Fluid Maintenance Pediatrics Practice Questions

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Parents of a newborn are concerned because the infant's eyes often "look crossed" when the infant is looking at an object. The nurse's response is that this is normal based on the knowledge that binocularity is normally present by what age?

  • A. 1 month
  • B. 3 to 4 months
  • C. 6 to 8 months
  • D. 12 months
Correct Answer: C

Rationale: Binocularity refers to the ability of both eyes to focus on the same object and create a single, three-dimensional image. In infants, binocularity typically develops between the ages of 6 to 8 months. Prior to this age, it is common for infants to show occasional misalignment or "crossed" eyes when focusing on an object. This is usually a normal part of the visual development process and tends to resolve as binocular vision strengthens with age. Therefore, it is considered normal for newborns to show occasional crossed eyes until binocularity develops around 6 to 8 months of age.

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The nurse is teaching a client with type 1 diabetes mellitus how to treat adverse reactions to insulin. To reverse a hypoglycemic reaction, the client ideally should ingest an oral carbohydrate. However, this treatment isn't always a possible or safe. Therefore, the nurse should advise the client to keep which alternate treatment on hand?

  • A. Epinephrine
  • B. 50% dextrose
  • C. Glucagon
  • D. Hydrocortisone
Correct Answer: C

Rationale: Glucagon is the hormone responsible for raising blood sugar levels in the body. In cases of severe hypoglycemic reactions where the client is unconscious or unable to ingest oral carbohydrates, glucagon can be administered via injection to help raise blood sugar levels rapidly. It is important for clients with type 1 diabetes mellitus to have glucagon on hand as a precautionary measure in case of severe hypoglycemic episodes. Epinephrine is typically used for severe allergic reactions, 50% dextrose is a form of oral carbohydrate, and hydrocortisone is a corticosteroid medication used for various conditions but not for treating hypoglycemia in clients with diabetes.

A 16-year-old, 165-pound patient reports consuming 20-40 325-mg capsules containing acetaminophen 1 hour ago. You should

  • A. measure the plasma level and determine potential toxicity from the level on the nomogram
  • B. wait until 4 hours after ingestion to measure the plasma level and do nothing else
  • C. administer activated charcoal immediately and measure the plasma level of acetaminophen 4 hours after ingestion
  • D. send the patient home because an ingestion of this magnitude is not toxic
Correct Answer: C

Rationale: Activated charcoal can help reduce absorption of acetaminophen, and plasma levels should be measured 4 hours post-ingestion to assess toxicity using the nomogram.

Which of the following blood types would the nurse identify as the rarest?

  • A. A
  • B. AB
  • C. B
  • D. O
Correct Answer: B

Rationale: Blood type AB is the rarest of all the blood types. This is because individuals with AB blood type have both A and B antigens on their red blood cells, making it less common than other blood types. In the ABO blood group system, the distribution of blood types in the general population is approximately 45% type O, 40% type A, 11% type B, and only about 4% type AB. Therefore, blood type AB would be identified as the rarest in the given options.

A 3-year-old with croup has the following vital signs: HR 90, RR 44, BP 100/52, T 98.8°F. The parents ask if these are normal. The nurse's best response is:

  • A. Your son's blood pressure is elevated.
  • B. Your son's temperature is elevated.
  • C. Your son's respiratory rate is elevated; a normal rate for his age is 20-30 breaths per minute.
  • D. Your son's heart rate is elevated.
Correct Answer: C

Rationale: The elevated respiratory rate is concerning since normal for a 3- to 6-year-old is about 20-30 breaths per minute.

Which of the following malignancies is least likely to occur in a 10-month-old infant?

  • A. neuroblastoma
  • B. nephroblastoma
  • C. retinoblastoma
  • D. hepatoblastoma
Correct Answer: D

Rationale: Hepatoblastoma is rare in infants under 1 year old, being more common in toddlers.

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