Pediatric CCRN Practice Questions

Pediatric CCRN Practice Questions Related

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A client who was diagnosed with type I diabetes mellitus 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level?

  • A. Cool, moist skin
  • B. Arm and leg trembling
  • C. Rapid, thready pulse
  • D. Slow, shallow respirations
Correct Answer: B

Rationale: A blood glucose level of 470 mg/dl indicates severe hyperglycemia in a client with type I diabetes mellitus. Arm and leg trembling, known as tremors, is a common symptom associated with high blood glucose levels. Tremors are often a result of the body's stress response to the extreme levels of glucose in the blood. Other common symptoms of hyperglycemia include increased thirst, frequent urination, blurred vision, and fatigue. Cool, moist skin, rapid, thready pulse, and slow, shallow respirations are not typically associated with hyperglycemia and are more indicative of other conditions or clinical situations.

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The patient is dangling at the bedside and states, "Oh, my stomach is tearing open." Which of the following actions should the nurse immediately take when dehiscence occurs?

  • A. Have patient sit upright in a chair.
  • B. Have patient lie down.
  • C. Slow IV fluids.
  • D. Obtain a sterile suture set.
Correct Answer: B

Rationale: When dehiscence, which is the separation of the layers of a surgical incision, occurs in a patient, it is important to have the patient lie down. This position will help decrease intra-abdominal pressure and reduce the risk of further complications. Having the patient sit upright in a chair can increase intra-abdominal pressure, worsening the dehiscence. Slowing IV fluids may be necessary to prevent fluid overload in certain situations, but it is not the immediate action required when dehiscence occurs. Obtain a sterile suture set may eventually be needed, but the priority in this situation is to stabilize the patient by having them lie down.

Prenatal changes associated with maternal diabetes include all the following EXCEPT

  • A. shorter birth length
  • B. lower neonatal neurodevelopmental status
  • C. reduced milk production of the most times
  • D. increased neonatal learning problems
Correct Answer: C

Rationale: Reduced milk production is not directly associated with maternal diabetes.

A preterm newborn has been receiving orogastric feedings of breast milk. The nurse initiates nipple feedings, but the newborn tires easily and has weak sucking and swallowing reflexes. What is the most appropriate nursing intervention?

  • A. Encourage mother to breastfeed.
  • B. Try nipple-feeding preterm newborn formula.
  • C. Resume orogastric feedings of breast milk.
  • D. Resume orogastric feedings of formula.
Correct Answer: C

Rationale: The most appropriate nursing intervention in this situation is to resume orogastric feedings of breast milk. The newborn is showing signs of fatigue and weak sucking and swallowing reflexes during nipple feedings, indicating that they may not be ready to tolerate full oral feedings yet. By resuming orogastric feedings of breast milk, the newborn can continue to receive nutrition while building strength and coordination for oral feedings. It is important to progress gradually and monitor the newborn's tolerance for oral feedings before attempting nipple feedings again.

The dietary practice that will help a client reduce the dietary intake of sodium is

  • A. Increasing the use of dairy products
  • B. Using an artificial sweetener in coffee
  • C. Avoiding the use of carbonated beverages
  • D. Using catsup for cooking and flavoring food
Correct Answer: C

Rationale: The dietary practice that will help a client reduce the dietary intake of sodium is avoiding the use of carbonated beverages. Carbonated beverages, such as sodas, contain high amounts of sodium that can contribute to increased sodium intake. By avoiding carbonated beverages, the client can effectively reduce their overall sodium consumption. Increasing the use of dairy products, using artificial sweeteners in coffee, and using catsup for cooking and flavoring food do not specifically address the reduction of sodium intake in the same way that avoiding carbonated beverages does.

Although melanoma is relatively rare in children, some risk factors may increase its incidence. All the following are risk factors for development of melanoma EXCEPT

  • A. positive family history of melanoma
  • B. dark-skinned child
  • C. hairy nevus
  • D. dysplastic nevus
Correct Answer: B

Rationale: Dark-skinned individuals have a lower risk of melanoma.

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