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RN Nursing Care of Children Online Practice 2019 A
1. What clinical manifestation(s) is associated with calcium depletion (hypocalcemia)?
- A. Nausea, vomiting
- B. Weakness, fatigue
- C. Muscle hypotonicity
- D. Neuromuscular irritability
Correct answer: D
Rationale: Hypocalcemia can lead to neuromuscular irritability, causing symptoms such as muscle cramps, tetany, or seizures. Other symptoms like nausea, vomiting, and weakness are less specific and can be related to various conditions.
2. For minimal change nephrotic syndrome (MCNS), prednisone is effective when what occurs?
- A. Appetite increases and blood pressure is normal
- B. Urinary tract infection is gone and edema subsides
- C. Generalized edema subsides and blood pressure is normal
- D. Diuresis occurs as urinary protein excretion diminishes
Correct answer: D
Rationale: The effectiveness of prednisone in treating MCNS is indicated by diuresis and a decrease in urinary protein excretion. Subsidence of generalized edema is also a positive sign, but the key indicator is the reduction in proteinuria, which is achieved through diuresis.
3. What is the primary treatment goal for a child with nephrotic syndrome?
- A. Reduce proteinuria
- B. Lower blood pressure
- C. Increase urine output
- D. Prevent infections
Correct answer: A
Rationale: The correct answer is A: Reduce proteinuria. In nephrotic syndrome, the primary treatment goal is to reduce proteinuria to prevent further kidney damage. Lowering blood pressure (choice B) is important in managing some types of kidney disease but is not the primary treatment goal in nephrotic syndrome. Increasing urine output (choice C) and preventing infections (choice D) are important aspects of supportive care but are not the primary treatment goal for nephrotic syndrome.
4. What is the first step in managing a child with anaphylaxis?
- A. Administer antihistamines
- B. Establish IV access
- C. Administer epinephrine
- D. Monitor vital signs
Correct answer: C
Rationale: The correct answer is to administer epinephrine. Administering epinephrine is the crucial first step in managing anaphylaxis as it helps reverse the severe allergic reaction by constricting blood vessels and relaxing airway muscles, preventing a life-threatening situation. Antihistamines (Choice A) are not the first-line treatment for anaphylaxis and should not delay the administration of epinephrine. Establishing IV access (Choice B) may be necessary but is not the initial step in managing anaphylaxis. Monitoring vital signs (Choice D) is important but should not take precedence over administering epinephrine in the acute management of anaphylaxis.
5. Which physiological acid-base balance complication would be most important for the nurse to assess in a patient with diarrhea?
- A. High serum pH
- B. Normal serum pH
- C. Metabolic alkalosis
- D. Metabolic acidosis
Correct answer: D
Rationale: The correct answer is metabolic acidosis. Diarrhea can lead to the loss of bicarbonate, causing an imbalance in the acid-base status of the body, specifically resulting in metabolic acidosis. High serum pH (choice A) is incorrect as diarrhea-induced bicarbonate loss would lower pH, not increase it. Normal serum pH (choice B) is not the best answer as diarrhea can disrupt the acid-base balance. Metabolic alkalosis (choice C) is an alkaline state, which is less likely to be caused by diarrhea.
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