Which is the most common cause of acute renal failure in children?
- A. Pyelonephritis
- B. Tubular destruction
- C. Urinary tract obstruction
- D. Inadequate perfusion
Correct Answer: D
Rationale: Inadequate perfusion, usually due to conditions such as shock or severe dehydration, is the most common cause of acute renal failure in children. Reduced blood flow to the kidneys impairs their ability to function properly and filter waste products from the blood. This can lead to a rapid decline in kidney function and the development of acute renal failure. Other potential causes such as pyelonephritis, tubular destruction, and urinary tract obstruction can also result in acute renal failure, but inadequate perfusion is the most common trigger, especially in pediatric patients.
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A client's IV fluid orders for 24 hour's are 1500 ml D5W followed by 1250 ml of NS. The IV tubing has a drop factor of 15 gtt/ml. To administer the required fluids the nurse should set the drip rate at;
- A. 13 gtt/min
- B. 29 gtt/min
- C. 16 gtt/min
- D. 32 gtt/min Situation 5: Protection of self and patient can be done by supporting the body's immunity.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which of the ff nursing interventions would a nurse perform to avoid maceration from irritating drainage or the wound compresses in a client with breast abscess?
- A. Apply zinc oxide to the surrounding skin
- B. Use a binder to hold the dressing in place
- C. Support the arm and the shoulder with pillows
- D. Instruct the client not to shave the axillary hair on the side with abscess
Correct Answer: A
Rationale: Applying zinc oxide to the surrounding skin can help protect it from becoming macerated due to irritating drainage or wound compresses. Zinc oxide acts as a barrier that helps prevent moisture from affecting the skin, thus reducing the risk of maceration. It provides a protective layer and promotes healing by keeping the affected area dry and free from further irritation. It is an effective intervention to maintain skin integrity and promote optimal wound healing in clients with a breast abscess.
The most effective pharmacologic agent for the treatment of Parkinson's disease is:
- A. Levodopa
- B. Selegilene
- C. Permax
- D. Symmetrel
Correct Answer: A
Rationale: Levodopa is considered the most effective pharmacologic agent for the treatment of Parkinson's disease. Levodopa is a precursor of dopamine, a neurotransmitter that is deficient in Parkinson's disease. By increasing dopamine levels in the brain, levodopa helps to alleviate the motor symptoms of Parkinson's disease, such as tremors, stiffness, and slowness of movement. Levodopa is often combined with another medication called carbidopa to enhance its effectiveness and reduce side effects. While other medications like selegiline, pergolide (Permax), and amantadine (Symmetrel) can also be used to manage Parkinson's disease symptoms, levodopa remains the primary and most effective treatment option for many patients.
Which clinical manifestation should the nurse expect to see as shock progresses in a child and becomes decompensated shock?
- A. Thirst
- B. Irritability
- C. Apprehension
- D. Confusion and somnolence
Correct Answer: D
Rationale: As shock progresses and becomes decompensated in a child, profound perfusion abnormalities lead to inadequate oxygen and nutrient delivery to the brain. This can result in altered mental status such as confusion and somnolence. As the body struggles to maintain adequate perfusion to vital organs, the brain may be one of the first organs to demonstrate signs of inadequate perfusion. Thirst, irritability, and apprehension are more commonly seen in the early stages of shock. Confusion and somnolence indicate a more severe and critical state of shock where the child's body is struggling to maintain adequate blood flow to vital organs, including the brain.
An 8-month-old infant has a hypercyanotic spell while blood is being drawn. What is the priority nursing action?
- A. Assess for neurologic defects
- B. Place the child in the knee-chest position
- C. Begin cardiopulmonary resuscitation
- D. Prepare family for imminent death
Correct Answer: B
Rationale: When an 8-month-old infant has a hypercyanotic spell, the priority nursing action is to place the child in the knee-chest position. This position helps to increase venous return to the heart and improve systemic circulation, which can relieve the cyanosis by decreasing right-to-left shunting of blood. Placing the child in the knee-chest position helps optimize oxygenation and circulation, which is crucial during a hypercyanotic spell. Assessing for neurologic defects, beginning cardiopulmonary resuscitation, or preparing the family for imminent death are not the priority actions during a hypercyanotic spell in this scenario.