Wongs Essentials of Pediatric Nursing 11th Edition Hockenberry; Wilson; Rodger

Test Bank For Wongs Essentials of Pediatric Nursing 11th
Edition Hockenberry; Wilson; Rodgers | 9780323624190|
Chapter 1-31| All Chapters with Answers and Rationals

1. Which condition in a child should alert a nurse for increased fluid requirements?
a.
Fever
b.
Mechanical ventilation
c.
Congestive heart failure
d.
Increased intracranial pressure (ICP) - ANSWER: a.
Fever

ANS: A
Fever leads to great insensible fluid loss in young children because of increased body surface area
relative to fluid volume. Respiratory rate influences insensible fluid loss and should be monitored in
the mechanically ventilated child. Congestive heart failure is a case of fluid overload in children.
Increased ICP does not lead to increased fluid requirements in children.

DIF: Cognitive Level: Understand REF: p. 689
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

2. A nurse is conducting an in-service on gastrointestinal disorders. The nurse includes that melena,
the passage of black, tarry stools, suggests bleeding from which area?
a.
Perianal or rectal area
b.
Hemorrhoids or anal fissures
c.
Upper gastrointestinal (GI) tract
d.
Lower GI tract - ANSWER: c.
Upper gastrointestinal (GI) tract

ANS: C
Melena is denatured blood from the upper GI tract or bleeding from the right colon. Blood from the
perianal or rectal area, hemorrhoids, or lower GI tract would be bright red.

DIF: Cognitive Level: Apply REF: p. 696
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

3. Which type of dehydration is defined as "dehydration that occurs in conditions in which electrolyte
and water deficits are present in approximately balanced proportion"?
a.
Isotonic dehydration
b.
Hypotonic dehydration
c.
Hypertonic dehydration
d.

,All types of dehydration in infants and small children - ANSWER: a.
Isotonic dehydration


ANS: A
Isotonic dehydration is the correct term for this definition and is the most frequent form of
dehydration in children. Hypotonic dehydration occurs when the electrolyte deficit exceeds the water
deficit, leaving the serum hypotonic. Hypertonic dehydration results from water loss in excess of
electrolyte loss and is usually caused by a proportionately larger loss of water or a larger intake of
electrolytes. This definition is specific to isotonic dehydration.

DIF: Cognitive Level: Understand REF: p. 694
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

4. A nurse is admitting an infant with dehydration caused from water loss in excess of electrolyte loss.
Which type of dehydration is this infant experiencing?
a.
Isotonic
b.
Isosmotic
c.
Hypotonic
d.
Hypertonic - ANSWER: d.
Hypertonic


ANS: D
Hypertonic dehydration results from water loss in excess of electrolyte loss. This is the most
dangerous type of dehydration. It is caused by feeding children fluids with high amounts of solute.
Isotonic dehydration occurs in conditions in which electrolyte and water deficits are present in
balanced proportion and is another term for isomotic dehydration. Hypotonic dehydration occurs
when the electrolyte deficit exceeds the water deficit, leaving the serum hypotonic.

DIF: Cognitive Level: Understand REF: p. 694
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

5. An infant is brought to the emergency department with dehydration. Which physical assessment
finding does the nurse expect?
a.
Weight gain
b.
Bradycardia
c.
Poor skin turgor
d.
Brisk capillary refill - ANSWER: c.
Poor skin turgor

ANS: C
Clinical manifestations of dehydration include poor skin turgor, weight loss, lethargy, and tachycardia.
The infant would have prolonged capillary refill, not brisk.

DIF: Cognitive Level: Understand REF: p. 691
TOP: Integrated Process: Nursing Process: Assessment

, MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation

6. Parents call the clinic and report that their toddler has had acute diarrhea for 24 hours. The nurse
should further ask the parents if the toddler has which associated factor that is causing the acute
diarrhea?
a.
Celiac disease
b.
Antibiotic therapy
c.
Immunodeficiency
d.
Protein malnutrition - ANSWER: b.
Antibiotic therapy

ANS: B
Acute diarrhea is a sudden increase in frequency and change in consistency of stools and may be
associated with antibiotic therapy. Celiac disease is a problem with gluten intolerance and may cause
chronic diarrhea if not identified and managed appropriately. Immunodeficiency would occur with
chronic diarrhea. Protein malnutrition or kwashiorkor causes chronic diarrhea from lowered
resistance to infection.

DIF: Cognitive Level: Apply REF: p. 691
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation

7. Which pathogen is the viral pathogen that frequently causes acute diarrhea in young children?
a.
Giardia organisms
b.
Shigella organisms
c.
Rotavirus
d.
Salmonella organisms - ANSWER: c.
Rotavirus


ANS: C
Rotavirus is the most frequent viral pathogen that causes diarrhea in young children. Giardia
(parasite) and Salmonella are bacterial pathogens that cause diarrhea. Shigella is a bacterial pathogen
that is uncommon in the United States.

DIF: Cognitive Level: Understand REF: p. 697
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation

8. Which is a parasite that causes acute diarrhea?
a.
Shigella organisms
b.
Salmonella organisms
c.
Giardia lamblia
d.
Escherichia coli - ANSWER: c.
Giardia lamblia