The home health care nurse is visiting a child with renal failure undergoing continuous ambulatory peritoneal dialysis (CAPD). Which of the following would lead the nurse to identify a nursing diagnosis of fluid overload related to CAPD?

poor skin turgor

shortness of breath

Redness at the tube insertion site

Fever

Answer and Explanation

The Correct Answer is B

A. Poor skin turgor typically indicates dehydration, not fluid overload.

B. Shortness of breath can be a sign of fluid overload, particularly in children with renal failure, as excess fluid can accumulate and lead to pulmonary edema.

C. Redness at the tube insertion site may indicate infection but does not specifically relate to fluid overload.

D. Fever is a sign of infection or inflammation and does not directly indicate fluid overload.

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Correct Answer is D

Explanation

A. Back pain may occur but is not typically urgent unless severe; it’s important to monitor but not the priority.

B. Frequent nosebleeds can occur due to dry mucous membranes but are not the most critical symptom to report immediately.

C. Itching of the skin can be managed with moisturizers and does not represent a medical emergency.

D. Feelings of isolation and depression are serious side effects associated with isotretinoin and should be reported immediately due to the risk of self-harm or suicidal thoughts.

A. Soccer B. Gymnastics C. Swimming D. Football

Correct Answer is C

Explanation

A. Soccer is a contact sport with a high risk of injury, which is not suitable for a child with hemophilia.

B. Gymnastics can also pose risks of falls and injuries that are not advisable for children with bleeding disorders.

C. Swimming is generally considered safe for children with hemophilia as it is a non-contact activity and does not involve high risk of injury.

D. Football is a contact sport and carries a high risk of trauma, making it unsafe for children with hemophilia.

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The home health care nurse is visiting a child with renal failure undergoing continuous ambulatory peritoneal dialysis (CAPD). Which of the following would lead the nurse to identify a nursing diagnosis of fluid overload related to CAPD?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a 17-year-old female client who has severe acne about the use of isotretinoin. Which of the following adverse effects should the nurse instruct the client is the priority to report immediately to the provider?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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