Nokea
What is an approximate method of estimating output for a child who is not toilet trained?
- A. Have parents estimate output.
- B. Weigh diapers after each void.
- C. Place a urine collection device on the child.
- D. Have the child sit on a potty chair 30 minutes after eating.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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Where would nonpathologic cyanosis normally be present in the newborn shortly after birth?
- A. Feet and hands
- B. Bridge of nose
- C. Circumoral area
- D. Mucous membranes
Correct Answer: A
Rationale: Nonpathologic cyanosis in newborns shortly after birth is typically present in the feet and hands, known as acrocyanosis. This is a normal finding due to the immature peripheral circulation in newborns. Cyanosis of the bridge of the nose, circumoral area, and mucous membranes indicates generalized cyanosis, which suggests a potential underlying distress or major abnormality. Therefore, choice A is correct as it describes the expected location for nonpathologic cyanosis in newborns, while choices B, C, and D represent areas associated with abnormal cyanosis.
The nurse determines that a child's intravenous infusion has infiltrated. The infused solution is a vesicant. What is the most appropriate nursing action?
- A. Stop the infusion and apply ice.
- B. End the infusion and notify the practitioner.
- C. Slow the infusion rate and notify the practitioner.
- D. Discontinue the infusion and apply warm compresses.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
What is the most consistent and commonly used indicator of pain in infants?
- A. Increased respirations
- B. Increased heart rate
- C. Thrashing of arms and legs
- D. Facial expression of discomfort
Correct Answer: D
Rationale: Facial expression has consistently been validated as an indicator of pain in infants. Behavioral pain measures are most reliable for sharp procedural pain in infants. Increased heart rate and respirations are indicative of a generalized and complex response to stress, not specific for pain in infants. Thrashing of arms and legs is a reliable indicator in young children, not specifically in infants.
The nurse is admitting a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the doctor to order initially to replace fluids?
- A. 0.9% normal saline
- B. D5 0.2% (1/4) normal saline
- C. D5W
- D. Albumin
Correct Answer: A
Rationale: In the case of severe isotonic dehydration, the initial fluid of choice is 0.9% normal saline. This solution is preferred because it helps to restore both fluids and electrolytes effectively. Options B, C, and D are not suitable for the initial management of severe isotonic dehydration. D5 0.2% (1/4) normal saline (Choice B) is a hypotonic solution and might worsen the imbalance. D5W (Choice C) is a hypotonic solution that does not contain electrolytes essential for rehydration. Albumin (Choice D) is a colloid solution used for specific indications like hypoproteinemia or hypoalbuminemia, not for initial rehydration in severe dehydration.
A school-age child with cancer is being prepared for a procedure. The child says, "I have had one of these before. They hurt." The nurse bases her response on what knowledge related to pain in this patient?
- A. Often misrepresent experiencing pain
- B. Tolerate pain better than adults
- C. Become accustomed to painful procedures
- D. Commonly experience treatment-related moderate to severe pain when they have cancer
Correct Answer: D
Rationale: The correct answer is D. Pain is frequently reported by children with cancer, with around 84% experiencing it. Most children report moderate to severe pain, with about half finding it highly distressing. There is no evidence to suggest that children often misrepresent their pain experiences. Pain tolerance is not solely based on age but is a complex phenomenon. Children do not become accustomed to painful procedures, as each experience of pain is unique.