A nurse in an urgent care clinic is caring for an infant who presents with vomiting, diarrhea, and decreased oral intake. Which of the following manifestations should the nurse expect?
Hypertension
Decreased temperature
Oliguria
Bulging anterior fontanel
The Correct Answer is C
Rationale:
A. Hypertension: Dehydration in infants typically causes hypotension, not hypertension, due to reduced circulating volume and poor perfusion as fluid loss progresses.
B. Decreased temperature: While temperature may fluctuate in dehydration, fever is more common due to infection-related fluid loss. A decreased temperature is not a consistent sign.
C. Oliguria: Decreased urine output is a key indicator of dehydration in infants. The kidneys conserve water during hypovolemia, resulting in oliguria (less than 1 mL/kg/hr).
D. Bulging anterior fontanel: A bulging fontanel usually indicates increased intracranial pressure, not dehydration. Dehydration typically causes a sunken fontanel in infants.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Take your temperature 1 hour after getting out of bed: Delaying temperature measurement can result in inaccurate readings due to physical activity or environmental changes, making it unreliable for detecting ovulation patterns.
B. Take your temperature every night before going to bed: Basal body temperature (BBT) must be taken in the morning, not at night, because the temperature needs to reflect complete rest, which occurs after several hours of sleep.
C. Take your temperature within 30 minutes after your first morning void: Voiding and moving around before taking your temperature can alter the basal reading, reducing the method’s accuracy for predicting fertile days.
D. Take your temperature immediately after waking and before getting out of bed: BBT should be taken at the same time each morning immediately upon waking and before any activity to ensure the most accurate and consistent readings for fertility tracking.
Correct Answer is B
Explanation
Rationale:
A. Provide frequent stimulation for the newborn: Newborns with neonatal abstinence syndrome (NAS) are often hypersensitive to stimuli. Excessive stimulation can worsen symptoms such as tremors, irritability, and sleep disturbances.
B. Decrease the lighting levels in the nursery: Reducing environmental stimuli such as bright lights and loud noises helps soothe infants with NAS. A calm, low-stimulation setting promotes comfort and minimizes overstimulation.
C. Wrap the newborn loosely in a blanket: Tight swaddling not loose wrapping is recommended for NAS to provide a sense of security and decrease tremors and agitation. Loose wrapping can increase distress and reduce effectiveness.
D. Encourage frequent eye contact with the newborn during feedings: Direct eye contact can be overstimulating for infants experiencing NAS. Instead, feedings should be calm and gentle, with minimal stimulation to reduce stress and improve tolerance.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.