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NR 328 Exam -2 Practice Questions _ All Module Exams Questions and Answers.pdf
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9/1/24, 3:50 AMNR 328 Exam #2 Practice Questions
Jeremiah
Terms in this set (139)
Answer: A
What factor predisposes an infant to fluid
Rationale: The infant’s kidneys are functionally immature at birth and are inefficient in
imbalances?
excreting waste products of metabolism. Infants have a relatively high body surface
a. Immature kidney functioning
area (BSA) compared with adults. This allows a higher loss of fluid to the environment. A
b. Decreased surface area
higher metabolic rate is present as a result of the higher BSA in relation to active
c. Lower metabolic rate
metabolic tissue. The higher metabolic rate increases heat production, which results in
d. Decreased daily exchange of extracellular
greater insensible water loss. Infants have a greater exchange of extracellular fluid,
fluid
leaving them with a reduced fluid reserve in conditions of dehydration.
Answer: A
What is the required number of milliliters of
Rationale: For the first 10 kg of body weight, a child requires 100 mL/kg. For each
fluid needed per day for a 14 kg child?
additional kilogram of body weight, an extra 50 mL is needed.
a. 1200
10 kg ´ 100 mL/kg/day = 1000 mL
b. 1100
4 kg ´ 50 mL/kg/day = 200 mL
c. 1300
1000 mL + 200 mL = 1200 ml/day
d. 1400
800 to 1000 mL is too little; 1400 mL is too much.
An infant is brought to the emergency Answer: A
department with the following clinical Rationale: These clinical manifestations indicate water depletion or dehydration. Edema
manifestations: poor skin turgor, weight and weight gain occur with water excess or over-hydration. Sodium or potassium
loss, lethargy, tachycardia, and tachypnea. excess would not cause these symptoms.
This is suggestive of which situation?
a. Water depletion
b. Water excess
c. Potassium excess
d. Sodium depletion
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What explains physiologically the edema Answer: A
formation that occurs with burns? Rationale: With a major burn, capillary permeability increases, allowing plasma
a. Increased capillary permeability proteins, fluids, and electrolytes to be lost into the interstitial space, causing edema.
b. Decreased capillary permeability Maximum edema in a small wound occurs about 8 to 12 hr after injury. In larger injuries,
c. Vasoconstriction the maximum edema may not occur until 18 to 24 hr later. Vasodilation occurs, causing
d. Diminished hydrostatic pressure within an increase in hydrostatic pressure.
capillaries
What is the most immediate threat to life in Answer: A
children with thermal injuries? Rationale: The immediate threat to life in children with thermal injuries is airway
a. Shock compromise and profound shock. Anemia is not of immediate concern. During the
b. Anemia healing phase, local infection or sepsis is the primary complication.
c. Local infection
d. Systemic sepsis
After the acute stage and during the Answer: A
healing process, what is the primary Rationale: During the healing phase, local infection or sepsis is the primary
complication from burn injury? complication. Respiratory problems, primarily airway compromise, and shock are the
a. Infection primary complications during the acute stage of burn injury. Renal shutdown is not a
b. Shock complication of the burn injury but may be a result of the profound shock.
c. Renal shutdown
d. Asphyxia
What finding is the most reliable guide to Answer: A
the adequacy of fluid replacement for a Rationale: Replacement fluid therapy is delivered to provide a urinary output of 30
small child with burns? mL/hr in older children or 1 to 2 mL/kg of body weight/hr for children weighing less
a. Urinary output of 1 to 2 mL/kg of body than 30 kg (66 pounds). Thirst is the result of a complex set of interactions and is not a
weight/hr reliable indicator of hydration. Thirst occurs late in dehydration. A falling hematocrit
b. Increased seepage from burn wound would be indicative of hemodilution. This may reflect fluid shifts and may not accurately
c. Falling hematocrit represent fluid replacement therapy. Increased seepage from a burn wound would be
d. Absence of thirst indicative of increased output, not adequate hydration.
What intervention is contraindicated in a Answer: A
suspected case of appendicitis? Rationale: In any instance in which severe abdominal pain is observed and appendicitis
a. Enemas is suspected, the nurse must be aware of the danger of administering laxatives or
b. Palpating the abdomen enemas. Such measures stimulate bowel motility and increase the risk of perforation.
c. Administration of antibiotics The abdomen is palpated after other assessments are made. Antibiotics should be
d. Administration of antipyretics for fever administered, and antipyretics are not contraindicated.
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An infant had a gastrostomy tube placed Answer: A
for feedings after a Nissen fundoplication Rationale: If bolus feedings are initiated through a gastrostomy after a Nissen
and bolus feedings are initiated. Between fundoplication, the tube may need to remain vented for several days or longer to avoid
feedings while the tube is clamped, the gastric distention from swallowed air. Edema surrounding the surgical site and a tight
infant becomes irritable, and there is gastric wrap may prohibit the infant from expelling air through the esophagus, so
evidence of cramping. What action should burping does not relieve the distention. Some infants benefit from clamping of the tube
the nurse implement? for increasingly longer intervals until they are able to tolerate continuous clamping
a. Vent the gastrostomy tube. between feedings. During this time, if the infant displays increasing irritability and
b. Withhold the next feeding. evidence of cramping, some relief may be provided by venting the tube. The next
c. Burp the infant. feeding should not be withheld, and calling the health care provider is not necessary.
d. Notify the health care provider.
The nurse should instruct parents to Answer: A
administer a daily proton pump inhibitor to Rationale: Proton pump inhibitors are most effective when administered 30 minutes
their child with gastroesophageal reflux at before breakfast so that the peak plasma concentrations occur with mealtime. If they
which time? are given twice a day, the second best time for administration is 30 minutes before the
a. 30 minutes before breakfast evening meal.
b. Midmorning
c. Bedtime
d. With a meal
The nurse is assisting a child with celiac Answer: A
disease to select foods from a menu. What Rationale: Treatment of celiac disease consists primarily of dietary management.
foods should the nurse suggest? Although a gluten-free diet is prescribed, it is difficult to remove every source of this
a. Corn on the cob with butter protein. Some patients are able to tolerate restricted amounts of gluten. Because
b. Hamburger on a bun gluten occurs mainly in the grains of wheat and rye but also in smaller quantities in
c. Spaghetti with meat sauce barley and oats, these foods are eliminated. Corn, rice, and millet are substitute grain
d. Peanut butter and crackers foods. Corn on the cob with butter would be gluten free.
An infant is born with a gastroschisis. Care Answer: A
preoperatively should include which Rationale: Initial management of a gastroschisis involves covering the exposed bowel
priority intervention? with a transparent plastic bowel bag or loose, moist dressings. The infant cannot be
a. Covering the defect with a sterile bowel placed prone, and feedings will be withheld until surgery is performed. Electrolyte
bag laboratory values will be monitored but not before covering the defect with a sterile
b. Monitoring serum laboratory electrolytes bowel bag.
c. Sterile water feedings
d. Prone position
A 3-day-old infant presents with abdominal Answer: A
distention, is vomiting, and has not passed Rationale: The clinical manifestations of Hirschsprung disease in a 3-day-old infant
any meconium stools. What disease should include abdominal distention, vomiting, and failure to pass meconium stools. Pyloric
the nurse suspect? stenosis would present with vomiting but not distention or failure to pass meconium
a. Hirschsprung disease stools. Intussusception presents with abdominal cramping and celiac disease presents
b. Intussusception with malabsorption.
c. Celiac disease
d. Pyloric stenosis
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