A 4-month-old is brought to the emergency department with severe dehydration. The heart rate is 198, and the blood pressure is 68/38. The infant's anterior fontanel is sunken. The nurse notes that the infant does not cry when the intravenous line is inserted. The child's parents state that she has not "held anything down" in 18 hours. The nurse obtains a finger-stick blood sugar of 94. Which action would the nurse expect to do immediately?

Administer a bolus of D10W.

Offer the child a bottle of an oral rehydration solution such as Pedialyte.

Administer a bolus of hypertonic saline.

Administer a bolus of normal saline.

Answer and Explanation

The Correct Answer is D

Choice A reason: Administering a bolus of D10W is not the first-line treatment for severe dehydration and may not address the immediate fluid needs of the infant.
Choice B reason: Offering an oral rehydration solution is not appropriate for an infant with severe dehydration and a compromised ability to hold down fluids.
Choice C reason: Administering a bolus of hypertonic saline is not typically the initial treatment for dehydration and could potentially worsen the infant's condition.
Choice D reason: This is the correct choice. Administering a bolus of normal saline is the immediate action to treat severe dehydration and restore circulatory volume.

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Correct Answer is A

Explanation

Choice A reason: This is the correct choice. A urinary tract infection is a common cause of urinary incontinence in children and should be evaluated first.
Choice B reason: While emotional trauma can cause changes in behavior, including incontinence, it is not the first complication to be evaluated in this scenario.
Choice C reason: Sexual abuse can result in behavioral changes, but there is no immediate indication of this being the cause without further assessment.
Choice D reason: A structural defect of the urinary tract could cause incontinence, but it is less likely to be the cause of a sudden onset of symptoms compared to a urinary tract infection.

A. Massage. B. Ice. C. Video games. D. Moist heat.

Correct Answer is D

Explanation

Choice A reason: Massage can be helpful but may not be the most effective method for reducing joint pain in rheumatoid arthritis.
Choice B reason: Ice can help reduce inflammation but is typically used for acute injuries rather than chronic conditions like rheumatoid arthritis.
Choice C reason: Video games are not a pain management strategy and can potentially exacerbate joint pain due to repetitive motions.
Choice D reason: This is the correct choice. Moist heat can help relieve stiffness and pain in the joints, making it a suitable non-pharmacological measure for rheumatoid arthritis.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 6-year-old child has been sent to the school nurse for wetting her pants three times in the past 2 days. The nurse should recommend that this child be evaluated for which complication first?

Correct Answer is A

Explanation

For an adolescent client diagnosed with rheumatoid arthritis, which non-pharmacological measure is most appropriate to reduce joint pain?

Correct Answer is D

Explanation

A group of children on one hospital unit are all suffering from separation anxiety. Which child is experiencing the "despair" stage of separation anxiety?

A 3-year-old admitted to the hospital with croup has the following vital signs: heart rate 90, respiratory rate 48, blood pressure 100/52, and temperature 98.8°F (37.1°C). The parents ask the nurse if these vital signs are normal. The nurse's best response is:

In an outpatient diabetic clinic, the nurse is assessing clients. Which entry provides the best indication that the client is adhering to the prescribed diabetic regimen?

A child is admitted to the hospital unit with physical injuries. The nurse is taking the child's history. Which statement by the parent would arouse suspicion of abuse?

The nurse observes that a client with Parkinson’s disease (PD) has a mask-like face. Which follow-up assessment is most important for the nurse to implement?

The nurse is giving a health promotion class to adolescents. The nurse will be sure to include information regarding the leading cause of death in adolescents aged 15 and up.

What is the likely result of a child fracturing a bone through a portion of the epiphyseal plate?

Which statement by the nurse would best help alleviate parental guilt about their child, George, who has been recently diagnosed with autism?