Question 1

What is the purpose of a high-protein diet for a child with major burns?

Accepted Answer

A)  Promote growth 
B)  Improve appetite 
C)  Minimize protein breakdown 
D)  Diminish risk of stress-induced hyperglycemia 
A)  Promote growth 
B)  Improve appetite 
C)  Minimize protein breakdown 
D)  Diminish risk of stress-induced hyperglycemia

Question 2

Fentanyl and midazolam (Versed)are given before débridement of a child's burn wounds.What is the purpose of using these medications?

Accepted Answer

A)  Facilitate healing 
B)  Provide pain relief 
C)  Minimize risk of infection 
D)  Decrease amount of débridement needed 
A)  Facilitate healing 
B)  Provide pain relief 
C)  Minimize risk of infection 
D)  Decrease amount of débridement needed

Question 3

An infant is brought to the emergency department with the following clinical manifestations: poor skin turgor,weight loss,lethargy,tachycardia,and tachypnea.This is suggestive of which situation?

Accepted Answer

A)  Water excess 
B)  Sodium excess 
C)  Water depletion 
D)  Potassium excess 
A)  Water excess 
B)  Sodium excess 
C)  Water depletion 
D)  Potassium excess

Question 4

What type of dehydration occurs when the electrolyte deficit exceeds the water deficit?

Accepted Answer

A)  Isotonic dehydration 
B)  Hypotonic dehydration 
C)  Hypertonic dehydration 
D)  Hyperosmotic dehydration 
A)  Isotonic dehydration 
B)  Hypotonic dehydration 
C)  Hypertonic dehydration 
D)  Hyperosmotic dehydration

Question 5

Physiologically,the child compensates for fluid volume losses by which mechanism?

Accepted Answer

A)  Inhibition of aldosterone secretion 
B)  Hemoconcentration to reduce cardiac workload 
C)  Fluid shift from interstitial space to intravascular space 
D)  Vasodilation of peripheral arterioles to increase perfusion 
A)  Inhibition of aldosterone secretion 
B)  Hemoconcentration to reduce cardiac workload 
C)  Fluid shift from interstitial space to intravascular space 
D)  Vasodilation of peripheral arterioles to increase perfusion

Question 6

What sign is one of the first to indicate overwhelming sepsis in a child with burn injuries?

Accepted Answer

A)  Seizures 
B)  Bradycardia 
C)  Disorientation 
D)  Decreased blood pressure 
A)  Seizures 
B)  Bradycardia 
C)  Disorientation 
D)  Decreased blood pressure

Question 7

What flush solution is recommended for intravenous catheters larger than 24 gauge?

Accepted Answer

A)  Saline 
B)  Heparin 
C)  Alteplase 
D)  Heparin and saline combination 
A)  Saline 
B)  Heparin 
C)  Alteplase 
D)  Heparin and saline combination

Question 8

In what condition should the nurse be alert for altered fluid requirements in children?

Accepted Answer

A)  Oliguric renal failure 
B)  Increased intracranial pressure 
C)  Mechanical ventilation 
D)  Compensated hypotension 
E)  Tetralogy of Fallot
F) Type 1 diabetes mellitus 
A)  Oliguric renal failure 
B)  Increased intracranial pressure 
C)  Mechanical ventilation 
D)  Compensated hypotension 
E)  Tetralogy of Fallot
F) Type 1 diabetes mellitus

Question 9

The presence of which pair of factors is a good predictor of a fluid deficit of at least 5% in an infant?

Accepted Answer

A)  Weight loss and decreased heart rate 
B)  Capillary refill of less than 2 seconds and no tears 
C)  Increased skin elasticity and sunken anterior fontanel 
D)  Dry mucous membranes and generally ill appearance 
A)  Weight loss and decreased heart rate 
B)  Capillary refill of less than 2 seconds and no tears 
C)  Increased skin elasticity and sunken anterior fontanel 
D)  Dry mucous membranes and generally ill appearance

Question 10

Ongoing fluid losses can overwhelm the child's ability to compensate,resulting in shock.What early clinical sign precedes shock?

Accepted Answer

A)  Tachycardia 
B)  Slow respirations 
C)  Warm, flushed skin 
D)  Decreased blood pressure 
A)  Tachycardia 
B)  Slow respirations 
C)  Warm, flushed skin 
D)  Decreased blood pressure

Question 11

What factor predisposes an infant to fluid imbalances?

Accepted Answer

A)  Decreased surface area 
B)  Lower metabolic rate 
C)  Immature kidney functioning 
D)  Decreased daily exchange of extracellular fluid 
A)  Decreased surface area 
B)  Lower metabolic rate 
C)  Immature kidney functioning 
D)  Decreased daily exchange of extracellular fluid

Question 12

Match the type of skin graft to its definition.
-Skin that is obtained from members of a different species,primarily pigskin

Accepted Answer

A) Allografts 
B) Xenografts 
C) Autografts 
D) Isografts 
A) Allografts 
B) Xenografts 
C) Autografts 
D) Isografts

Question 13

What condition is often associated with severe diarrhea?

Accepted Answer

A)  Metabolic acidosis 
B)  Metabolic alkalosis 
C)  Respiratory acidosis 
D)  Respiratory alkalosis 
A)  Metabolic acidosis 
B)  Metabolic alkalosis 
C)  Respiratory acidosis 
D)  Respiratory alkalosis

Question 14

The nurse is teaching the family of a child with a long-term central venous access device about signs and symptoms of bacteremia.What finding indicates the presence of bacteremia?

Accepted Answer

A)  Hypertension 
B)  Pain at the entry site 
C)  Fever and general malaise 
D)  Redness and swelling at the entry site 
A)  Hypertension 
B)  Pain at the entry site 
C)  Fever and general malaise 
D)  Redness and swelling at the entry site

Question 15

What is the most immediate threat to life in children with thermal injuries?

Accepted Answer

A)  Shock 
B)  Anemia 
C)  Local infection 
D)  Systemic sepsis 
A)  Shock 
B)  Anemia 
C)  Local infection 
D)  Systemic sepsis

Question 16

What explains physiologically the edema formation that occurs with burns?

Accepted Answer

A)  Vasoconstriction 
B)  Reduced capillary permeability 
C)  Increased capillary permeability 
D)  Diminished hydrostatic pressure within capillaries 
A)  Vasoconstriction 
B)  Reduced capillary permeability 
C)  Increased capillary permeability 
D)  Diminished hydrostatic pressure within capillaries

Question 17

What is the most frequent cause of hypovolemic shock in children?

Accepted Answer

A)  Sepsis 
B)  Blood loss 
C)  Anaphylaxis 
D)  Heart failure 
A)  Sepsis 
B)  Blood loss 
C)  Anaphylaxis 
D)  Heart failure

Question 18

What clinical manifestation(s)should the nurse expect to see as shock progresses in a child and becomes decompensated shock?

Accepted Answer

A)  Thirst 
B)  Irritability 
C)  Apprehension 
D)  Confusion and somnolence 
A)  Thirst 
B)  Irritability 
C)  Apprehension 
D)  Confusion and somnolence

Question 19

Match the type of skin graft to its definition.
-Skin that is obtained from genetically different members of the same species who are free of disease

Accepted Answer

A) Allografts 
B) Xenografts 
C) Autografts 
D) Isografts 
A) Allografts 
B) Xenografts 
C) Autografts 
D) Isografts

Question 20

When caring for a child with an intravenous (IV)infusion,what is an appropriate nursing action?

Accepted Answer

A)  Change the insertion site every 24 hours. 
B)  Check the insertion site frequently for signs of infiltration. 
C)  Use a macrodropper to facilitate reaching the prescribed flow rate. 
D)  Avoid restraining the child to prevent undue emotional stress. 
A)  Change the insertion site every 24 hours. 
B)  Check the insertion site frequently for signs of infiltration. 
C)  Use a macrodropper to facilitate reaching the prescribed flow rate. 
D)  Avoid restraining the child to prevent undue emotional stress.

Exam 24: The Child With Fluid and Electrolyte Imbalance

What is the purpose of a high-protein diet for a child with major burns?

Fentanyl and midazolam (Versed)are given before débridement of a child's burn wounds.What is the purpose of using these medications?

An infant is brought to the emergency department with the following clinical manifestations: poor skin turgor,weight loss,lethargy,tachycardia,and tachypnea.This is suggestive of which situation?

What type of dehydration occurs when the electrolyte deficit exceeds the water deficit?

Physiologically,the child compensates for fluid volume losses by which mechanism?

What sign is one of the first to indicate overwhelming sepsis in a child with burn injuries?

What flush solution is recommended for intravenous catheters larger than 24 gauge?

In what condition should the nurse be alert for altered fluid requirements in children?

The presence of which pair of factors is a good predictor of a fluid deficit of at least 5% in an infant?

Ongoing fluid losses can overwhelm the child's ability to compensate,resulting in shock.What early clinical sign precedes shock?

What factor predisposes an infant to fluid imbalances?

Match the type of skin graft to its definition. -Skin that is obtained from members of a different species,primarily pigskin

What condition is often associated with severe diarrhea?

The nurse is teaching the family of a child with a long-term central venous access device about signs and symptoms of bacteremia.What finding indicates the presence of bacteremia?

What is the most immediate threat to life in children with thermal injuries?

What explains physiologically the edema formation that occurs with burns?

What is the most frequent cause of hypovolemic shock in children?

What clinical manifestation(s)should the nurse expect to see as shock progresses in a child and becomes decompensated shock?

Match the type of skin graft to its definition. -Skin that is obtained from genetically different members of the same species who are free of disease

When caring for a child with an intravenous (IV)infusion,what is an appropriate nursing action?

Perspectives of Pediatric Nursing

Social,cultural,religious,and Family Influences on Child Health Promotion

Hereditary Influences on Health Promotion of the Child and Family

Communication, physical, and Developmental Assessment

Pain Assessment and Management in Children

Childhood Communicable and Infectious Diseases

Health Promotion of the Newborn and Family

Health Problems of Newborns

The High-Risk Newborn and Family

Health Promotion of the Infant and Family

Health Problems of the Infant

Health Promotion of the Toddler and Family

Health Promotion of the Preschooler and Family

Health Problems of Early Childhood

Health Promotion of the School-Age Child and Family

Health Problems of the School-Age Child

Health Promotion of the Adolescent and Family

Health Problems of the Adolescent

Family-Centered Care of the Child With Chronic Illness or Disability

Family-Centered Palliative Care

The Child With Cognitive, sensory, or Communication Impairment

Family-Centered Care of the Child During Illness and Hospitalization

Pediatric Nursing Interventions and Skills

The Child With Renal Dysfunction

The Child With Gastrointestinal Dysfunction

Overview of Oxygen and Carbon Dioxide Exchange

The Child With Respiratory Dysfunction

The Child With Cardiovascular Dysfunction

The Child With Hematologic or Immunologic Dysfunction

The Child With Cancer

The Child With Cerebral Dysfunction

The Child With Endocrine Dysfunction

The Child With Musculoskeletal or Articular Dysfunction

The Child With Neuromuscular or Muscular Dysfunction

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