A nurse is admitting a 6-month-old infant who has dehydration.
Which of the following amounts of urinary output should indicate to the nurse that the treatment has corrected the fluid imbalance?
0.5 mL/kg/hr.
15 mL/kg/hr.
2 mL/kg/hr.
7.5 mL/kg/hr.
The Correct Answer is C
The correct answer is C. 2 mL/kg/hr.
Choice A rationale: An output of 0.5 mL/kg/hr is insufficient and indicative of ongoing dehydration or inadequate fluid intake.
Choice B rationale: An output of 15 mL/kg/hr is excessive and could suggest overhydration or a different pathology.
Choice C rationale: A urinary output of 2 mL/kg/hr is an ideal measure for indicating that fluid balance has been restored in infants.
Choice D rationale: An output of 7.5 mL/kg/hr is unusually high and not typical for a corrected fluid balance in infants.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Having a psychiatric disorder, such as depression, anxiety disorder, or bipolar disorder, is a significant risk factor for suicide in adolescents.
Choice A is not correct because while family conflict can be a contributing factor to suicide risk, it is not the greatest risk factor.
Choice B is not correct because homosexuality itself is not a risk factor for suicide; however, discrimination and bullying related to one’s sexual orientation can increase suicide risk.
Choice C is not correct because while the availability of firearms can increase the likelihood of a completed suicide attempt, it is not the greatest risk factor for suicide.
Correct Answer is ["A","C"]
Explanation
Choice A rationale: Teaching caregivers to change diapers immediately when wet is essential for preventing skin breakdown and secondary infections, especially when an infant has been experiencing high fevers or potential gastrointestinal distress.
Choice B rationale: Administering 16 oz of water to an infant after each stool is dangerous. Infants are at high risk for water intoxication and electrolyte imbalances; rehydration should involve breast milk, formula, or oral rehydration solutions.
Choice C rationale: Cleansing the diaper area with mild soap and water is a standard nursing intervention to maintain skin integrity. It removes irritants and bacteria effectively, reducing the risk of developing a secondary diaper dermatitis.
Choice D rationale: Collecting nasal drainage for culture is not indicated based on the provided vital signs. The infant's temperature has improved, and there is no specific evidence of a worsening respiratory infection requiring a culture.
Choice F rationale: Caregivers should never apply talcum powder to an infant’s skin creases. Talcum powder poses a significant aspiration risk and can lead to severe respiratory distress or chronic lung irritation if inhaled.
Choice G rationale: Using a nasal aspirator should be done before feedings, not after. Suctioning after a feeding can trigger the gag reflex and cause the infant to vomit, increasing the risk of aspiration.
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