1. An infant weighing 15 lb has just been treated for severe diarrhea in the hospital. Discharge instructions by the nurse will include maintenance fluid requirements for the pediatric client. Which of the following values best indicates the nurses understanding of normal fluid requirements for this infant?
A) 240 mL/day B) 680 mL/day C) 330 mL/day D) 960 mL/day
2. A normal 3-year-old child is suspected of having meningitis. The doctor has ordered a lumbar puncture. In light of this procedure and developmental characteristics of this age group, which nursing measure is most appropriate?
A) Emphasize those aspects of the procedure that require cooperation. B) Tell the child not to cry or yell. C) Tell the child that he will get a 'stick' in his back. D) Use medical terminology when explaining the procedure to the client.
3. A mother brings a 6-month-old infant and a 4-year-old child to the nursing clinic for routine examination and screening. Which of these plans by the nurse would be most successful?
A) Examine the 4 year old first. B) Provide time for play and becoming acquainted. C) Have the mother leave the room with one child, and examine the other child privately. D) Examine painful areas first to get them 'over with.'
4. An 11-month-old infant is admitted with a possible diagnosis of pyloric stenosis. Which of the following best describes the characteristic clinical manifestations of pyloric stenosis?
A) Pain, especially when eating B) Poor appetite and sucking reflex C) Increased frequency and quantity of stools D) Palpable olive-shaped mass in the epigastrium just right of the umbilical cord
5. As soon as a child has been diagnosed as 'hearing impaired,' special education should begin. Which of the following special education tasks is the most difficult for a severely hearing-impaired child?
A) Auditory training B) Speech C) Lip reading D) Signing
1. Right Answer: B Explanation: (A, C, D) These answers are incorrect. (B) Normal fluid requirement for this pediatric client is based on the fact that 010 kg of weight equals 100 mL/kg per day.This infant weighs 15 pounds (6.8 kg). Thus, 100 mL X 6.8 = 680 mL/day.
2. Right Answer: A Explanation: (A) The nurse should emphasize what is required to elicit cooperation and help to develop a sense of autonomy. (B) The child may express discomfort verbally and should be encouraged to express his feelings. (C) Selecting nonthreatening words to explain a procedure will prevent misinterpretation. (D) When explaining the procedure to the parent with the child present, the nurse should use words that the child can understand to avoid misunderstanding.
3. Right Answer: B Explanation: (A) The 6 month old should be examined first. If several children will be examined, begin with the most cooperative and less anxious child to provide modeling. (B)Providing time for play and getting acquainted minimizes stress and anxiety associated with assessment of body parts. (C) Children generally cooperate best when their mother remains with them. (D) Painful areas are best examined last and will permit maximum accuracy of assessment.
4. Right Answer: D Explanation: (A) There is no evidence of pain in infants with pyloric stenosis whether eating or not. (B) There are both good appetite and feeding habits in these children. (C)Because of regurgitation, there is usually decreased frequency and quantity of stools and also signs of dehydration and weight loss. (D) Along with upper abdominal distention, there is a characteristic palpable olive-shaped mass located to the right of the umbilicus.
5. Right Answer: B Explanation: (A) With the slight and mild hard of hearing, auditory training is beneficial. (B) Speech is the most difficult task because it is learned by visual and auditory stimulation, imitation, and reinforcement. (C, D) Lip reading and signing are aimed at establishing communicative skills, but they are learned more easily by visual stimulation.
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