Nursing Elites

1. A child with pyloric stenosis is having excessive vomiting. The nurse should assess for what potential complication?

• A. Hyperkalemia
• B. Hyperchloremia
• C. Metabolic acidosis
• D. Metabolic alkalosis

Correct answer: D

Rationale: Excessive vomiting in pyloric stenosis leads to the loss of stomach acid (hydrochloric acid), resulting in metabolic alkalosis, not hyperkalemia, hyperchloremia, or metabolic acidosis. Metabolic alkalosis is characterized by a higher pH level in the blood due to the loss of acid and a relative increase in bicarbonate. Hyperkalemia is an elevated level of potassium in the blood and is not directly related to excessive vomiting in pyloric stenosis. Hyperchloremia is an excess of chloride in the blood, which is not typically associated with this condition. Metabolic acidosis is a condition characterized by a lower pH level in the blood, caused by an excess of acid or a loss of bicarbonate, which is not the typical complication seen in pyloric stenosis with excessive vomiting.

2. Several types of seizures can occur in neonates. What is characteristic of clonic seizures?

• A. Apnea
• B. Tremors
• C. Extension of all four limbs
• D. Jerking that cannot be stopped by flexion of the affected limb

Correct answer: D

Rationale: Clonic seizures are characterized by slow, rhythmic, jerking movements that cannot be stopped by flexion of the affected limb. Therefore, the correct characteristic of clonic seizures is option D. Option A, apnea, is not characteristic of clonic seizures. Option B, tremors, does not describe clonic seizures accurately. Option C, extension of all four limbs, is not a typical feature of clonic seizures but rather seen in tonic seizures.

3. What amount of fluid loss occurs with moderate dehydration?

• A. <50 ml/kg
• B. 50 to 90 ml/kg
• C. <5% total body weight
• D. >15% total body weight

Correct answer: B

Rationale: Moderate dehydration is typically defined as a loss of 50 to 90 mL/kg of body weight. This amount reflects significant fluid loss that requires medical attention but is not yet severe.

4. What organism is a parasite that causes acute diarrhea?

• A. Shigella organisms
• B. Salmonella organisms
• C. Giardia lamblia
• D. Escherichia coli

Correct answer: C

Rationale: Giardia lamblia is a protozoan parasite known to cause acute diarrhea, often through contaminated water or food. Shigella, Salmonella, and E. coli are bacterial pathogens that also cause diarrhea but are not parasites.

5. A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. What should the therapeutic plan initially include?

• A. Bowel cleansing
• B. Dietary modification
• C. Structured toilet training
• D. Behavior modification

Correct answer: B

Rationale: Dietary modification is often the first step in managing chronic constipation in children, focusing on increasing fiber and fluid intake. Other interventions like bowel cleansing and toilet training may follow if dietary changes are insufficient.

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