the nurse is admitting a child with severe isotonic dehydration which intravenous fluid should the nurse anticipate the doctor to order initially to r
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ATI RN

RN Nursing Care of Children Online Practice 2019 A

1. 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?

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.

2. Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?

Correct answer: B

Rationale: Morphine is the drug of choice for PCA in children because of its efficacy, safety profile, and rapid onset of action for pain management.

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

Correct answer: C

Rationale: In response to dehydration, the body compensates by shifting fluids from the interstitial spaces to the intravascular space to maintain blood pressure and perfusion to vital organs. Hemoconcentration and vasoconstriction are other compensatory mechanisms but are less immediate.

4. The nurse is assessing a child suspected of having pinworms. Which is the most common symptom the nurse expects to assess?

Correct answer: D

Rationale: Intense perianal itching is the most common symptom of pinworm infection, especially at night when the female worms lay their eggs

5. Which type of breath sound is normally heard over the entire surface of the lungs except for the upper intrascapular area and the area beneath the manubrium?

Correct answer: A

Rationale: Vesicular breath sounds are normally heard over most of the lung fields, except near the trachea and main bronchi, where bronchial or bronchovesicular sounds may be heard.

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