NR 602 FINAL EXAM PREP – PRIMARY CARE OF THE
CHILDBEARING & CHILDREARING FAMILY PRACTICE
QUESTIONS COMPLETE WITH 100% VERIFIED ANSWERS
PART 1: MULTIPLE CHOICE QUESTIONS (1-200)
1. A 6-month-old infant presents with vomiting and diarrhea for 2
days. Capillary refill is 4 seconds, mucous membranes are dry, and the
infant has not urinated in 8 hours. What is the most accurate
classification of dehydration?
A. No dehydration
B. Mild dehydration
C. Moderate dehydration
D. Severe dehydration
Correct Answer: D
Rationale: Prolonged capillary refill (>3 seconds), dry mucous
membranes, and absence of urine output for 8 hours indicate severe
dehydration. Infants with severe dehydration also typically exhibit
sunken eyes, absent tears, lethargy, and poor perfusion. Hypotension is
a late sign, and severe dehydration requires urgent fluid resuscitation.
2. A 3-year-old child has 8% weight loss from gastroenteritis. Which
classification best describes this dehydration?
,A. No dehydration
B. Mild dehydration
C. Moderate dehydration
D. Severe dehydration
Correct Answer: D
Rationale: In older children, weight loss of 9% or greater indicates
severe dehydration. An 8% weight loss approaches severe dehydration
and would be classified as severe, especially when accompanied by
other clinical signs such as decreased skin turgor, dry mucous
membranes, and altered mental status. Moderate dehydration is 6% in
older children, while severe is 9% or greater.
3. A 9-month-old infant has 12% weight loss from diarrheal illness.
What is the correct classification?
A. No dehydration
B. Mild dehydration
C. Moderate dehydration
D. Severe dehydration
Correct Answer: D
Rationale: In infants, severe dehydration is defined as weight loss of
15% or greater. However, 12% weight loss with clinical signs such as
lethargy, sunken eyes, and poor perfusion would be classified as severe
dehydration requiring urgent intervention. Moderate dehydration in
infants is 10% weight loss.
,4. A 2-year-old child with diarrhea has been drinking only water for
the past 24 hours. Serum sodium is 128 mEq/L. What is the most likely
diagnosis?
A. Isonatremic dehydration
B. Hyponatremic dehydration
C. Hypernatremic dehydration
D. Hypertonic dehydration
Correct Answer: B
Rationale: When diarrheal losses containing electrolytes are replaced
with free water alone, serum sodium becomes diluted, resulting in
hyponatremic dehydration (serum sodium <130 mEq/L). This occurs
because stool losses contain significant sodium and other electrolytes,
and water-only replacement fails to replenish these losses.
5. A child presents with lethargy, sunken eyes, absent tears, and a
capillary refill of 4 seconds. What is the severity of dehydration?
A. No dehydration
B. Mild dehydration
C. Moderate dehydration
D. Severe dehydration
Correct Answer: D
Rationale: Lethargy, prolonged capillary refill, absent tears, sunken eyes,
and poor perfusion are red flags for severe dehydration. These findings
indicate significant intravascular volume depletion and require urgent
fluid management, often with intravenous fluids.
, 6. A 4-year-old with gastroenteritis has tachypnea. What is the most
likely explanation for this finding?
A. Respiratory infection
B. Compensation for metabolic acidosis
C. Parental anxiety
D. Fever only
Correct Answer: B
Rationale: Tachypnea in dehydration occurs as compensation for
metabolic acidosis from bicarbonate loss in diarrheal stools and lactic
acidosis from poor perfusion. The respiratory system attempts to blow
off carbon dioxide to compensate for the metabolic acidosis, preserving
tissue perfusion and acid-base balance.
7. Which of the following is the most reliable early sign of dehydration
in a child?
A. Weight loss
B. Capillary refill
C. Blood pressure changes
D. Urine output
Correct Answer: B
Rationale: Capillary refill is a practical early perfusion marker. Delayed
capillary refill (>2 seconds) suggests reduced intravascular volume
before blood pressure falls. Hypotension is a late and ominous sign of
CHILDBEARING & CHILDREARING FAMILY PRACTICE
QUESTIONS COMPLETE WITH 100% VERIFIED ANSWERS
PART 1: MULTIPLE CHOICE QUESTIONS (1-200)
1. A 6-month-old infant presents with vomiting and diarrhea for 2
days. Capillary refill is 4 seconds, mucous membranes are dry, and the
infant has not urinated in 8 hours. What is the most accurate
classification of dehydration?
A. No dehydration
B. Mild dehydration
C. Moderate dehydration
D. Severe dehydration
Correct Answer: D
Rationale: Prolonged capillary refill (>3 seconds), dry mucous
membranes, and absence of urine output for 8 hours indicate severe
dehydration. Infants with severe dehydration also typically exhibit
sunken eyes, absent tears, lethargy, and poor perfusion. Hypotension is
a late sign, and severe dehydration requires urgent fluid resuscitation.
2. A 3-year-old child has 8% weight loss from gastroenteritis. Which
classification best describes this dehydration?
,A. No dehydration
B. Mild dehydration
C. Moderate dehydration
D. Severe dehydration
Correct Answer: D
Rationale: In older children, weight loss of 9% or greater indicates
severe dehydration. An 8% weight loss approaches severe dehydration
and would be classified as severe, especially when accompanied by
other clinical signs such as decreased skin turgor, dry mucous
membranes, and altered mental status. Moderate dehydration is 6% in
older children, while severe is 9% or greater.
3. A 9-month-old infant has 12% weight loss from diarrheal illness.
What is the correct classification?
A. No dehydration
B. Mild dehydration
C. Moderate dehydration
D. Severe dehydration
Correct Answer: D
Rationale: In infants, severe dehydration is defined as weight loss of
15% or greater. However, 12% weight loss with clinical signs such as
lethargy, sunken eyes, and poor perfusion would be classified as severe
dehydration requiring urgent intervention. Moderate dehydration in
infants is 10% weight loss.
,4. A 2-year-old child with diarrhea has been drinking only water for
the past 24 hours. Serum sodium is 128 mEq/L. What is the most likely
diagnosis?
A. Isonatremic dehydration
B. Hyponatremic dehydration
C. Hypernatremic dehydration
D. Hypertonic dehydration
Correct Answer: B
Rationale: When diarrheal losses containing electrolytes are replaced
with free water alone, serum sodium becomes diluted, resulting in
hyponatremic dehydration (serum sodium <130 mEq/L). This occurs
because stool losses contain significant sodium and other electrolytes,
and water-only replacement fails to replenish these losses.
5. A child presents with lethargy, sunken eyes, absent tears, and a
capillary refill of 4 seconds. What is the severity of dehydration?
A. No dehydration
B. Mild dehydration
C. Moderate dehydration
D. Severe dehydration
Correct Answer: D
Rationale: Lethargy, prolonged capillary refill, absent tears, sunken eyes,
and poor perfusion are red flags for severe dehydration. These findings
indicate significant intravascular volume depletion and require urgent
fluid management, often with intravenous fluids.
, 6. A 4-year-old with gastroenteritis has tachypnea. What is the most
likely explanation for this finding?
A. Respiratory infection
B. Compensation for metabolic acidosis
C. Parental anxiety
D. Fever only
Correct Answer: B
Rationale: Tachypnea in dehydration occurs as compensation for
metabolic acidosis from bicarbonate loss in diarrheal stools and lactic
acidosis from poor perfusion. The respiratory system attempts to blow
off carbon dioxide to compensate for the metabolic acidosis, preserving
tissue perfusion and acid-base balance.
7. Which of the following is the most reliable early sign of dehydration
in a child?
A. Weight loss
B. Capillary refill
C. Blood pressure changes
D. Urine output
Correct Answer: B
Rationale: Capillary refill is a practical early perfusion marker. Delayed
capillary refill (>2 seconds) suggests reduced intravascular volume
before blood pressure falls. Hypotension is a late and ominous sign of
