Concerning acute bronchiolitis, all of the following are true except:

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding acute bronchiolitis is crucial for providing effective care to infants. The correct answer, D, states that the disease is more benign in infants born prematurely. This is false because premature infants are actually at a higher risk for severe complications from bronchiolitis due to their underdeveloped respiratory systems. Option A is true as epidemics of acute bronchiolitis often occur during winter months due to increased viral activity and close contact among individuals indoors. Option B is accurate as the disease predominantly affects infants younger than 2 years old, with a peak incidence around 3-6 months of age. Option C is incorrect because immunodeficiency is not an indication for treatment with ribavirin in acute bronchiolitis. Ribavirin is reserved for severe cases and is not routinely recommended due to limited efficacy and potential side effects. Educationally, it is important for nurses to have a solid understanding of acute bronchiolitis, including risk factors, clinical manifestations, and appropriate management strategies. By knowing the key facts about the condition, nurses can provide prompt and effective care, educate families on prevention measures, and recognize when to escalate care for infants with severe bronchiolitis symptoms.

Correct Answer: B

Rationale: In this pediatric nursing practice question, the correct answer is B) Renal tubular acidosis. Renal tubular acidosis is a condition where the kidneys are unable to effectively excrete acids into the urine, leading to a normal anion gap metabolic acidosis. This occurs due to defects in the renal tubules that impair acid-base regulation. A) Diabetic ketoacidosis is a high anion gap metabolic acidosis caused by the accumulation of ketones in the blood due to insulin deficiency in diabetes. C) Lactic acidosis is also a high anion gap metabolic acidosis caused by the accumulation of lactic acid, often seen in conditions like sepsis or hypoperfusion. D) Salicylate poisoning can lead to high anion gap metabolic acidosis due to the toxic effects of salicylates on cellular metabolism. Educationally, understanding the different types of metabolic acidosis and their underlying causes is crucial for pediatric nurses to assess and manage patients effectively. Recognizing the specific characteristics of normal anion gap metabolic acidosis, such as in renal tubular acidosis, helps in providing appropriate interventions and treatment to pediatric patients with this condition.

Correct Answer: D

Rationale: In pediatric nursing, understanding the characteristics of lobar pneumonia is crucial for accurate assessment and treatment. In this case, the correct answer is D) Hyper-resonance on percussion. Lobar pneumonia typically presents with bronchial breathing (A), fine consonating crepitations (B), and increased vocal resonance (C) due to consolidation of a lobe of the lung. Hyper-resonance on percussion (D) is not a typical finding in lobar pneumonia; instead, it is associated with conditions like emphysema where there is increased air in the lung causing a hyper-resonant sound. By recognizing this distinction, nurses can differentiate between various respiratory conditions and provide appropriate care. Educationally, this question helps reinforce the importance of assessing lung sounds, vocal resonance, and percussion findings in pediatric patients with respiratory conditions. Understanding these nuances can guide nursing interventions, such as positioning, respiratory treatments, and monitoring for complications like respiratory distress. By explaining these distinctions, nurses can enhance their clinical reasoning skills and provide optimal care for pediatric patients with respiratory conditions.

Correct Answer: D

Rationale: In pediatric nursing, understanding the etiology of unilateral dilated fixed pupils is crucial for prompt and effective intervention. The correct answer is D) Tentorial herniation. When a child experiences tentorial herniation, increased intracranial pressure causes the brain to herniate through the tentorium cerebelli, resulting in compression of the oculomotor nerve. This compression leads to unilateral dilated fixed pupil, a critical neurological sign indicating impending herniation and brainstem compromise. Option A) Narcotics may cause bilateral pinpoint pupils, not unilateral dilated fixed pupil. Option B) Organophosphates typically manifest as miosis, not mydriasis. Option C) Anticholinergics can cause bilateral dilated pupils but not specifically unilateral dilated fixed pupil. In an educational context, this question highlights the importance of recognizing neurological signs in pediatric patients. Understanding the specific causes of unilateral dilated fixed pupils can guide nurses in assessing and managing children with neurological emergencies effectively. By grasping these nuances, pediatric nurses can provide timely interventions and prevent further deterioration in patients with critical conditions such as tentorial herniation.

Correct Answer: D

Rationale: The correct answer is D) Uncompensated respiratory alkalosis. In this scenario, the high pH indicates alkalosis, the low carbon dioxide levels suggest a respiratory cause, and the normal bicarbonate levels indicate that the body has not had enough time to fully compensate for the primary respiratory alkalosis by increasing bicarbonate levels. Option A) Compensated respiratory acidosis is incorrect because the pH would not be high in this case, as acidosis indicates a low pH. Option B) Compensated respiratory alkalosis is incorrect because in this case, the bicarbonate levels would be elevated as a compensatory mechanism, which is not the case here. Option C) Uncompensated respiratory acidosis is incorrect because the pH would be low in acidosis, not high as indicated in the question stem. Understanding acid-base imbalances in pediatric patients is crucial for nurses to provide safe and effective care. Recognizing the underlying cause of the imbalance helps in determining appropriate interventions. In this case, identifying uncompensated respiratory alkalosis guides the nurse in addressing the respiratory issue to restore balance and improve the child's condition.