Fluid Maintenance Pediatrics Practice Questions

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A client hyperparathyroidism declines surgery and is to receive hormone replacement therapy with estrogen and progesterone. Which of the following instructions would be most important to include in the client's teaching plan?

  • A. maintain a moderate exercise
  • B. Lose weight
  • C. Jog at least 2 miles per day
  • D. Rest as much as possible
Correct Answer: A

Rationale: The most important instruction to include in the client's teaching plan would be to maintain a moderate exercise routine (Option A). Regular physical activity is important for overall health, including helping to maintain bone health and strength. This is particularly crucial for individuals with hyperparathyroidism who are declining surgery and opting for hormone replacement therapy, as exercise can help to support bone density and reduce the risk of fractures. However, it is essential to emphasize that the exercise should be moderate and appropriate for the individual's current fitness level, as excessive exercise can have negative effects on bone health in this population.

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An adult is to receive an IM injection of Morphine for post op pain. Which of the following is necessary for the nurse to assess prior to giving a narcotic analgesic?

  • A. The client's level of alertness and respiratory rate
  • B. The last time the client ate or drank something
  • C. The client's bowel habits and last bowel movement
  • D. The client's history of addictions
Correct Answer: A

Rationale: When administering a narcotic analgesic like Morphine, assessing the client's level of alertness and respiratory rate is crucial to monitor for any adverse effects such as respiratory depression. Morphine can cause respiratory depression as one of its side effects, especially in higher doses. By assessing the client's respiratory rate and level of alertness before administering the medication, the nurse can ensure the client's safety and take appropriate action if any signs of respiratory depression occur. This assessment is essential in preventing potential complications and ensuring the client's well-being during pain management.

When should the nurse expect breastfeeding-associated jaundice to first appear in a normal newborn?

  • A. 0 to 12 hours
  • B. 12 to 24 hours
  • C. 2 to 4 days
  • D. 4 to 5 days
Correct Answer: C

Rationale: Breastfeeding-associated jaundice typically first appears in a normal newborn between 2 to 4 days after birth. This type of jaundice is usually mild and is caused by insufficient milk intake, leading to decreased bilirubin elimination. It is important for healthcare providers to monitor the baby's weight and ensure adequate feeding to prevent or address breastfeeding-associated jaundice.

The baby with newly diagnosed diabetes is displaying shakiness, confusion, irritability, and slurred speech. What should the nurse suspect is happening?

  • A. DKA
  • B. Hypoglycemia
  • C. HHS
  • D. Hyperglycemia
Correct Answer: B

Rationale: The baby's symptoms of shakiness, confusion, irritability, and slurred speech are indicative of hypoglycemia, which is low blood sugar. In a baby with newly diagnosed diabetes, the administration of insulin or oral hypoglycemic agents may have led to excessive lowering of blood glucose levels, causing these symptoms to manifest. It is crucial to address hypoglycemia promptly by administering a rapid-acting carbohydrate source such as glucose gel or juice to raise blood sugar levels back to normal range. Left untreated, severe hypoglycemia can lead to seizures, loss of consciousness, and potential long-term neurological damage. It is important for healthcare providers and caregivers to be vigilant in monitoring blood glucose levels in babies newly diagnosed with diabetes to prevent episodes of hypoglycemia.

In Langerhans cell histiocytosis (LCH), all the following manifestations are at high risk of mortality in patients EXCEPT

  • A. liver
  • B. spleen
  • C. lung
  • D. hematopoietic system
Correct Answer: C

Rationale: Lung involvement, while serious, is less lethal compared to liver, spleen, or hematopoietic system involvement.

A 2-year-old male child has an asymptomatic right flank mass discovered incidentally by the mother while bathing. Suspicion of Wilms tumor is raised. Of the following, the LEAST likely investigation to be performed in this child is

  • A. plain abdominal radiography
  • B. computerized tomography (CT) scan of the abdomen
  • C. CT scan of the chest
  • D. biopsy of the mass
Correct Answer: D

Rationale: Biopsy is generally avoided in suspected Wilms tumor to prevent upstaging the disease.

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