Wongs Essentials of Pediatric Nursing 11th Edition Test Bank

Wongs Essentials of Pediatric Nursing 11th Edition Test Bank Related

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An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting:

  • A. 2 to 5 of a simple carbohydrate.
  • B. 18 to 20 g of a simple carbohydrat
  • C. 10 to 15 g of a simple carbohydrate.
  • D. 25 to 30 g of a simple carbohydrate.
Correct Answer: C

Rationale: When treating hypoglycemia, it is important to provide a quick source of sugar to raise blood glucose levels rapidly. Consuming 10 to 15 grams of a simple carbohydrate is appropriate for treating mild to moderate hypoglycemia. Examples of foods that contain approximately 10 to 15 grams of simple carbohydrates include four glucose tabs, 4 ounces of fruit juice, 5 to 6 pieces of hard candy, or 1 tablespoon of honey. It is also recommended to recheck blood glucose levels after 15 minutes and have a snack or meal to prevent glucose levels from dropping again.

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A client agreed to become an organ donor is pronounced dead. What is the most important factor in selecting a transplant recipient?

  • A. Blood relationship
  • B. Compatible blood and tissue types
  • C. Sex and size
  • D. Need
Correct Answer: B

Rationale: The most important factor in selecting a transplant recipient for an organ that has been donated by a deceased donor is ensuring compatibility in terms of blood and tissue types. Matching these factors between the donor and recipient minimizes the risk of rejection and increases the likelihood of a successful transplant. Compatibility ensures that the recipient's body is less likely to identify the transplanted organ as foreign and mount an immune response against it. Blood relationship, sex, and size are important factors to consider but they are secondary to compatibility in terms of blood and tissue types when it comes to organ transplantation. Ultimately, the goal is to have the best chance of a successful transplant by ensuring a good match between the donor organ and the recipient.

A nurse notes that a 12-hour-old newborn has not had the first meconium stool. The nurse documents this finding and continues to monitor the newborn because, in term newborns, the first meconium stool occurs within how many hours of birth?

  • A. 6 to 8
  • B. 8 to 12
  • C. 12 to 24
  • D. 24 to 48
Correct Answer: A

Rationale: In term newborns, the first meconium stool typically occurs within the first 6 to 8 hours after birth. Meconium is the baby's first stool, and its presence signifies that the baby's gastrointestinal system is functioning properly. If a newborn has not passed meconium within this timeframe, it may indicate an issue such as bowel obstruction that requires further evaluation and intervention. Therefore, the nurse should document and monitor the situation closely to ensure the newborn's health and well-being.

The primary underlying disorder of pulmonary edema is:

  • A. Decreased left ventricular pumping
  • B. Increased left atrial contractility
  • C. Decreased right ventricular elasticity
  • D. Increased right atrial pressure
Correct Answer: A

Rationale: Pulmonary edema is a condition where fluid accumulates in the air sacs of the lungs, leading to difficulty breathing. The primary underlying disorder of pulmonary edema is often decreased left ventricular pumping. When the left ventricle of the heart fails to effectively pump blood to the rest of the body, it can lead to a backlog of blood in the pulmonary circulation. This increase in pressure in the pulmonary circulation can cause fluid to leak out of the capillaries and into the alveoli of the lungs, resulting in pulmonary edema. Therefore, decreased left ventricular pumping is a key factor in the development of pulmonary edema.

Osteosarcoma is the most common primary malignant bone tumor in children and adolescents; it has multiple subtypes and requires different modalities of treatment including surgery and chemotherapy. Of the following, the subtype of osteosarcoma which is treated by surgery alone is

  • A. fibroblastic
  • B. chondroblastic
  • C. parosteal
  • D. periosteal
Correct Answer: D

Rationale: Periosteal osteosarcoma is often treated with surgery alone if margins are clear.

In children diagnosed with sickle cell disease (SCD), tissue damage results from which of the following?

  • A. Air hunger and respiratory alkalosis due to deoxygenated red blood cells.
  • B. Hypersensitivity of the central nervous system (CNS) due to elevated serum bilirubin levels
  • C. A general inflammatory response due to an autoimmune reaction from hypoxia
  • D. Local tissue damage with ischemia and necrosis due to obstructed circulation
Correct Answer: D

Rationale: In children diagnosed with sickle cell disease (SCD), tissue damage results from local tissue damage with ischemia and necrosis due to obstructed circulation. Sickle cell disease is a genetic disorder characterized by abnormal hemoglobin that causes red blood cells to assume a sickle shape. These sickle-shaped cells can adhere to blood vessel walls, leading to vaso-occlusion and impaired blood flow. This obstruction results in tissue ischemia and eventual necrosis, causing significant pain and organ damage. The chronic vaso-occlusive events in SCD are responsible for the development of acute and chronic complications seen in affected individuals, such as painful crises, stroke, and organ damage.

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