Chapter 18 Principles of Pediatric Nursing 6th Ed By Ball

Chapter 18 Principles of Pediatric Nursing 6th Ed By Ball

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

A nurse is taking care of four different pediatric clients. Which client poses the great risk for dehydration?

1. 15-year-old working out in a weight room for an hour before football practice
2. 10-year-old playing baseball outdoors in 85 degree heat
3. 5-year-old refusing to eat because of a virus
4. A newborn under a radiant warmer for an hour after the first bath

Correct Answer: 2

Rationale 1: A condition that increases the risk of insensible fluid loss places the child at risk for dehydration. Any of these situations can place the child at risk for dehydration but the child at greatest risk is the child playing baseball in direct heat, which will increase utilization of extracellular fluids more rapidly than the other situations.

Rationale 2: A condition that increases the risk of insensible fluid loss places the child at risk for dehydration. Any of these situations can place the child at risk for dehydration but the child at greatest risk is the child playing baseball in direct heat, which will increase utilization of extracellular fluids more rapidly than the other situations.

Rationale 3: A condition that increases the risk of insensible fluid loss places the child at risk for dehydration. Any of these situations can place the child at risk for dehydration but the child at greatest risk is the child playing baseball in direct heat, which will increase utilization of extracellular fluids more rapidly than the other situations.

Rationale 4: A condition that increases the risk of insensible fluid loss places the child at risk for dehydration. Any of these situations can place the child at risk for dehydration but the child at greatest risk is the child playing baseball in direct heat, which will increase utilization of extracellular fluids more rapidly than the other situations.

Global Rationale: A condition that increases the risk of insensible fluid loss places the child at risk for dehydration. Any of these situations can place the child at risk for dehydration but the child at greatest risk is the child playing baseball in direct heat, which will increase utilization of extracellular fluids more rapidly than the other situations.

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 18.3 Interpret threats to fluid and electrolyte balance in children.

 

Question 2

Type: MCSA

The nurse is assessing an infant brought to the clinic with diarrhea. The infant is alert but has dry mucous membranes. Which other sign indicates the infant is still in the early or mild stage of dehydration?

1. Tachycardia
2. Bradycardia
3. Increased blood pressure
4. Decreased blood pressure

Correct Answer: 1

Rationale 1: Tachycardia is a sign that indicates mild dehydration. Bradycardia and increased blood pressure are not signs of dehydration. Decreased blood pressure is not a sign of mild dehydration. Decreased blood pressure indicates moderate to severe dehydration.

Rationale 2: Tachycardia is a sign that indicates mild dehydration. Bradycardia and increased blood pressure are not signs of dehydration. Decreased blood pressure is not a sign of mild dehydration. Decreased blood pressure indicates moderate to severe dehydration.

Rationale 3: Tachycardia is a sign that indicates mild dehydration. Bradycardia and increased blood pressure are not signs of dehydration. Decreased blood pressure is not a sign of mild dehydration. Decreased blood pressure indicates moderate to severe dehydration.

Rationale 4: Tachycardia is a sign that indicates mild dehydration. Bradycardia and increased blood pressure are not signs of dehydration. Decreased blood pressure is not a sign of mild dehydration. Decreased blood pressure indicates moderate to severe dehydration.

Global Rationale: Tachycardia is a sign that indicates mild dehydration. Bradycardia and increased blood pressure are not signs of dehydration. Decreased blood pressure is not a sign of mild dehydration. Decreased blood pressure indicates moderate to severe dehydration.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 18.5 Analyze assessment findings to recognize fluid-electrolyte problems and acid–base imbalance in children.

 

Question 3

Type: MCSA

A 1-month-old client is admitted to the emergency room with severe diarrhea. Which assessment suggests the client is severely dehydrated?

1. Skin moist and flushed; mucous membranes dry
2. Low specific gravity of urine; skin color pale
3. Fontanels depressed; capillary refill greater than three seconds
4. High specific gravity of urine; moist mucous membranes

Correct Answer: 3

Rationale 1: Two signs of severe dehydration are depressed fontanels and capillary refill time greater than three seconds. Moist, flushed skin; moist mucous membranes; and low specific gravity of urine are not signs of dehydration. Dry mucous membranes and pale skin color are signs of mild dehydration, not severe.

Rationale 2: Two signs of severe dehydration are depressed fontanels and capillary refill time greater than three seconds. Moist, flushed skin; moist mucous membranes; and low specific gravity of urine are not signs of dehydration. Dry mucous membranes and pale skin color are signs of mild dehydration, not severe.

Rationale 3: Two signs of severe dehydration are depressed fontanels and capillary refill time greater than three seconds. Moist, flushed skin; moist mucous membranes; and low specific gravity of urine are not signs of dehydration. Dry mucous membranes and pale skin color are signs of mild dehydration, not severe.

Rationale 4: Two signs of severe dehydration are depressed fontanels and capillary refill time greater than three seconds. Moist, flushed skin; moist mucous membranes; and low specific gravity of urine are not signs of dehydration. Dry mucous membranes and pale skin color are signs of mild dehydration, not severe.

Global Rationale: Two signs of severe dehydration are depressed fontanels and capillary refill time greater than three seconds. Moist, flushed skin; moist mucous membranes; and low specific gravity of urine are not signs of dehydration. Dry mucous membranes and pale skin color are signs of mild dehydration, not severe.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 18.5 Analyze assessment findings to recognize fluid-electrolyte problems and acid–base imbalance in children.

 

Question 4

Type: MCSA

The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the practitioner to order initially to replace fluids?

1. D5W
2. 0.9 percent Normal Saline (NS)
3. Albumin
4. D5 0.2 percent (¼) Normal Saline

Correct Answer: 2

Rationale 1: 0.9 percent Normal Saline (NS) maintains Na and chloride at present levels. D5W can lower sodium levels so would not be used to initially replace fluids in severe isotonic dehydration. Albumin is used to restore plasma proteins. D5 0.2 percent (¼) Normal Saline would not be used initially but later, as maintenance fluids.

Rationale 2: 0.9 percent Normal Saline (NS) maintains Na and chloride at present levels. D5W can lower sodium levels so would not be used to initially replace fluids in severe isotonic dehydration. Albumin is used to restore plasma proteins. D5 0.2 percent (¼) Normal Saline would not be used initially but later, as maintenance fluids.

Rationale 3: 0.9 percent Normal Saline (NS) maintains Na and chloride at present levels. D5W can lower sodium levels so would not be used to initially replace fluids in severe isotonic dehydration. Albumin is used to restore plasma proteins. D5 0.2 percent (¼) Normal Saline would not be used initially but later, as maintenance fluids.

Rationale 4: 0.9 percent Normal Saline (NS) maintains Na and chloride at present levels. D5W can lower sodium levels so would not be used to initially replace fluids in severe isotonic dehydration. Albumin is used to restore plasma proteins. D5 0.2 percent (¼) Normal Saline would not be used initially but later, as maintenance fluids.

Global Rationale: 0.9 percent Normal Saline (NS) maintains Na and chloride at present levels. D5W can lower sodium levels so would not be used to initially replace fluids in severe isotonic dehydration. Albumin is used to restore plasma proteins. D5 0.2 percent (¼) Normal Saline would not be used initially but later, as maintenance fluids.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 18.6 Plan appropriate nursing interventions for children experiencing fluid-electrolyte problems and acid–base imbalance.

 

Question 5

Type: MCSA

Parents of an infant with slow weight gain ask the nurse if they can feed their baby a highly concentrated formula. Which response by the nurse is the most appropriate?

1. “A higher-concentrated formula could lead to dehydration because of high sodium content; let’s discuss other strategies.”
2. “An undiluted formula concentrate could be given to help the child gain weight; let’s look at brands.”
3. “Evaporated milk could be given to the infant instead of the current formula you’re using.”
4. “A higher-concentrated formula could be given for daytime feedings; let’s work on a schedule.”

Correct Answer: 1

Rationale 1: Parents and caregivers of bottle-fed babies should be taught never to give undiluted formula concentrate or evaporated milk due to the high sodium content.

Rationale 2: Parents and caregivers of bottle-fed babies should be taught never to give undiluted formula concentrate or evaporated milk due to the high sodium content.

Rationale 3: Parents and caregivers of bottle-fed babies should be taught never to give undiluted formula concentrate or evaporated milk due to the high sodium content.

Rationale 4: Parents and caregivers of bottle-fed babies should be taught never to give undiluted formula concentrate or evaporated milk due to the high sodium content.

Global Rationale: Parents and caregivers of bottle-fed babies should be taught never to give undiluted formula concentrate or evaporated milk due to the high sodium content.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Basic Care and Comfort

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 18.3 In