What is the most appropriate nursing diagnosis for a child diagnosed with moderate anemia?
Risk for injury related to depressed sensorium.
Decreased cardiac output related to abnormal hemoglobin.
Activity intolerance related to generalized weakness.
Risk for Injury related to dehydration and abnormal hemoglobin.
The Correct Answer is C
The correct answer is choice C. Activity intolerance related to generalized weakness.
Choice A rationale:
Risk for injury related to depressed sensorium. This choice is not the most appropriate nursing diagnosis for a child with moderate anemia. While anemia can lead to fatigue and weakness, the main concern is the child's ability to tolerate physical activities, not the risk of injury due to a depressed sensorium.
Choice B rationale:
Decreased cardiac output related to abnormal hemoglobin. This choice is not the most suitable nursing diagnosis for a child with moderate anemia. While abnormal hemoglobin levels can affect cardiac output, moderate anemia typically doesn't lead to such a significant decrease in cardiac output that it becomes the primary nursing diagnosis. Activity intolerance is a more relevant concern.
Choice C rationale:
Activity intolerance related to generalized weakness. This is the most appropriate nursing diagnosis for a child diagnosed with moderate anemia. Moderate anemia results in a decrease in oxygen-carrying capacity, leading to generalized weakness and reduced ability to perform physical activities without becoming fatigued. The child's hemoglobin levels are likely low enough to cause noticeable activity intolerance.
Choice D rationale:
Risk for Injury related to dehydration and abnormal hemoglobin. This choice is not the best nursing diagnosis for a child with moderate anemia. Dehydration may exacerbate the effects of anemia, but the primary issue here is the anemia itself causing weakness and activity intolerance, which are better addressed with the choice C diagnosis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choice D. Give small amounts of favorite fluids frequently to prevent dehydration.
Choice A rationale:
Having the child wear heavy clothing to prevent chilling is not an appropriate nursing intervention for an infant with an elevated temperature. Infants are more susceptible to temperature regulation issues, and heavy clothing could exacerbate their discomfort and potentially raise their body temperature further.
Choice B rationale:
Giving tepid water baths to reduce fever is not recommended for fever management in infants. Tepid baths might cause discomfort and shivering, which could lead to increased heat production and potential elevation of body temperature.
Choice C rationale:
Encouraging food intake to maintain caloric needs is important, but it might not be well-tolerated by an infant with an elevated temperature and upper respiratory tract infection. Infants often have reduced appetite during illness.
Choice D rationale:
Giving small amounts of favorite fluids frequently to prevent dehydration is an appropriate nursing intervention. Fever and elevated temperature can lead to increased fluid loss through sweating and increased respiratory rate. Offering small, frequent fluid intake helps maintain hydration and prevent dehydration. Using favorite fluids can also encourage the child to drink more.
Correct Answer is ["A","E"]
Explanation
The correct answer is choice A, E.
Choice A rationale:
Using an air conditioner is an effective way to reduce exposure to pollens and dust. Air conditioners filter the air and help prevent outdoor allergens from entering the indoor environment. This choice is correct because it addresses one of the primary sources of exposure to allergens.
Choice B rationale:
Keeping humidity in the house above 60% is not a recommended approach. High humidity can promote the growth of mold and dust mites, which can exacerbate allergies. Maintaining humidity levels between 30-50% is generally recommended for reducing allergen exposure.
Choice C rationale:
Keeping pets outside might seem like a logical option to reduce allergen exposure; however, pet allergens can still be carried indoors on clothing and shoes. Moreover, if individuals are not allergic to pet dander, keeping the pets inside may not pose an issue.
Choice D rationale:
Replacing wall-to-wall carpeting with wood and tile floors is a good strategy for reducing allergen exposure. Carpets can trap dust, pollen, and other allergens, while hard surfaces are easier to clean and do not accumulate allergens as readily. This choice is correct because it addresses a common source of indoor allergens.
Choice E rationale:
Putting dust-proof covers on pillows and mattresses is another effective strategy for reducing allergen exposure. These covers create a barrier that prevents dust mites and their allergens from permeating the sleeping environment. This choice is correct because it directly addresses the issue of dust mite allergens.
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