Pedi Ch 35 Questions

The LPN/LVN is reviewing the process of metabolism in young children. Which factors about the differences between a young child and an adult would the LPN/LVN understand? Select all that apply. 1.A higher metabolism exists in children to provide energy for rapid growth. 2.A young child requires more water to remove waste products. 3.Fevers in a young child will increase insensible fluid loss. 4.Insensible fluid loss is higher in adults due to body size. 5.The metabolic rate of a young child is ten times higher than that of an adult.

1.A higher metabolism exists in children to provide energy for rapid growth. 2.A young child requires more water to remove waste products. 3.Fevers in a young child will increase insensible fluid loss. Option 1:Young children have a higher metabolism than do adults to provide energy for rapid growth. Option 2:The metabolic rate of a young child requires more water to remove the greater quantity of waste products associated with a higher metabolism. Option 3:If the child is experiencing a greater caloric expenditure, such as occurs during high fevers, the insensible fluid loss is even greater. Option 4:Due to higher respiration, heart, and peristaltic rates, the young child experiences more insensible water loss. Option 5:The metabolic rate of a young child is approximately two to three times higher than that of an adult.

A new parent asks the LPN/LVN why his infant became dehydrated after 1 day of diarrhea and vomiting. Which previously taught information by the RN would the LPN/LVN reinforce for the parent? Select all that apply. 1.Body water percentage is higher in infants than in adults. 2.Infants have a larger ratio of body surface area to weight. 3.Infants have less body fluid in the intracellular space. 4.A premature infant has a higher body water percentage. 5.The infant cannot conserve a source of body water as well as an adult.

1.Body water percentage is higher in infants than in adults. 2.Infants have a larger ratio of body surface area to weight. 3.Infants have less body fluid in the intracellular space. 5.The infant cannot conserve a source of body water as well as an adult. Option 1:The body water percentage in infants is approximately 75% to 80%, whereas the body water percentages of older patients, such as teenagers, is close to 55% to 65%. Option 2:Infants also have a larger total body surface area to body weight compared with adults, causing greater fluid losses. Diarrhea and vomiting accelerate the loss of body fluids. Option 3:The infant has less reserve than an adult to pull from the intracellular space. The intracellular fluid can be pulled as needed in an adult. However, an infant will dehydrate faster because of the lower reserve. Option 4:A premature infant's body water percentage is closer to 90%, making them more susceptible to dehydration. However, there is no information about the infant being premature. Option 5:The infant has an extracellular fluid turnover rate of close to 50% per day, whereas adults have only a 20% daily fluid turnover rate. The higher extracellular fluid percentage and the higher turnover rate put the infant at greater risk for dehydration

The nurse in a pediatric clinic is observing a school-age child who presents with a headache, sore throat, and rash on the buttocks and legs. Which additional findings would contribute to the nurse's suspicion that the patient has acute glomerulonephritis (AGN)? Select all that apply. 1.Dark brown (tea-colored) urine 2.History of a sore throat 10 days prior 3.High blood pressure 4.Reports of fatigue and lethargy 5.Low overall urine output

1.Dark brown (tea-colored) urine 2.History of a sore throat 10 days prior 3.High blood pressure 4.Reports of fatigue and lethargy 5.Low overall urine output Option 1:Dark brown (tea-colored) urine is an assessment finding associated with AGN. Option 2:Glomerulonephritis may present 1 week to 10 days after a strep throat or strep upper respiratory infection that was not treated. Option 3:High blood pressure in a child is a reason for the nurse to suspect AGN. Option 4:Fatigue and lethargy may or may not be specific to AGN; however, in conjunction with the other assessment findings, these will reinforce the nurse's suspicion. Option 5:AGN has clinical symptoms that represent kidney injury, as the final filtration membrane becomes clogged with antibody/antigen molecules. Low overall urine output is a common symptom.

The nurse is aware that multiple medications are prescribed for the child with nephrotic syndrome. Which medication and indication would the nurse identify as correct? 1.Diuretics for fluid overload 2.Corticosteroids for joint inflammation 3.Albumin infusions (10%) to replace lost albumin 4.Prophylactic antibiotics to prevent peritonitis

1.Diuretics for fluid overload Option 1:Diuretics are routinely prescribed for the child with nephrotic syndrome because of the symptom of fluid retention and edema. Option 2:Corticosteroids are prescribed for the child with nephrotic syndrome in an effort to reduce the size of pores on the glomeruli. Option 3:25% albumin infusions are given to reduce edema and replace lost albumin. Option 4:Antibiotics are not prescribed prophylactically for the child with nephrotic syndrome. Antibiotics are prescribed for a diagnosis of peritonitis.

The nurse is observing an infant during a well-baby visit at a pediatric clinic. The nurse collects a urine sample for specific gravity (SG) testing. Test results indicate an SG of 1.008. Which action would the nurse perform regarding the infant's urine SG? 1.Document the SG in the health record. 2.Contact the health care provider. 3.Repeat the SG test for accuracy. 4.Ask another nurse to validate the results.

1.Document the SG in the health record. Option 1:Infants' kidneys do not concentrate waste products in the urine as well as adults' kidneys do, producing a urine SG of less than 1.010. The test results are documented. Option 2:The infant's SG is not abnormal; there is no reason to contact the health care provider. Option 3:The infant's SG is normal, and there is no reason to repeat the test for accuracy. Option 4:Although it is not incorrect to ask another nurse to validate test results, it is not necessary in this scenario.

The LPN/LVN is assisting the RN in preparing an educational program about genitourinary disorders that are associated with kidney damage. Which condition would the LPN/LVN suggest is solely seen in males? 1.Hypospadias 2.Ureterocele 3.Hydronephrosis 4.Neurogenic bladder

1.Hypospadias Option 1:Hypospadias is abnormal positioning of the urinary meatus in various areas of the penis or base of the penis. Option 2:Ureterocele is a condition of a cystlike dilation of tissue near a ureteral opening into the urinary bladder caused by a congenital stenosis of the ureteral orifice and is present in both males and females. Option 3:Hydronephrosis is an obstruction of urinary outflow by any means, including kidney stones or bladder outlet obstruction, and can occur in both males and females. Option 4:Neurogenic bladder is when there is nerve damage resulting in abnormal retention or leaking of urine from the bladder and can occur in both males and females.

The nurse is preparing information for parents about urinary tract infections (UTIs) in children. Which information would the nurse include? Select all that apply. 1.Male infants are more prone to UTIs than female infants. 2.After infancy, girls are more prone to UTIs than boys. 3.UTIs occur only in the bladder and urethra. 4.Diapered infants and toilet-training toddlers are at greatest risk. 5.UTIs in children are rare and difficult to diagnose.

1.Male infants are more prone to UTIs than female infants. 2.After infancy, girls are more prone to UTIs than boys. 4.Diapered infants and toilet-training toddlers are at greatest risk. Option 1:Male infants have more UTIs than female infants due to the presence of bacteria in uncircumcised infants. Option 2:Past infancy, girls are more likely to develop UTIs due to their short urethra, which allows bacteria to migrate up the urinary tract. Option 3:UTIs can occur in the bladder (cystitis), urethra (urethritis), or the kidneys (pyelonephritis). Option 4:Diapered infants and toilet-training toddlers are at greatest risk because the stool is more likely to enter the urethra. Option 5:UTIs are one of the most common childhood infections for which parents seek medical attention for their child.

A child is brought to the emergency department exhibiting confusion and seizure activity. Laboratory results indicate hyponatremia, and observation reveals pleural effusion. Which additional information about the child would cause the nurse to suspect water intoxication? Select all that apply. 1.The child is identified as having low cognitive functioning. 2.The child received a high volume of IV normal saline. 3.The child has a history of child abuse involving excessive water intake. 4.The child has a history of severe mental illness. 5.The child has a physiological condition causing excessive thirst.

1.The child is identified as having low cognitive functioning. 3.The child has a history of child abuse involving excessive water intake. 4.The child has a history of severe mental illness. 5.The child has a physiological condition causing excessive thirst. Option 1:Children with low cognitive functioning are at risk for water intoxication caused by unmonitored free water intake. Option 2:Normal saline is not a hypotonic fluid, and a high volume may cause fluid overload; however, it is not a cause of water intoxication. Option 3:Child abuse may take a form of forced water intake, which can result in water intoxication. Option 4:Severe mental illness may be a cause of water intoxication from excessive free water intake. Option 5:Certain physiological conditions can be responsible for water intoxication, especially if the condition is related to excessive thirst.

A 6-month-old infant is being admitted with severe dehydration from an infection. The health care provider prescribes a normal saline bolus of 20 mL per kilogram of body weight to be administered by IV. If the infant weighs 12.5 lb, how much fluid would be given?

113.6 12.5 lb/2.2 kg per lb = 5.68 kg5.68 kg x 20 mL/kg = 113.6 mL

The nurse on a pediatric unit is providing care for a school-age child who is moderately dehydrated. The health care provider initially prescribes oral fluid intake of 80 mL of fluid per kilogram of body weight. How many 8-oz glasses of fluid would be needed if the child's weight is 86 lb?

13 86 lb/2.2 lb per kg = 39 kg39 kg x 80 mL = 3120 mL8 oz = 240 mL3120 mL/240 mL = 13 glasses

The nurse at a pediatric clinic is providing teaching to the parents of a preschool-age child with mild dehydration. The nurse has determined that the child can be safely rehydrated at home. Which comments by the parents would indicate that teaching has been effective? Select all that apply. 1."We can stop and get some cola on the way home." 2."A commercial electrolyte solution is appropriate." 3."A milkshake may be better tolerated." 4."It is safe to add a small amount of juice to electrolyte solutions." 5."We will only offer extra fluids with meals and snacks."

2."A commercial electrolyte solution is appropriate." 4."It is safe to add a small amount of juice to electrolyte solutions." Option 1:Parents should not try to rehydrate a child with soda or sugary drinks because this will contribute to dehydration. Option 2:Commercial electrolyte solutions are appropriate for infants and young children. Option 3:Milk should not be used to rehydrate children. Option 4:A small amount of juice can be safely added to electrolyte solutions to add some flavor. Option 5:Extra fluids for rehydration are not solely given with meals and snacks. The child is encouraged to drink fluids on a regular basis.

The nurse is providing care for an early school-age girl recently diagnosed with Turner syndrome. Which unique manifestations would be likely to have alerted medical personnel to the diagnosis? Select all that apply. 1.Short stature 2.Distinctive physical characteristics 3.Delayed intellectual development 4.The presence of one X chromosome 5.Underdeveloped sex organs

2.Distinctive physical characteristics Option 1:Short stature is noted in girls with Turner syndrome; however, short stature is not exclusive to the condition. Option 2:Girls with Turner syndrome exhibit characteristics that include a webbed neck, widely spaced nipples, a small mandible, epicanthal folds, a broad chest, and delayed sexual maturation during adolescence. Option 3:Turner syndrome does not affect intellectual development. Option 4:It is true that girls with Turner syndrome are born with one X chromosome; however, this finding was likely identified after the physical manifestations were noticed. Option 5:This manifestation may not have been noticed until after a diagnosis was made based on the other physical manifestations.

The nurse in a pediatric clinic is observing a female patient who is 13 years of age for symptoms of a urinary tract infection (UTI). The nurse notices labial adhesions that appear related to female genital mutilation (FGM). Which initial action would the nurse perform regarding this finding? 1.Ask the patient questions about her sexual history. 2.Explain the cause and treatment of the UTI to the accompanying adults. 3.Request a consultation with a surgeon to correct the cause of the UTI. 4.Ask the patient about the details of the procedure.

2.Explain the cause and treatment of the UTI to the accompanying adults. Option 1:The nurse may ask about this if the patient shows signs of a sexually transmitted infection, but not necessarily a UTI. Option 2:The nurse must remain professional and respectful of cultural practices. The most culturally sensitive management is to initially provide an explanation about the child's condition. Option 3:The family may or may not be inclined to have surgery performed on the child. The nurse will report the finding to a health care provider for medical intervention but will not request a consult with a surgeon. There is a better initial action. Option 4:It is inappropriate for the nurse to question the child about the performance of FGM. To do so can be interpreted as being culturally insensitive.

A mother delivers a newborn with exstrophy of the bladder, a congenital urinary anomaly. Which nursing intervention would the nurse include in the plan of care related to this anomaly? 1.Teach the mother how to care for the exposed bladder. 2.Provide the mother with information about the anomaly and treatment. 3.Explain to the mother the importance of having genetic studies. 4.Encourage the mother to examine the newborn's anomaly.

2.Provide the mother with information about the anomaly and treatment. Option 1:The newborn will have corrective surgery soon after birth. It is unlikely the mother will be expected to provide care for this anomaly. However, postsurgical teaching will be necessary. Option 2:The mother is likely to have a knowledge deficit about the anomaly and treatment, which will include surgery soon after birth. Option 3:This congenital urinary anomaly is not the result of a genetic defect. Option 4:When a newborn is delivered with a visible congenital anomaly, the mother may or may not want to examine the newborn's anomaly. The nurse will respect the mother's decision.

The LPN/LVN is reinforcing teaching by the RN to the parent of a toddler who exhibits signs of dehydration. Which signs of the condition would the LPN/LVN emphasize? Select all that apply. 1.Sunken fontanels 2.Rapid heart rate 3.Decrease in mental activity 4.Decrease in skin tenting 5.Slow capillary refill time

2.Rapid heart rate 3.Decrease in mental activity 5.Slow capillary refill time Option 1:Sunken fontanels are an indication of dehydration in newborn and young infants; however, this sign is not seen in toddlers. Option 2:Tachycardia is noted in children who are dehydrated. Option 3:Decreased mentation is a sign of dehydration. Option 4:With dehydration, skin tenting is increased. Option 5:A prolonged capillary refill time is a sign of dehydration.

The LPN/LVN is providing care for a child diagnosed with primary nephrotic syndrome. Which would the LPN/LVN anticipate for this child? Select all that apply. 1.Urine cultures to identify pathogens 2.Relapses throughout childhood 3.Treatment of diabetes mellitus 4.Severe hypoproteinemia 5.Prescription of a low-salt, high-protein diet

2.Relapses throughout childhood 4.Severe hypoproteinemia 5.Prescription of a low-salt, high-protein diet Option 1:Most cases of nephrotic syndrome during childhood are considered idiopathic, meaning no known cause is found. Urine cultures are not necessary. Option 2:The pathology of primary nephrotic syndrome is associated with relapses throughout childhood. Relapses are associated with poorer clinical outcomes and higher mortality rates. Option 3:Secondary nephrotic syndrome is caused by common diseases or conditions such as diabetes mellitus. Primary nephrotic syndrome is idiopathic. Option 4:Severely low levels of protein left in the serum lead to generalized edema, especially noted in the abdomen (ascites). Option 5:A nutritionist will follow the child and initiate a low-salt diet to manage ascites and a high-protein diet to offset protein losses.

The LPN/LVN is reviewing the medical record of a child who is coming to the clinic for a follow-up visit for a urinary tract infection (UTI). Which information would cause the LPN/LVN to identify a congenital anomaly? 1.The child experiences urinary urgency. 2.The child's voiding cystourethrogram indicates urinary reflux. 3.The child has a history of UTIs. 4.The child wears protection for urinary dribbling.

2.The child's voiding cystourethrogram indicates urinary reflux. Option 1:Urinary urgency can be caused by multiple disorders and may be related to the recent UTI. Option 2:Vesicoureteral reflux (VUR) is a condition in which urine flows back from the bladder into the ureters and often up into the kidneys during or after urination. VUR is considered a congenital anomaly. Option 3:A history of UTIs does not necessarily mean a child has a congenital anomaly. However, a diagnosis of VUR often involves multiple UTIs. Option 4:Urinary dribbling is associated with VUR but may be caused by other conditions not associated with a congenital anomaly.

A child's laboratory results indicate hypokalemia, and the health care provider prescribes potassium replacement therapy. For which reason would the nurse contact the health care provider before initiating the prescribed care? 1.Potassium level has improved since the previous test. 2.There is no recent record of urinary output. 3.Dietary teaching is needed for the child's parents. 4.Electrocardiographic changes are noted.

2.There is no recent record of urinary output. Option 1:The nurse does not contact the health care provider because the current test shows improvement over the previous test. Determining the need for the prescribed therapy is outside the scope of practice for the nurse. Option 2:The nurse never administers a potassium-replacement infusion without knowing that the child has an adequate urine output. Administering potassium with poor or no urine output can place the child in danger of cardiac dysrhythmias. This is the reason the nurse will contact the health care provider. Option 3:Potassium therapy is most generally prescribed via IV infusion. Dietary teaching may or may not be needed for the parents. The nurse does not call the health care provider for this reason. Option 4:Electrocardiographic changes are related to hypokalemia and may be the reason for the prescribed care. The nurse does not call the health care provider for this reason.

The nurse in the pediatric intensive care unit is providing care for a child admitted with hemolytic uremic syndrome (HUS). The nurse is providing support for the child's family members. Which comment by a family member would give the nurse a hint about the cause of the child's diagnosis? 1."We are vegetarians and don't eat any meat." 2."We live on a dairy farm but pasteurize our own milk." 3."We buy only organically grown fruits and vegetables." 4."We change clothes before entering the house after using manure."

3."We buy only organically grown fruits and vegetables." Option 1:This comment indicates that the HUS is unlikely to have come from meat contaminated with Escherichia coli. Option 2:Unpasteurized milk and juices can be a source of E. coli and cause HUS, but this is not a risk as long as the milk is pasteurized. Option 3:Organically grown fruits and vegetables are grown with nonchemical fertilization. Organically grown foods need careful washing to prevent the ingestion of E. coli found in organic fertilizers and the development of HUS. Option 4:Animal feces, or manure, is used as fertilizer and can be a source of E. coli. Changing clothes before entering the house prevents contamination of the home environment.

The nurse is assisting a couple whose baby was born with external genitalia that appear male. The couple learns that the baby was born with XX chromosomes and adrenal hyperplasia. Which comment by the parents would indicate a need for emotional support from the nurse? 1."We will just raise the baby as a girl until she can decide." 2."We want them to make her appear as a girl as soon as possible." 3."What do we tell people? Everyone thinks she is a boy." 4."It is better for all of us that we find this out now instead of years later."

3."What do we tell people? Everyone thinks she is a boy." Option 1:This comment is indicative of a need for medical information and support. The baby is genetically a girl with XX chromosomes. Option 2:This comment is indicative of a need for medical support and information. Option 3:This comment indicates the parents are dealing with how to manage the new information about the baby's gender. This comment indicates a need for emotional support from the nurse. Option 4:This comment indicates some level of acceptance about the baby's condition. The couple may or may not need emotional support from the nurse.

The LPN/LVN is directed to obtain a urine specimen for culture and sensitivity from a child diagnosed with a urinary tract infection. Which factor would the LPN/LVN recognize as part of the process? 1.A series of three tests promotes accuracy of results. 2.Sensitivity results can be determined quickly. 3.Contamination of the specimen is avoided. 4.Antibiotic therapy is delayed until sensitivity is complete.

3.Contamination of the specimen is avoided. Option 1:A series of three tests is not needed to promote accuracy results. Option 2:Sensitivity is determined after the bacterial growth is exposed to various antibiotics. The process occurs over time. Option 3:The urine collected for culture and sensitivity is collected as a sterile specimen. Contamination of the urine can result in the growth of microbes not present in the urine, leading to incorrect treatment. Option 4:A broad-spectrum antibiotic is prescribed until specific sensitivity is determined.

The LPN/LVN is assisting with the care of an infant who is hospitalized with dehydration from diarrhea. The infant is placed in the intensive care unit (ICU) on IVs and cardiac monitoring. Which condition would the LPN/LVN associate with the need for cardiac monitoring? 1.Physiological stress 2.Decreased circulation 3.Electrolyte imbalances 4.Poor oxygen perfusion

3.Electrolyte imbalances Option 1:Physiological stress is a broad term defining the effects of illness or disease on the body. Cardiac monitoring is not used specifically for this condition. Option 2:Dehydration is a reduction in body fluids, which results in decreased circulation of blood volume. Cardiac monitoring is not used specifically for this condition. Option 3:Dehydration is accompanied by fluid and electrolyte imbalances. The two major electrolytes affected are sodium and potassium. Hypokalemia, or low potassium, which occurs with vomiting and diarrhea, is very serious because potassium regulates skeletal, smooth, and cardiac muscles. Hypokalemia results in electrocardiographic changes. Option 4:With dehydration, poor oxygen perfusion is a result of a lower circulating fluid volume. Cardiac monitoring is not specifically used for this condition.

The nurse is reviewing information from the health care provider with the parents of a child diagnosed with a kidney disorder. The nurse uses the illustration below to promote understanding. Which disorder would be indicated? 1.Acute glomerulonephritis 2.Diurnal incontinence 3.Nephrotic syndrome 4.Hemolytic uremic syndrome

3.Nephrotic syndrome Option 1:Glomerulonephritis (also called poststreptococcus glomerulonephritis) follows a severe infection such as a strep infection. Serum proteins are not lost with this condition. Option 2:Diurnal incontinence is daytime incontinence and is mostly associated with a condition called unstable bladder. Option 3:Nephrotic syndrome is characterized by the development of pores along the final filtration membrane of the kidney and subsequent loss of serum proteins. Option 4:Hemolytic uremic syndrome is a rare and potentially lethal form of kidney failure in children who have developed an infection such as Escherichia coli.

A child is admitted with vomiting, severe abdominal pain, and bloody diarrhea. Which additional symptom would cause the nurse to suspect a diagnosis of hemolytic uremic syndrome (HUS)? 1.Severe dehydration 2.Fluid retention 3.Small bruises in the mouth 4.High blood pressure

3.Small bruises in the mouth Option 1:Severe dehydration in the child with HUS is caused by vomiting and diarrhea. However, this symptom alone is not indicative of HUS. Option 2:Fluid retention is a symptom of HUS; however, this symptom alone is not indicative of the diagnosis. Option 3:The child with HUS may demonstrate unexplained, small bruises visible only in the lining of the mouth. Option 4:High blood pressure in a child with HUS is a reason for dialysis; however, this symptom alone is not indicative of HUS.

The nurse is preparing a presentation for high-school students about urinary tract infections and sexually transmitted infections (STIs) when sexually active. Which information would be correct? 1.Genital warts are cured with human papilloma virus (HPV) immunization. 2.Prompt treatment for viral STIs is essential for a cure. 3.Urinate before and after sexual intercourse. 4.Intact condoms are safe for multiple acts of intercourse.

3.Urinate before and after sexual intercourse. Option 1:Genital warts can be prevented by pre-exposure immunization against HPV. There is no cure for genital warts. Option 2:Viral STIs cannot be cured, only managed. Bacterial STIs can be effectively treated with antibiotics. Option 3:An empty bladder before sex reduces the friction associated with the development of bladder inflammation. The act of urinating flushes the urethra and helps cleanse bacteria from the opening of the meatus. Option 4:Use a fresh latex condom for each act of intercourse. A condom is at greater risk for breaking after initial use.

The nurse is performing a well-baby check in a clinic on a 1-month-oldf infant. The baby was born with hypospadias. The parents have elected to wait until the child is ready to potty train before having corrective surgery. Which comment by the nurse would be appropriate? 1."If it is corrected now, he won't have any memory of the surgery." 2."Toddlers are more traumatized by hospitalizations and invasive procedures." 3."I agree that the problem won't be an issue until that time." 4."Just let the health care provider know when you are ready."

4."Just let the health care provider know when you are ready." Option 1:Even toddlers have a short memory regarding surgical procedures. With this comment, the nurse is inserting a personal opinion. Option 2:Toddlers may or may not be traumatized by a hospitalization. The surgery may be done on an outpatient basis. This comment is a form of manipulation. Option 3:The parents have decided on a specific age when they feel the corrective surgery needs to be performed. The nurse's opinion is not important or needed. Option 4:This comment indicates the nurse is being therapeutic, supportive, and respectful of the parent's right to make a medical decision for their child.

The nurse is providing care for a toddler admitted for treatment of a urinary tract infection (UTI) caused by Escherichia coli. Which prescription would cause the nurse to contact the health care provider regarding medication therapy? 1.Sulfamethoxazole/trimethoprim 2.Cephalexin 3.Gentamicin 4.Amoxicillin

4.Amoxicillin Option 1:Sulfamethoxazole/trimethoprim has a high cure rate for UTIs and is commonly prescribed. The nurse would not call the health care provider if this medication is prescribed. Option 2:Cephalexin is commonly prescribed for UTI. The nurse would not call the health care provider if this medication is prescribed. Option 3:Gentamicin is commonly prescribed for the treatment of a UTI. The nurse would not call the health care provider if this medication is prescribed. Option 4:Amoxicillin is a first-line drug for the treatment of a UTI, but it is also associated with E. coli resistance. The nurse will contact the health care provider regarding this medication.

The LPN/LVN is assisting with the care of a 12-year-old child admitted for dehydration. Admitting observations indicate a fever of 101.2°F (38.4°C), blood pressure of 116/68 mm Hg, and respiration rate of 18 breaths per minute. The child reports "feeling very tired." Which change would the LPN/LVN report immediately to the RN? 1.Temperature increases to 101.8°F (38.8°C). 2.Blood pressure increases to 118/72 mm Hg. 3.Respiration rate is now 16 breaths per minute. 4.The child asks, "Where am I, and why am I here?"

4.The child asks, "Where am I, and why am I here?" Option 1:The LPN/LVN will report this change to the RN; however, the temperature change does not warrant immediate reporting. Option 2:This fluctuation does not warrant immediate reporting by the LPN/LVN to the RN. Option 3:The child's respiratory rate remains within normal limits and does not need to be reported immediately to the RN. Option 4:Any change in mental status is reported immediately by the LPN/LVN to the RN because change in mental status can be a critical sign.

The LPN/LVN is reinforcing teaching by the RN to a school-age female patient who is being treated for vulvitis and vaginitis. Which information about the patient would indicate a cause? 1.The patient is 16 years old. 2.The patient tests negative for fungal infections. 3.The patient adamantly denies being sexually active. 4.The patient practices for a swim team 5 days a week.

4.The patient practices for a swim team 5 days a week. Option 1:The patient is past puberty. The fact that prepubertal girls lack protective pubic hair and labial fat pads and are therefore more susceptible to trauma and irritation is not a consideration for this patient. Option 2:Vulvar inflammation is often associated with vaginitis from candidiasis (fungal) infections; however, the patient is negative for fungal infections. Option 3:Sexual inactivity rules out a variety of causes for vulvitis and vaginitis. Option 4:Chemicals in many soaps and commonly used bubble-bath substances may also cause irritation and sensitivity to the vulvar skin and tissues. The fact that the patient practices for a swim team 5 days a week indicates frequent exposure to pool chemicals, as well as long periods of time in a wet bathing suit.

A child is admitted to the emergency department with diabetic ketoacidosis. Which biological process would impact the acid-base imbalance in this child first? 1.The renal system will release bicarbonate. 2.The respiratory system will retain carbon dioxide. 3.The renal system will retain bicarbonate. 4.The respiratory system will blow off carbon dioxide.

4.The respiratory system will blow off carbon dioxide. Option 1:The renal system will also assist in the regulation of the acid-base imbalance but takes considerably longer to upregulate than the respiratory system. The renal system releases bicarbonate when the patient is in a state of alkalosis. Option 2:The respiratory retains carbon dioxide in response to alkalosis and not acidosis. Option 3:The renal system will also assist in the regulation of the acid-base imbalance but takes considerably longer to upregulate than the respiratory system. The renal system will retain bicarbonate. Option 4:The body's first response to acidosis involves the respiratory system, which will blow off carbon dioxide.

The LPN/LVN is preparing to collect a clean-catch, midstream urine sample from a 7-year-old male patient. In which order would the LPN/LVN perform the actions associated with this process? Place the options in the correct order. All options must be used. 1. Clean the meatus of the penis. 2. Catch urine sample after voiding starts. 3. Explain the procedure to the patient. 4. Direct the patient to void.

1. Explain the procedure to the patient. 2. Clean the meatus of the penis. 3. Direct the patient to void. 4. Catch urine sample after voiding starts.

The LPN/LVN is instructed to obtain a urine specimen from a male infant for specific gravity and pH testing. Which action would indicate appropriate procedure? 1.Placing a collection bag over the penis and testicles 2.Placing cotton balls in a clean diaper after cleaning the perineum 3.Performing an in-and-out catheterization 4.Collecting a midstream sample during voiding

1.Placing a collection bag over the penis and testicles Option 1:Using a collection bag is appropriate for a clean-catch specimen for an infant, especially when enough urine is needed for specific gravity testing. Option 2:Placing cotton balls in a clean diaper to collect urine is a method used to obtain a clean-catch urine specimen. However, it may be difficult to get enough urine squeezed from the cotton balls for the necessary testing. Option 3:Catheterization is performed only when a sterile urine sample is needed. The procedure is necessary for urine culture and sensitivity. Option 4:Collecting a clean-catch sample midstream is not effective for an infant; this method is used with older children.

Question 15. The nurse is providing care for an infant who is 2 months old. The infant has been exhibiting symptoms of severe diarrhea. The infant is on strict intake and output. Which conclusion would the nurse draw from the weight of the infant's diaper being 0.1 g when weighed after 1 hour? 1.Urinary output is normal. 2.Dehydration is present. 3.Fluid input is deficient. 4.Diarrhea is resolving.

2.Dehydration is present. Option 1:The normal urinary output for an infant is 5 to 10 mL/hr. Option 2:An hourly output of 0.1 g is equivalent to 1 mL of urine. The decreased output indicates dehydration. Option 3:Fluid intake may or may not be deficient. The nurse would most likely conclude that the low urinary output is related to dehydration. Option 4:The weight of 1 g on the scale does not support a resolution of the diarrhea. The absence of diarrhea would indicate resolution; the low output supports dehydration.

The nurse is providing care for an 8-year-old female patient who is hospitalized for a severe bacterial urinary tract infection (UTI). Which intervention would be a priority for this patient? 1.Administer medication as prescribed. 2.Collect a sterile urine specimen. 3.Determine the patient's choice of fluids. 4.Maintain a record of fluid intake and output

3.Determine the patient's choice of fluids. Option 1:The administration of prescribed medication is a collaborative intervention involving both the health care provider and the nurse. Option 2:If prescribed, the nurse will collect a sterile urine specimen, which is most commonly collected for culture and sensitivity. Option 3:The priority nursing intervention is to determine the patient's choice of fluids in order to promote fluid intake to help wash out the bacteria from the bladder. Option 4:Fluid intake and output is usually prescribed for the patient with a UTI; however, it can also be a nursing intervention. Regardless, the priority nursing intervention is to determine the patient's choice of fluids.

The nurse is assisting with a well-child appointment for a 12-year-old child. Observation reveals hypertension, hyperlipidemia, and proteinuria. Which additional finding would lead the nurse to suspect nephrotic syndrome? 1.Decreased appetite 2.High level of fatigue 3.Incidents of diarrhea 4.Golden-yellow, foamy urine

4.Golden-yellow, foamy urine Option 1:Decreased appetite can be caused by many conditions and is not specific for nephrotic syndrome. This is a subjective assessment finding without observed characteristics. Option 2:The report of a high level of fatigue is subjective based on the child's report. Fatigue can be caused by numerous conditions and is not specific to nephrotic syndrome. Option 3:Unless the nurse observes diarrhea, it is a subjective finding reported by the child. Diarrhea can be caused by multiple conditions and is not specific to nephrotic syndrome. Option 4:Golden-yellow, foamy urine is a characteristic of nephrotic syndrome. This is an objective assessment finding, which is observed by the nurse.

The nurse is developing a plan of care for a 4-year-old child who is experiencing nocturnal enuresis. Which intervention would the nurse include in the plan of care? 1.Implement an alarm for wetness. 2.Monitor medication effectiveness. 3.Establish a reward for motivation. 4.Limit fluids after dinner.

4.Limit fluids after dinner. Option 1:Older children may benefit from the use of an alarm that detects wetness via electrodes in the linen or underwear. Option 2:Medications can be used to manage enuresis but are not considered curative. At the age of 4 years, this intervention is not an appropriate intervention. Option 3:For older children, support the parents in initiating a plan of motivation with rewards. Option 4:For children younger than 5 years, fluid restrictions in the evening can help prevent enuresis.

The nurse is preparing a school-age child for a voiding cystourethrogram (VCUG). The child's parent asks about the reason for the test. Which information would the nurse include in an explanation? 1.VCUG is a noninvasive procedure. 2.The child is sedated during the test. 3.The test is used to measure the bladder capacity. 4.VCUG helps identify an abnormal flow of urine.

4.VCUG helps identify an abnormal flow of urine. Option 1:The test requires the administration of contrast material (dye), which is instilled into the child's bladder via a catheter. Therefore, the test has an invasive factor. Option 2:The child will be asked to void after the dye is instilled in the bladder. Sedation will interfere with the child's ability to follow directions. Option 3:The purpose of the VCUG is to check the bladder and surrounding structures during the process of voiding. Option 4:A VCUG determines the presence of urinary reflux or blockage of urine due to strictures.