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NR 328 Exam #2 Practice Questions With 100% CORRECT ANSWERS
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JACKLINENR 328 Exam #2 Practice Questions With 100% CORRECT ANSWERS
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 excreting
imbalances?
waste products of metabolism. Infants have a relatively high body surface area (BSA)
a. Immature kidney functioning
compared with adults. This allows a higher loss of fluid to the environment. A higher metabolic
b. Decreased surface area
rate is present as a result of the higher BSA in relation to active metabolic tissue. The higher
c. Lower metabolic rate
metabolic rate increases heat production, which results in greater insensible water loss. Infants
d. Decreased daily exchange of extracellular
have a greater exchange of extracellular fluid, leaving them with a reduced fluid reserve in
fluid
conditions of dehydration.
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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 additional
fluid needed per day for a 14 kg child?
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.
NR 328 Exam #2 Practice Questions
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,An infant is brought to the emergency Answer: A
department with the following clinical Rationale: These clinical manifestations indicate water depletion or dehydration. Edema and
manifestations: poor skin turgor, weight loss, weight gain occur with water excess or over-hydration. Sodium or potassium excess would not
lethargy, tachycardia, and tachypnea. This is cause these symptoms.
suggestive of which situation?
a. Water depletion
b. Water excess
c. Potassium excess
d. Sodium depletion
What explains physiologically the edema Answer: A
formation that occurs with burns? Rationale: With a major burn, capillary permeability increases, allowing plasma proteins, fluids,
a. Increased capillary permeability and electrolytes to be lost into the interstitial space, causing edema. Maximum edema in a
b. Decreased capillary permeability small wound occurs about 8 to 12 hr after injury. In larger injuries, the maximum edema may not
c. Vasoconstriction occur until 18 to 24 hr later. Vasodilation occurs, causing an increase in hydrostatic pressure.
d. Diminished hydrostatic pressure within
capillaries
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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 compromise
a. Shock and profound shock. Anemia is not of immediate concern. During the healing phase, local
b. Anemia infection or sepsis is the primary complication.
c. Local infection
d. Systemic sepsis
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After the acute stage and during the healing Answer: A
process, what is the primary complication from Rationale: During the healing phase, local infection or sepsis is the primary complication.
burn injury? Respiratory problems, primarily airway compromise, and shock are the primary complications
a. Infection during the acute stage of burn injury. Renal shutdown is not a complication of the burn injury
b. Shock but may be a result of the profound shock.
c. Renal shutdown
d. Asphyxia
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NR 328 Exam #2 Practice Questions
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,What finding is the most reliable guide to the Answer: A
adequacy of fluid replacement for a small child Rationale: Replacement fluid therapy is delivered to provide a urinary output of 30 mL/hr in
with burns? older children or 1 to 2 mL/kg of body weight/hr for children weighing less than 30 kg (66
a. Urinary output of 1 to 2 mL/kg of body pounds). Thirst is the result of a complex set of interactions and is not a reliable indicator of
weight/hr hydration. Thirst occurs late in dehydration. A falling hematocrit would be indicative of
b. Increased seepage from burn wound hemodilution. This may reflect fluid shifts and may not accurately represent fluid replacement
c. Falling hematocrit therapy. Increased seepage from a burn wound would be indicative of increased output, not
d. Absence of thirst adequate hydration.
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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 is
a. Enemas suspected, the nurse must be aware of the danger of administering laxatives or enemas. Such
b. Palpating the abdomen measures stimulate bowel motility and increase the risk of perforation. The abdomen is
c. Administration of antibiotics palpated after other assessments are made. Antibiotics should be administered, and
d. Administration of antipyretics for fever antipyretics are not contraindicated.
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An infant had a gastrostomy tube placed for Answer: A
feedings after a Nissen fundoplication and Rationale: If bolus feedings are initiated through a gastrostomy after a Nissen fundoplication,
bolus feedings are initiated. Between feedings the tube may need to remain vented for several days or longer to avoid gastric distention from
while the tube is clamped, the infant becomes swallowed air. Edema surrounding the surgical site and a tight gastric wrap may prohibit the
irritable, and there is evidence of cramping. infant from expelling air through the esophagus, so burping does not relieve the distention.
What action should the nurse implement? Some infants benefit from clamping of the tube for increasingly longer intervals until they are
a. Vent the gastrostomy tube. able to tolerate continuous clamping between feedings. During this time, if the infant displays
b. Withhold the next feeding. increasing irritability and evidence of cramping, some relief may be provided by venting the
c. Burp the infant. tube. The next feeding should not be withheld, and calling the health care provider is not
d. Notify the health care provider. necessary.
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The nurse should instruct parents to administer Answer: A
a daily proton pump inhibitor to their child with Rationale: Proton pump inhibitors are most effective when administered 30 minutes before
gastroesophageal reflux at which time? breakfast so that the peak plasma concentrations occur with mealtime. If they are given twice a
a. 30 minutes before breakfast day, the second best time for administration is 30 minutes before the evening meal.
b. Midmorning
c. Bedtime
d. With a meal
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NR 328 Exam #2 Practice Questions
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, 10/30/24, 3:44 PM
The nurse is assisting a child with celiac disease Answer: A
to select foods from a menu. What foods Rationale: Treatment of celiac disease consists primarily of dietary management. Although a
should the nurse suggest? gluten-free diet is prescribed, it is difficult to remove every source of this protein. Some
a. Corn on the cob with butter patients are able to tolerate restricted amounts of gluten. Because gluten occurs mainly in the
b. Hamburger on a bun grains of wheat and rye but also in smaller quantities in barley and oats, these foods are
c. Spaghetti with meat sauce eliminated. Corn, rice, and millet are substitute grain foods. Corn on the cob with butter would
d. Peanut butter and crackers be gluten free.
An infant is born with a gastroschisis. Care Answer: A
preoperatively should include which priority Rationale: Initial management of a gastroschisis involves covering the exposed bowel with a
intervention? transparent plastic bowel bag or loose, moist dressings. The infant cannot be placed prone,
a. Covering the defect with a sterile bowel bag and feedings will be withheld until surgery is performed. Electrolyte laboratory values will be
b. Monitoring serum laboratory electrolytes monitored but not before covering the defect with a sterile bowel bag.
c. Sterile water feedings
d. Prone position
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A 3-day-old infant presents with abdominal Answer: A
distention, is vomiting, and has not passed any Rationale: The clinical manifestations of Hirschsprung disease in a 3-day-old infant include
meconium stools. What disease should the abdominal distention, vomiting, and failure to pass meconium stools. Pyloric stenosis would
nurse suspect? present with vomiting but not distention or failure to pass meconium stools. Intussusception
a. Hirschsprung disease presents with abdominal cramping and celiac disease presents with malabsorption.
b. Intussusception
c. Celiac disease
d. Pyloric stenosis
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NR 328 Exam #2 Practice Questions
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