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

Correct Answer: D

Rationale: In pediatric nursing, understanding acute bronchiolitis is crucial due to its prevalence and impact on infants. The correct answer, option D, states that the disease is more benign in infants born prematurely. This is incorrect because infants born prematurely are actually at higher risk for severe bronchiolitis due to their underdeveloped immune systems and respiratory function. Option A is true because epidemics of bronchiolitis often occur during winter when respiratory viruses are more prevalent. Option B is correct as the disease primarily affects infants younger than 2 years of age due to their smaller airways and immature immune systems. Option C is incorrect because ribavirin is not recommended for routine treatment of acute bronchiolitis, and immunodeficiency is not an indication for its use. Educationally, this question highlights the importance of understanding the specific characteristics of acute bronchiolitis in pediatric patients. It emphasizes the need for nurses to be knowledgeable about risk factors, clinical manifestations, and evidence-based treatments for this common respiratory condition in infants. By understanding these key points, nurses can provide optimal care and support to pediatric patients with acute bronchiolitis.

Correct Answer: B

Rationale: In pediatric nursing, understanding the causes of normal anion gap metabolic acidosis is crucial for providing appropriate care to children. 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 acidosis with a normal anion gap. This can occur in children due to various reasons such as genetic disorders or kidney damage. A) Diabetic ketoacidosis is a high anion gap metabolic acidosis commonly seen in children with diabetes mellitus. It is characterized by the presence of ketones in the blood. C) Lactic acidosis is another high anion gap metabolic acidosis that can occur in children due to conditions such as sepsis, shock, or hypoxia. It is characterized by elevated levels of lactic acid in the blood. D) Salicylate poisoning can also lead to high anion gap metabolic acidosis in children. Salicylates can cause metabolic acidosis by directly affecting cellular metabolism. Educationally, understanding the different causes of metabolic acidosis in children is essential for nurses to accurately assess and provide appropriate interventions. Recognizing the specific etiologies of acid-base disorders allows for targeted treatment and management strategies to improve patient outcomes.

Correct Answer: D

Rationale: In pediatric nursing practice, understanding the characteristics of lobar pneumonia is crucial for accurate assessment and intervention. In this case, option D, "Hyper-resonance on percussion," is the correct answer as it is not typically associated with lobar pneumonia. Lobar pneumonia is characterized by consolidation of a lobe of the lung, leading to specific clinical findings. Bronchial breathing (Option A) is a classic sign, indicating consolidation and loss of air in the alveoli. Fine consonating crepitations (Option B) are commonly heard due to the movement of thick secretions in the consolidated lobe. Increased vocal resonance (Option C) occurs due to the solid nature of the lung tissue, enhancing sound transmission. Understanding these distinctions is vital for nurses caring for pediatric patients with respiratory conditions. Recognizing these clinical manifestations aids in early identification, prompt treatment, and prevention of complications associated with lobar pneumonia in children. By differentiating these signs, nurses can provide timely and appropriate care to improve patient outcomes.

Correct Answer: D

Rationale: In pediatric nursing, understanding the causes of unilateral dilated fixed pupil is crucial for timely and accurate assessment and intervention. The correct answer is D) Tentorial herniation. Tentorial herniation occurs when there is displacement of brain tissue through the tentorial notch, resulting in compression of the oculomotor nerve. This compression leads to a unilateral dilated fixed pupil on the affected side. Option A) Narcotics can cause bilateral fixed pupils, not unilateral. Narcotics affect the central nervous system and can lead to miosis (constricted pupils) rather than mydriasis (dilated pupils). Option B) Organophosphates typically cause miosis due to their effects on the muscarinic receptors, leading to excessive parasympathetic stimulation and constricted pupils. Option C) Anticholinergics cause mydriasis bilaterally due to their blockade of acetylcholine receptors, resulting in dilated pupils on both sides rather than unilaterally. Educational context: Understanding the etiology of unilateral dilated fixed pupil is essential in pediatric nursing to differentiate between various possible causes, such as traumatic brain injury, intracranial hemorrhage, or herniation syndromes. Recognizing this clinical sign promptly can guide appropriate interventions and prevent potential complications.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Uncompensated respiratory alkalosis. Explanation of the correct answer: - A high pH indicates alkalosis, which aligns with respiratory alkalosis. - Low carbon dioxide levels (hypocapnia) are consistent with respiratory alkalosis as the primary disturbance. - Normal bicarbonate levels suggest that compensation has not occurred, indicating an uncompensated state. Explanation of why others are wrong: - A) Compensated respiratory acidosis: This option is incorrect as the pH would not be high in acidosis, and bicarbonate levels would be elevated in compensation. - B) Compensated respiratory alkalosis: This option is incorrect as compensation would involve elevated bicarbonate levels. - C) Uncompensated respiratory acidosis: This option is incorrect as acidosis would be associated with a low pH, high carbon dioxide, and potentially elevated bicarbonate levels. Educational context: Understanding acid-base disorders is crucial in pediatric nursing to assess and manage a child's condition effectively. In this case, recognizing the specific blood gas values associated with respiratory alkalosis and differentiating between compensated and uncompensated states is essential for accurate clinical decision-making. This knowledge helps nurses provide timely interventions and ensure optimal patient outcomes.