Nokea
An infant who has had diarrhea for 3 days is admitted in a lethargic state and is breathing rapidly. The parent states that the baby has been ingesting formula, although not as much as usual, and cannot understand the sudden change. What explanation should the nurse give the parent?
- A. Cellular metabolism is unstable in young children.
- B. The proportion of water in the body is less than in adults.
- C. Renal function is immature in children until they reach school age.
- D. The extracellular fluid requirement per unit of body weight is greater than in adults.
Correct Answer: D
Rationale: The correct answer is D. Infants have a higher extracellular fluid requirement per unit of body weight, making them more susceptible to dehydration and electrolyte imbalances during illnesses such as diarrhea. Choice A is incorrect because cellular metabolism being unstable is not the primary explanation for the symptoms described. Choice B is incorrect as the proportion of water in the body alone does not fully explain the increased risk of dehydration in infants. Choice C is incorrect because while renal function is immature in children, it is not the most relevant factor in this scenario compared to the increased fluid requirements.
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Before starting kindergarten, the child should receive boosters of which primary immunizations to ensure ongoing protection?
- A. IPV, HepB, Td.
- B. DTaP, HepB, Td.
- C. MMR, DTaP, Hib.
- D. DTaP, IPV, MMR.
Correct Answer: D
Rationale: Before starting kindergarten, the child should receive boosters of DTaP, IPV, and MMR. DTaP provides protection against diphtheria, tetanus, and pertussis, IPV protects against polio, and MMR immunization covers measles, mumps, and rubella. These boosters are essential to maintain immunity and protect the child from these diseases as they enter school. Choices A, B, and C are incorrect because they do not include the recommended boosters for kindergarten entry and may leave the child susceptible to certain infections.
A 3-year-old child has a sudden onset of respiratory distress. The mother denies any recent illnesses or fever. You should suspect
- A. croup
- B. epiglottitis
- C. lower respiratory infection
- D. foreign body airway obstruction
Correct Answer: D
Rationale: In a 3-year-old child presenting with sudden respiratory distress and no history of recent illnesses or fever, foreign body airway obstruction should be suspected. Foreign body airway obstruction commonly leads to acute respiratory distress without preceding symptoms. Croup (Choice A) typically presents with a barking cough and stridor. Epiglottitis (Choice B) often presents with high fever, drooling, and a muffled voice. Lower respiratory infection (Choice C) may manifest with symptoms such as cough, fever, and respiratory distress, but the sudden onset without fever or recent illness suggests a more acute event like foreign body airway obstruction.
When evaluating the laboratory report of a 1-year-old infant's hematocrit, a healthcare provider compares it with the expected hematocrit range for this age group. What is the hematocrit of a healthy 12-month-old infant?
- A. 19% to 32%
- B. 29% to 41%
- C. 37% to 47%
- D. 42% to 69%
Correct Answer: C
Rationale: The correct hematocrit range for a healthy 12-month-old infant is between 37% to 47%. At this age, this range reflects the normal blood volume and red blood cell (RBC) levels in infants. Choice A (19% to 32%) is too low for a healthy hematocrit level in a 12-month-old. Choice B (29% to 41%) is also below the typical range for a 12-month-old. Choice D (42% to 69%) includes an upper limit that is higher than expected for a healthy infant, making it an incorrect option.
A 3-year-old child has a sudden onset of respiratory distress. The mother denies any recent illnesses or fever. You should suspect
- A. croup
- B. epiglottitis
- C. lower respiratory infection
- D. foreign body airway obstruction
Correct Answer: D
Rationale: In a 3-year-old child presenting with sudden respiratory distress without fever or recent illness, the most likely cause is a foreign body airway obstruction. Foreign body airway obstruction can lead to a sudden onset of respiratory distress as it blocks the air passage. Croup typically presents with a barking cough and stridor, often preceded by a viral illness. Epiglottitis is characterized by high fever, drooling, and a muffled voice. Lower respiratory infections usually present with symptoms such as cough, fever, and chest congestion. Therefore, in this case, the absence of recent illness or fever makes foreign body airway obstruction the most likely cause of the respiratory distress.
The nurse is caring for an infant with osteogenesis imperfecta and is providing instruction on how to reduce the risk of injury. Which response from the mother indicates a need for further teaching?
- A. I need to avoid pushing or pulling on an arm or leg.
- B. I must avoid lifting the baby from under the armpits.
- C. I should not bend an arm or leg into an awkward position.
- D. We must avoid lifting the legs by the ankles to change diapers.
Correct Answer: B
Rationale: Lifting the baby from under the armpits can cause fractures in infants with osteogenesis imperfecta. The correct approach is to support the baby's body and head carefully, avoiding pressure on vulnerable areas prone to fractures. Choices A, C, and D demonstrate proper awareness of caring for an infant with osteogenesis imperfecta by emphasizing caution to prevent fractures.