The nurse, delegating care of this child to a licensed vocational nurse (LVN), cautions the LVN to watch for which clinical manifestation?&#10;A)Seizures&#10;B)Respiratory distress&#10;C)Hyperthermia&#10;D)Bradycardia&#10;

Accepted Answer

Hyponatremia (low sodium levels in the blood) can lead to neurological symptoms, such as seizures. Respiratory distress, hyperthermia, and bradycardia are not commonly associated with hyponatremia.

Question 7

A child is admitted to the hospital for hypercalcemia and is placed on diuretic therapy. Which diuretic would the nurse expect to give?&#10;A)Furosemide (Lasix)&#10;B)Hydrochlorothiazide (Aquazide)&#10;C)Spironolactone (Aldactone)&#10;D)Mannitol (Osmitrol)&#10;

Accepted Answer

Furosemide is a loop diuretic that works by inhibiting reabsorption of sodium and chloride in the Loop of Henle, leading to increased urine output and subsequent loss of calcium. It is commonly used to treat hypercalcemia. Hydrochlorothiazide is a thiazide diuretic that is not as effective in calcium excretion as loop diuretics like furosemide. Spironolactone is a potassium-sparing diuretic and is not indicated for the treatment of hypercalcemia. Mannitol is an osmotic diuretic and is not indicated for the treatment of hypercalcemia.

Question 8

A six-year-old child is hypokalemic. The nurse is helping the child complete the menu. The nurse would encourage this child to select which menu items?&#10;A)Pizza with a fruit plate&#10;B)Chicken strips with chips&#10;C)Fajita with rice&#10;D)A hamburger with French fries&#10;

Accepted Answer

Pizza with a fruit plate. Hypokalemia is a condition where there is a deficiency of potassium in the body. Potassium is an essential electrolyte required for the proper functioning of the heart, muscles, and nerves. Fruits are an excellent source of potassium, so selecting a menu item that includes fruit will help increase the child's intake of potassium. Pizza is also a good option as it contains cheese, which is a source of potassium, as well as other nutrients such as calcium and vitamin D. It is recommended to avoid foods that are high in sodium, such as chips and fries, as these can further deplete the body's potassium levels.

Question 9

A child with croup has an increased pCO₂, a decreased pH, and a normal HCO₃ blood gas value. The nurse interprets this as uncompensated: A)Metabolic alkalosis. B)Metabolic acidosis. C)Respiratory acidosis. D)Respiratory alkalosis.

Accepted Answer

The increased pCO2 and decreased pH indicate respiratory acidosis, which occurs when there is inadequate ventilation leading to retention of carbon dioxide. The normal HC03 value indicates that the body has not yet had time to compensate for the acidosis through the kidneys. Croup is a respiratory illness that can result in airway obstruction and difficulty breathing, leading to inadequate ventilation and respiratory acidosis.

Question 10

A four-year-old child is admitted to the hospital secondary to dehydration. Lab tests indicate a high hemoglobin and hematocrit, and the serum sodium is below normal levels. This fluid loss is indicative of which condition?

A)Hypernatremia
B)Metabolic acidosis
C)Hypotonic dehydration
D)Isotonic dehydration

Accepted Answer

The lab results indicate a low serum sodium level, which points to hypotonic dehydration. This type of dehydration occurs when there is a loss of electrolytes, including sodium, along with water. The high hemoglobin and hematocrit indicate that the body is trying to compensate for the fluid loss by concentrating the blood. Metabolic acidosis and hypernatremia are not indicated by the lab results in this case. Isotonic dehydration would not result in a low serum sodium level.

Question 11

A nurse is taking care of four different pediatric clients. Which of the following children is at greatest risk for dehydration?&#10;A)Seven-year-old child with migraine headaches&#10;B)Four-year-old child with a broken arm&#10;C)Two-year-old child with cellulitis of the left leg&#10;D)18-month-old child with tachypnea&#10;

Accepted Answer

The answer of A nurse is taking care of four...

Question 12

A nurse is planning care for a child with hyperkalemia. The nurse explains to the parents that an adverse outcome of hyperkalemia is:&#10;A)Hyperthermia&#10;B)Respiratory distress&#10;C)Seizures&#10;D)Cardiac arrhythmias&#10;

Accepted Answer

The answer of A nurse is planning care for a...

Question 13

A nine-month-old infant is hospitalized with vomiting and diarrhea. The mother questions why her child needed hospitalization since her school-age nephew had the same symptoms and was treated at home. The nurse would explain that an infant is more at risk for dehydration than a school-age child because: Standard Text: Select all that apply.

A)Infants have a lower proportion of their body weight as water.
B)The percentage of extra-cellular fluid is higher in the infant than the school-age child.
C)School-age children have a larger body surface area.
D)The school-age child's kidneys are more mature and better able to conserve water.
E)The metabolic rate of the school-age child is higher.

Accepted Answer

The answer of A nine-month-old infant is hospitalized with vomiting...

Question 14

The nurse notes that the specific gravity of urine is lower in infants than in older children. The nurse recognizes that the rationale for this difference is related to:&#10;A)The infant having a greater body surface area.&#10;B)The infant having a higher basal metabolic rate.&#10;C)The infant having a greater percentage of body weight that is water.&#10;D)The infant's kidneys being less able to concentrate urine.&#10;

Accepted Answer

The answer of The nurse notes that the specific gravity...

Deck 23: Alterations in Fluid, Electrolyte, and Acid-Base Balance