PEDS EXAM 3 REVIEW (CH 18 ,25,26,27,29,30) 2024-2025 |COMPLETE
EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES |ALREADY GRADED A+.
A nurse is taking care of four different pediatric clients. Which client
poses the great risk for dehydration?
1. 15-year-old working out in a weight room for an hour before
football practice
2. 10-year-old playing baseball outdoors in 85 degree heat
3. 5-year-old refusing to eat because of a virus
4. A newborn under a radiant warmer for an hour after the first bath -
ANSWER -Answer: 2
Rationale: A condition that increases the risk of insensible fluid loss
places the child at risk for dehydration. Any of these situations can
place the child at risk for dehydration but the child at greatest risk is
the child playing baseball in direct heat, which will increase utilization
of extracellular fluids more rapidly than the other situations.
The nurse is assessing an infant brought to the clinic with diarrhea.
The infant is alert but has dry mucous membranes. Which other sign
indicates the infant is still in the early or mild stage of dehydration?
1. Tachycardia
2. Bradycardia
3. Increased blood pressure
4. Decreased blood pressure - ANSWER -Answer: 1
,Rationale: Tachycardia is a sign that indicates mild dehydration.
Bradycardia and increased blood pressure are not signs of
dehydration. Decreased blood pressure is not a sign of mild
dehydration. Decreased blood pressure indicates moderate to severe
dehydration.
A 1-month-old client is admitted to the emergency room with severe
diarrhea. Which assessment suggests the client is severely
dehydrated?
1. Skin moist and flushed; mucous membranes dry
2. Low specific gravity of urine; skin color pale
3. Fontanels depressed; capillary refill greater than three seconds
4. High specific gravity of urine; moist mucous membranes -
ANSWER -Answer: 3
Rationale: Two signs of severe dehydration are depressed fontanels
and capillary refill time greater than three seconds. Moist, flushed
skin; moist mucous membranes; and low specific gravity of urine are
not signs of dehydration. Dry mucous membranes and pale skin color
are signs of mild dehydration, not severe.
The nurse is expecting the admission of a child with severe isotonic
dehydration. Which intravenous fluid should the nurse anticipate the
practitioner to order initially to replace fluids?
1. D5W
2. 0.9 percent Normal Saline (NS)
3. Albumin
4. D5 0.2 percent () Normal Saline - ANSWER -Answer: 2
,Rationale: 0.9 percent Normal Saline (NS) maintains Na and chloride
at present levels. D5W can lower sodium levels so would not be used
to initially replace fluids in severe isotonic dehydration. Albumin is
used to restore plasma proteins. D5 0.2 percent () Normal Saline
would not be used initially but later, as maintenance fluids.
Parents of an infant with slow weight gain ask the nurse if they can
feed their baby a highly concentrated formula. Which response by the
nurse is the most appropriate?
1. A higher-concentrated formula could lead to dehydration
because of high sodium content; lets discuss other strategies.
2. An undiluted formula concentrate could be given to help the
child gain weight; lets look at brands.
3. Evaporated milk could be given to the infant instead of the
current formula youre using.
4. A higher-concentrated formula could be given for daytime
feedings; lets work on a schedule. - ANSWER -Answer: 1
Rationale: Parents and caregivers of bottle-fed babies should be
taught never to give undiluted formula concentrate or evaporated milk
due to the high sodium content.
The nurse finishes a parent-teaching session on preventing
heatrelated illnesses for children who exercise. Which statement by a
parent indicates understanding of preventive techniques taught?
1. Hydration should occur at the end of an exercise session.
2. Water is the drink of choice to replenish fluids.
3. Wearing dark clothing during exercise is recommended.
, 4. During activity, stop for fluids every 1520 minutes. - ANSWER -
Answer: 4
Rationale: During activity, stopping for fluids every 1520 minutes is
recommended. Hydration should occur before and during the activity,
not just at the end. A combination of water and sports drinks is best
to replace fluids during exercise. Light-colored, light clothing is best
to wear during exercise activities; wearing of dark colors can increase
sweating.
A child is being treated for dehydration with intravenous fluids. The
child currently weighs 13 kg and is estimated to have lost 7 percent of
the normal body weight. The nurse is double-checking the IV rate the
practitioner has ordered. The formula the practitioner used was for
maintenance fluids: 1000 mL for 10 kg of body weight plus 50 cc for
every kg over 10 for 24 hours. Replacement fluid is the percentage of
lost body weight 10 per kg of body weight. According to the
calculation for maintenance plus replacement fluid, this childs hourly
IV rate for 24 hours should be ____ mL. Round the answer to the
nearest whole number. - ANSWER -Answer: 86
Rationale: Maintenance need for 13 kg is 1000 + (50 3), or 1150 mL/24
hours. Add to this the replacement-fluid loss = 7 (percent of total
body weight lost) 10 = 70 mL/kg/24 hours (70 13 = 910). 1150 + 910 =
2060 for 24 hours. 2060/24 = 86 mL per hour.
In the morning, a nurse receives a report on four pediatric clients who
have some form of fluid-volume excess. Which client should the
nurse assess first?
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