EXAM 1
Tested Questions with Rationales
Pediatric Health Concepts
Drexel University
This Document Description:
This document contains a collection of tested
and verified questions with accurate answers
from Exam 1 of NURS 328 at the Drexel
University. It covers core topics assessed in the
course and reflects the actual exam format and question style.
Ideal for exam preparation and concept reinforcement.
,A nurse is planning a teaching session for a group of adolescents. The nurse
understands that by adolescence the individual is in which stage of cognitive
development?
a. Concrete operations
b. Conventional thought
c. Post-conventional thought
d. Formal operations
d. Formal operations
An important consideration when using the FACES Pain Rating scale with
children is:
a. Children color the face with the color they choose to best describe their pain.
b. The scale can be used with most children as young as 3 years.
c. The scale is not appropriate for use with adolescents
d. The FACES scale is useful in pain assessment but not as accurate as physiologic
responses
b. The scale can be used with most children as young as 3 years.
What is an early clinical sign of dehydration?
a. Hypotension
b. Decreased urinary output
c. Capillary refill time over 3 seconds
d. Tachycardia
d. Tachycardia
Hypotension is a late sign of dehydration that occurs when fluid losses exceed the
body's ability to sustain blood volume and blood pressure.
Decreased urinary output is a compensatory mechanism caused by decreased
blood flow through the kidneys and is not an early sign of dehydration.
,Capillary refill time over 3 seconds indicates a seriously compromised circulatory
system and is an indication of severe dehydration.
The earliest detectable sign of dehydration is usually tachycardia, the body's
attempt to increase cardiac output because of the low blood volume.
What is most appropriate to manage mild dehydration in the home setting?
a. Diluted fruit juices
b. Oral rehydration fluids
c. Water
d. Warm milk
b. Oral rehydration fluids
Oral rehydration solutions are the fluids of choice for rehydration because of their
glucose-mediated and enhanced sodium absorption composition. Fruit juices are
not used as rehydrating solutions because of their high carbohydrate content, very
low electrolyte content, and high osmolality. Water is not used as a rehydrating
fluid because of its hypotonic nature and lack of electrolytes. Cow's milk is not
recommended because maldigestion of lactose can occur in children with
infectious diarrhea.
What are the more significant concerns with hypertonic dehydration?
a. Neurologic disturbances
b. Hypovolemic shock
c. Impaired kidney function
d. Parenteral therapy complications
a. Neurologic disturbances
Cerebral changes in hypertonic dehydration are serious and may result in
permanent damage and are therefore the most dreaded potential outcomes.
Shock is more likely to occur in hypotonic or isotonic dehydration than in
hypertonic dehydration.
, Renal compensation is impaired by reduced blood flow through the kidneys,
which occurs in any form of dehydration.
Parenteral therapy complications, such as too rapid initial fluid replacement, can
result in cerebral edema in hypertonic dehydration. Therefore, this can be the
cause of the dreaded outcome, rather than the outcome itself.
Shannon's dehydration increases and she is hospitalized with parenteral fluid
therapy. What replacement is not added until kidney function is reestablished?
a. Magnesium
b. Sodium chloride
c. Potassium
d. Sodium bicarbonate
c. Potassium
Potassium is not administered until kidney functions are appropriate because of
the risk of hyperkalemia, which causes cardiac arrhythmias, respiratory failure,
mental confusion, and numbness of extremities. Magnesium is usually decreased
with prolonged vomiting or diarrhea, and therefore the risk of excess magnesium
is low. Sodium chloride (0.9%) is the initial replacement fluid of choice in the
management of dehydration. Sodium bicarbonate can be added to replacement
fluid because acidosis is usually associated with dehydration.
What is the most appropriate method of rehydrating Brian, a mildly dehydrated
4 year old?
a. Administer intravenous fluids.
b. Give an oral rehydration solution.
c. Give soft drinks that have been diluted and decarbonated.
d. Give small amounts of gelatin or clear liquids such as juice and water.
b. Give an oral rehydration solution.