A 3-year-old boy with asthma has tremors and behavioral changes. ABG: pH 7.35, PCO2 72, HCO3 30. What is the acid-base disorder?

Correct Answer: A

Rationale: In this case, the correct answer is A) Respiratory acidosis, fully compensated. The ABG values show a pH of 7.35 (slightly acidic), elevated PCO2 of 72 (indicating respiratory acidosis), and elevated HCO3 of 30 (compensatory increase in bicarbonate levels). The child's asthma exacerbation likely led to increased CO2 retention, causing respiratory acidosis. The compensatory increase in bicarbonate (HCO3) levels indicates the kidneys are attempting to restore acid-base balance. This combination of respiratory acidosis with metabolic compensation results in fully compensated respiratory acidosis. Option B) Respiratory alkalosis, fully compensated, is incorrect as the ABG values do not support alkalosis. Option C) Metabolic acidosis, uncompensated, is incorrect because there is evidence of compensation (elevated HCO3). Option D) Metabolic acidosis, fully compensated, is incorrect as the primary disorder is respiratory (elevated PCO2). Educationally, understanding ABG interpretation is crucial in pediatric nursing to assess a child's respiratory status and guide appropriate interventions. Recognizing acid-base disorders and their compensatory mechanisms is essential for providing safe and effective care for pediatric patients with respiratory conditions like asthma.

Correct Answer: A

Rationale: In pediatric nursing, understanding dilated cardiomyopathy is crucial for providing effective care to children with heart conditions. Dilated cardiomyopathy is characterized by impaired contractility, which is the correct answer (A). This means the heart muscle is weakened and unable to pump blood effectively. Option B, normal ventricular size, is incorrect because dilated cardiomyopathy actually leads to enlargement of the heart chambers. Option C, dilated atrium, is incorrect because the dilation primarily affects the ventricles. Option D, abnormal relaxation, is incorrect because dilated cardiomyopathy is more associated with impaired contractility rather than relaxation abnormalities. Educationally, knowing these distinctions helps nurses accurately assess and manage pediatric patients with dilated cardiomyopathy. Recognizing the signs and symptoms of this condition can lead to prompt intervention and improved outcomes for children with heart failure. Understanding the pathophysiology behind dilated cardiomyopathy is essential for delivering safe and effective care in pediatric nursing practice.

Correct Answer: D

Rationale: In pediatric nursing, understanding common airway foreign bodies is crucial for providing prompt and effective care. The correct answer is D) Vegetable matter. This is because young children are more likely to inhale or ingest small pieces of vegetable matter, such as nuts or seeds, due to their size and consistency. Vegetables can easily become lodged in a child's airway, leading to respiratory distress or choking. Option A) Small plastic toys may also pose a risk, but they are less common than vegetable matter. Metallic foreign bodies (Option B) are concerning due to their potential for causing injury, but they are less likely to be aspirated into the airway. Hot dogs (Option C) are a well-known choking hazard, but they are not typically classified as airway foreign bodies. Educationally, this question highlights the importance of vigilance in pediatric care to prevent and manage airway obstructions. Nurses need to be aware of common foreign bodies, their risks, and appropriate interventions. Teaching parents and caregivers about choking hazards and safe eating practices can also help reduce the risk of airway emergencies in children.

Correct Answer: D

Rationale: The correct answer is D) Vitamin B12 deficiency. Macrocytosis is a condition characterized by larger than normal red blood cells. This occurs in Vitamin B12 deficiency anemia due to impaired DNA synthesis in red blood cell precursors, leading to larger and ineffective red blood cells. Option A) Sickle cell anemia is not associated with macrocytosis. Sickle cell anemia causes microcytosis, where red blood cells are smaller than normal due to the abnormal hemoglobin structure. Option B) Aplastic anemia is not associated with macrocytosis. Aplastic anemia is a condition where the bone marrow doesn't produce enough blood cells, leading to pancytopenia rather than macrocytosis. Option C) Congenital spherocytosis is not associated with macrocytosis. Congenital spherocytosis is a hemolytic anemia characterized by spherical-shaped red blood cells, not larger cells. Understanding the association between specific types of anemia and their corresponding red blood cell characteristics is crucial in pediatric nursing. Recognizing macrocytosis in Vitamin B12 deficiency anemia can guide appropriate diagnostic and treatment interventions to manage the condition effectively.

Correct Answer: C

Rationale: In pediatric nursing, understanding the interpretation of a tuberculin skin test is crucial for accurate diagnosis and treatment of tuberculosis. A false positive result occurs when the test indicates tuberculosis infection when the individual is not actually infected. In this case, the correct answer is C) Infection with atypical mycobacteria. Atypical mycobacteria are non-tuberculosis mycobacteria that can cause infections similar to tuberculosis but do not cause true tuberculosis disease. These mycobacteria can cross-react with the tuberculin skin test, leading to a false positive result. It is important for healthcare providers to be aware of this possibility, especially when interpreting tuberculin tests in regions where atypical mycobacterial infections are more common. Option A) Disseminated infection and option D) Active infection are incorrect because they both suggest true tuberculosis infection, which would not result in a false positive tuberculin test. Option B) Live viral vaccine is also incorrect as it does not relate to the mechanism of false positive tuberculin tests. Educationally, understanding the nuances of tuberculin testing and potential causes of false results is essential for pediatric nurses to accurately assess and manage tuberculosis infections in children. By knowing which conditions can lead to false positives, nurses can provide appropriate care and prevent unnecessary treatments based on incorrect test results.