Maternity and Pediatric Nursing 4th Edition Test Bank

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A client with end-stage acquired immunodeficiency syndrome (AIDS) has profound manifestations of Cryptosporidium infection caused by the protozoa. In planning the client's care, the nurse should focus on his need for:

  • A. Pain management
  • B. Antiretroviral therapy
  • C. Fluid replacement
  • D. High-calorie intake
Correct Answer: C

Rationale: In a client with end-stage acquired immunodeficiency syndrome (AIDS) manifesting with profound Cryptosporidium infection, fluid replacement is crucial for managing the symptoms and complications. Cryptosporidium infection can cause severe diarrhea and dehydration, leading to significant fluid loss. Therefore, the primary focus of care in this situation should be on maintaining adequate hydration through fluid replacement. This is essential for preventing further complications and supporting the client's overall health and well-being. Pain management, antiretroviral therapy, and high-calorie intake may be important aspects of care in other situations but are not the priority in managing a client with severe Cryptosporidium infection and dehydration.

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The child who can hop on one foot, copies circles, and brushes teeth without help has achieved the developmental age of

  • A. 2 yr
  • B. 3 yr
  • C. 4 yr
  • D. 5 yr
Correct Answer: B

Rationale: These skills are typically developed by age 3.

When caring for a patient with AIDS, which of the following nursing actions would be the most appropriate for infection control?

  • A. Wear gloves at all times
  • B. Wear gown and mask at all times
  • C. Wear gloves for blood/body fluid contact
  • D. Wear a mask during patient contact times
Correct Answer: C

Rationale: The most appropriate nursing action for infection control when caring for a patient with AIDS is to wear gloves for blood/body fluid contact. HIV, the virus that causes AIDS, is primarily spread through exposure to infected blood or body fluids. Therefore, wearing gloves when there is a potential for blood or body fluid contact is crucial in preventing the transmission of the virus. Wearing gloves at all times may not be necessary if there is no direct contact with blood or body fluids, and wearing a gown and mask at all times may not be indicated unless there is a specific need based on the situation. Wearing a mask during patient contact times may also not be necessary unless there is a risk of exposure to respiratory secretions.

The least common late neurologic sequelae that may be encountered post craniospinal irradiation in a 9-year-old child with medulloblastoma is

  • A. microcephaly
  • B. learning disabilities
  • C. cognitive impairment
  • D. second malignancy
Correct Answer: D

Rationale: Second malignancy is a rare late effect compared to cognitive and learning impairments.

Which of the following complications can occur if a clotted cannula is aggressively flushed?

  • A. A clot can enter the circulation.
  • B. An air embolism can enter the circulation.
  • C. A painful arterial spasm can occur.
  • D. Fluid extravasation into surrounding tissue can occur.
Correct Answer: A

Rationale: If a clotted cannula is aggressively flushed, there is a risk that the clot may break apart and enter the circulation. This can lead to serious complications such as embolism, where the clot travels through the blood vessels and blocks blood flow to vital organs. It is important to handle clotted cannulas with care to prevent such complications from occurring.

A febrile patient's fluid output is in excess of normal because of diaphoresis. The nurse should plan fluid replacement based on the knowledge that insensible losses in an afebrile person are normally not greater than:

  • A. 300ml/24hr
  • B. 900ml/24hr
  • C. 600ml/24hr
  • D. 1200ml/24hr
Correct Answer: C

Rationale: Insensible losses are the fluid losses that occur without the individual being aware of it, such as through breathing, sweating, and through the skin. In an afebrile person, insensible losses are normally around 600ml per 24 hours. This amount can vary depending on factors such as temperature, humidity, and individual metabolism. When a patient is febrile and experiencing diaphoresis (excessive sweating), the fluid output can increase significantly due to the body's attempts to cool itself down. It is important for the nurse to consider these increased fluid losses when planning fluid replacement for a febrile patient to prevent dehydration.

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