Nokea
A child is admitted to the hospital with acute renal failure. The parents ask about the prognosis for acute renal failure. The nurse's response should be based on which statement about acute renal failure?
- A. Children with acute renal failure will have to take prophylactic antibiotics for life.
- B. Acute renal failure always leads to chronic renal failure.
- C. Acute renal failure may be reversible.
- D. All children with acute renal failure will eventually need a kidney transplant.
Correct Answer: C
Rationale: The correct answer is C: Acute renal failure in children is often reversible, especially when the underlying cause is identified and treated promptly. It does not always lead to chronic renal failure or the need for a kidney transplant. Choice A is incorrect as prophylactic antibiotics for life are not a standard treatment for acute renal failure. Choice B is incorrect as acute renal failure does not always progress to chronic renal failure. Choice D is incorrect as not all children with acute renal failure will eventually require a kidney transplant.
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Why are neonates predisposed to problems with thermoregulation?
- A. Renal function is not fully developed
- B. Flexed posture favors heat loss
- C. A large body surface area favors heat loss to the environment
- D. A thick layer of subcutaneous fat provides excellent insulation
Correct Answer: C
Rationale: Newborns have a large surface area relative to their body weight, making them more susceptible to heat loss and requiring careful thermoregulation. Choice A is incorrect because renal function is not directly related to thermoregulation. Choice B is incorrect because a flexed posture actually helps reduce heat loss by minimizing the surface area exposed to the environment. Choice D is incorrect because neonates have limited subcutaneous fat, which contributes to their susceptibility to heat loss.
A mother brings 6-month-old Eric to the clinic for a well-baby checkup. She comments, "I want to go back to work, but I don't want Eric to suffer because I'll have less time with him." Which is the nurse's most appropriate answer?
- A. "I'm sure he'll be fine if you get a good babysitter."
- B. "You will need to stay home until Eric starts school."
- C. "Let's talk about the childcare options that will be best for Eric."
- D. "You should go back to work so Eric will get used to being with others."
Correct Answer: C
Rationale: The best approach is to discuss childcare options that would suit Eric's needs, allowing the mother to make an informed decision without guilt or pressure.
The nurse is planning care for a patient with a different ethnic background. Which should be an appropriate goal?
- A. Adapt, as necessary, ethnic practices to health needs
- B. Attempt, in a nonjudgmental way, to change ethnic beliefs
- C. Encourage continuation of ethnic practices in the hospital setting
- D. Strive to keep ethnic background from influencing health needs
Correct Answer: A
Rationale: Adapting ethnic practices to health needs respects the patient's cultural background while ensuring that care is effective and culturally sensitive.
The nurse is assessing a child with type 2 diabetes. The child is awake and alert with a serum glucose of 60 mg/dL. What action should the nurse take?
- A. Administer Insulin.
- B. Administer Epinephrine.
- C. Give 15 grams of carbohydrates.
- D. Give glucagon by injection.
Correct Answer: C
Rationale: For a conscious child with mild hypoglycemia, giving 15 grams of fast-acting carbohydrates is the appropriate intervention. This can quickly raise blood glucose levels to prevent further complications. Administering insulin (Choice A) would further lower the glucose level, which is not suitable in this scenario. Administering epinephrine (Choice B) is not indicated for hypoglycemia. Glucagon (Choice D) is used for severe hypoglycemia with altered consciousness, not for mild cases where the child is awake and alert.
Which actions by the nurse demonstrate clinical reasoning? (Select all that apply.)
- A. All below
- B. Considering alternative actions
- C. Using formal and informal thinking to gather data
- D. Giving deliberate thought to a patient's problem
Correct Answer: A
Rationale: Clinical reasoning involves deliberate and thoughtful decision-making, considering alternatives, and using both formal and informal data gathering methods to provide optimum care.