All are true about massive pleural effusion except:

Correct Answer: C

Rationale: In pediatric nursing, understanding pleural effusion is crucial as it can impact a child's respiratory function. In this question, the correct answer is C) Tactile vocal fremitus is increased. This is false because tactile fremitus is typically decreased or absent in cases of pleural effusion due to the presence of fluid in the pleural space dampening the transmission of vibrations. A) Trachea shifted to the opposite side is true in massive pleural effusion due to the pressure exerted by the accumulated fluid. B) Overlying stony dullness is a characteristic finding on percussion due to the fluid-filled nature of the pleural space. D) Complications like purulent pericarditis can arise from untreated or severe pleural effusion due to the proximity of the pleural and pericardial spaces. Educationally, this question helps reinforce key concepts related to assessing pleural effusion in pediatric patients. Understanding the clinical manifestations and complications associated with pleural effusion is vital for nurses caring for children with respiratory conditions. It highlights the importance of thorough assessment and knowledge of pediatric respiratory pathologies to ensure timely and appropriate interventions.

Correct Answer: C

Rationale: In cases of drowning, the most urgent immediate line of management at the scene is option C) Mouth-to-mouth breathing. This is the correct answer because in drowning, the primary concern is restoring oxygen supply to the body. Mouth-to-mouth breathing provides a way to deliver oxygen to the victim's lungs and can help prevent hypoxia, which is a critical concern in drowning cases. Option A) Chest compression is not the most urgent immediate line of management in drowning cases because the priority is to address the lack of oxygen rather than cardiac arrest, which may not be the primary issue at the scene. Option B) Draining water from the stomach is not the most urgent immediate line of management because the focus should be on restoring oxygenation to the victim through effective ventilation rather than addressing water in the stomach. Option D) Take off wet clothing, while important for preventing hypothermia and providing access for medical assessment, is not the most urgent immediate line of management in drowning cases. The primary focus should be on addressing the lack of oxygen in the body through interventions like mouth-to-mouth breathing. In an educational context, understanding the correct immediate interventions in drowning cases is crucial for healthcare providers, especially those working in pediatric settings where drowning incidents are more common. By knowing the correct priorities in managing drowning cases, healthcare professionals can act promptly and effectively to improve patient outcomes and potentially save lives.

Correct Answer: B

Rationale: In pediatric nursing, understanding respiratory distress signs is crucial for early intervention. The correct answer is B) Pneumonia. Expiratory grunting is a protective mechanism seen in children with pneumonia to maintain lung volume during expiration. Pneumonia causes alveolar consolidation, leading to decreased lung compliance and the need for increased expiratory effort. This results in the audible expiratory grunting sound. Option A) Asthma exacerbation typically presents with wheezing, prolonged expiratory phase, and diminished breath sounds, but not expiratory grunting. Option C) Pleural effusion manifests with decreased breath sounds and dullness to percussion, but not expiratory grunting. Option D) Croup is characterized by a barking cough and inspiratory stridor, not expiratory grunting. Educationally, recognizing these subtle respiratory distress signs in pediatric patients is vital for accurate assessment and prompt intervention. Understanding the specific clinical manifestations of different respiratory conditions helps nurses provide targeted care and improve patient outcomes. Practicing review questions like this enhances nurses' clinical reasoning and diagnostic skills in pediatric nursing.

Correct Answer: D

Rationale: The correct answer is D) Irritability. In young infants, irritability is an early manifestation of hypoxemia. When infants experience low oxygen levels, they may become irritable due to the body's natural response to stress. This can be a subtle yet important clue for healthcare providers to recognize and intervene promptly to prevent further complications. A) Cyanosis is a late sign of hypoxemia in infants. It occurs when oxygen saturation is significantly reduced, leading to bluish discoloration of the skin and mucous membranes. B) Glasgow coma score of six is not a typical manifestation of hypoxemia in infants. This scoring system is used to assess the level of consciousness and neurological functioning in patients with brain injuries or altered mental status. C) Irregular breathing can be a sign of various respiratory conditions but is not specific to hypoxemia in young infants. It can occur in response to respiratory distress but may not always be an early indicator of low oxygen levels. Educationally, understanding the early signs of hypoxemia in infants is crucial for healthcare providers working in pediatric settings. Recognizing subtle cues like irritability can help in early detection and prompt intervention to ensure optimal outcomes for pediatric patients. Regular review of such clinical manifestations is essential for healthcare professionals to enhance their clinical reasoning skills and provide quality care to infants in respiratory distress.

Correct Answer: C

Rationale: Metabolic acidosis with a large anion gap is often caused by the accumulation of organic acids in the body. In this case, salicylate overdose (Option C) is the likely cause. Salicylates are organic acids found in medications like aspirin and can lead to an elevated anion gap metabolic acidosis when consumed in excess. Option A, diarrhea, typically causes a non-anion gap metabolic acidosis due to loss of bicarbonate-rich fluid. Option B, renal failure on regular dialysis, can lead to metabolic acidosis, but it is usually a non-anion gap acidosis. Option D, severe chronic iron deficiency anemia, does not typically cause metabolic acidosis with a large anion gap. In an educational context, understanding the causes of metabolic acidosis is crucial for pediatric nurses to assess and manage patients effectively. Recognizing the specific etiologies of acid-base disturbances allows for prompt intervention and improved patient outcomes. It is essential for nurses to have a strong foundation in pathophysiology to make accurate clinical judgments and provide safe, evidence-based care to pediatric patients.