Nokea
Which patient is most at risk for fluid volume overload?
- A. The 40-year-old with meningitis
- B. The 60-year-old with psoriasis
- C. The 35-year-old with kidney failure
- D. The 2-year-old with influenza
Correct Answer: C
Rationale: The patient with kidney failure is most at risk for fluid volume overload because the kidneys are responsible for regulating fluid balance in the body. In kidney failure, the kidneys are unable to effectively filter and excrete excess fluids, leading to an accumulation of fluid in the body. This can result in fluid volume overload, which can be dangerous and lead to complications such as pulmonary edema, congestive heart failure, and hypertension. It is important to monitor this patient closely for signs and symptoms of fluid overload and manage their fluid intake carefully.
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Scoliosis That Greater 40 Degree Curvature Is Usually Treated By :
- A. Exercise
- B. Spinal fusion surgery
- C. Bracing
- D. Casting
Correct Answer: B
Rationale: When scoliosis progresses to a greater than 40-degree curvature, it is often treated with spinal fusion surgery. This surgical procedure involves fusing together the vertebrae in the curved part of the spine to correct the curvature. Spinal fusion surgery is typically recommended for severe cases of scoliosis to halt the progression of the curve and prevent further complications such as lung and heart problems. Other treatment options like exercise, bracing, and casting may be more suitable for milder cases or as a preventative measure in certain situations.
What should be the initial bolus of crystalloid fluid replacement for a pediatric patient in shock?
- A. 20 ml/kg
- B. 10 ml/kg
- C. 30 ml/kg
- D. 15 ml/kg
Correct Answer: A
Rationale: The initial bolus of crystalloid fluid replacement for a pediatric patient in shock is generally recommended to be 20 ml/kg. This is based on the principles of fluid resuscitation in pediatric patients to restore perfusion and improve hemodynamic stability. Administering the appropriate initial fluid bolus is crucial in treating pediatric patients in shock to avoid complications like cardiovascular collapse and multi-organ dysfunction. It is important to adjust the volume and rate of fluid administration based on the individual patient's response and ongoing assessment to prevent fluid overload.
The nurse is caring for a child with acute renal failure. Which clinical manifestation should the nurse recognize as a sign of hyperkalemia?
- A. Dyspnea
- B. Seizure
- C. Oliguria
- D. Cardiac arrhythmia
Correct Answer: D
Rationale: Hyperkalemia is a condition characterized by elevated levels of potassium in the blood. This can have serious effects on the heart, leading to cardiac arrhythmias which can be life-threatening. In acute renal failure, the kidneys are not able to properly regulate potassium levels in the blood, leading to a potential buildup of potassium, resulting in hyperkalemia. The nurse should recognize cardiac arrhythmias as a critical sign of hyperkalemia in a child with acute renal failure and take prompt action to address this electrolyte imbalance. Dyspnea, seizure, and oliguria are not typically directly correlated with hyperkalemia.
Older school-age children who begin to participate in competitive sports should have a careful evaluation of the
- A. vision
- B. hearing
- C. sexual maturity
- D. cardiovascular system
Correct Answer: D
Rationale: Cardiovascular evaluation is important for children participating in competitive sports.
Coarctation of the aorta causes all of the following signs except:
- A. higher B/P in the upper extremities
- B. right ventricular hypertrophy
- C. legs cooler than arms
- D. nosebleeds
Correct Answer: D
Rationale: Coarctation of the aorta is a congenital heart defect characterized by a narrowing of the aorta, the main artery carrying blood from the heart to the body. The signs of coarctation of the aorta include higher blood pressure in the upper extremities (Choice A) due to the narrowing of the aorta causing increased pressure proximal to the constriction. Right ventricular hypertrophy (Choice B) occurs as the heart works harder to overcome the obstruction in the aorta. Legs being cooler than arms (Choice C) is a result of decreased blood flow to the lower body due to the aortic narrowing. Hemodilution (Choice E) can occur as a compensatory mechanism in response to the increased blood pressure in the upper body. Nosebleeds (Choice D) are not typically associated with coarctation of the aorta but may occur due to other factors unrelated to this condition.