Expiratory grunting is a sign of:

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: 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.

Correct Answer: B

Rationale: The correct answer is B) Marked tachypnea with recessions. In pediatric nursing, signs of circulatory failure include cyanosis despite supplied O2, gallop rhythm/murmur, and an enlarged tender liver. Cyanosis despite supplied O2 indicates inadequate tissue oxygenation despite oxygen therapy, a hallmark of circulatory failure. The presence of a gallop rhythm or murmur suggests cardiac involvement in circulatory failure. An enlarged tender liver can indicate hepatic congestion due to circulatory compromise. Marked tachypnea with recessions, on the other hand, is more indicative of respiratory distress rather than circulatory failure. It points towards increased work of breathing and respiratory compromise rather than primary circulatory issues. Educationally, understanding these distinct clinical signs is crucial for pediatric nurses to accurately assess and intervene in cases of circulatory failure. Recognizing these signs promptly can lead to timely interventions and improved patient outcomes. Nurses must be able to differentiate between respiratory and circulatory issues to provide effective care to pediatric patients.

Correct Answer: A

Rationale: In pediatric nursing, understanding the different types of shock is crucial for providing effective care to critically ill children. In this scenario, the correct answer is A) Cardiogenic. The rationale for A) Cardiogenic being the correct answer lies in the fact that shock associated with decreased central venous pressure is not typically associated with cardiogenic shock. Cardiogenic shock is usually due to heart failure or myocardial dysfunction, leading to inadequate cardiac output. Option B) Hypovolemic, C) Septic, and D) Distributive are types of shock that can be associated with decreased central venous pressure. Hypovolemic shock is due to a decrease in blood volume, septic shock is caused by a systemic response to infection, and distributive shock involves abnormal distribution of blood flow. Educationally, this question helps learners differentiate between the various types of shock and understand the unique characteristics of each. It reinforces the importance of recognizing the underlying causes of shock in pediatric patients, which is essential for prompt and effective treatment in a clinical setting. By grasping these concepts, nurses can provide optimal care and improve outcomes for children experiencing shock.

Correct Answer: C

Rationale: The correct answer, C) Epigastric compression, is the Heimlich maneuver technique used to help a choking child. This method involves applying upward pressure on the child's abdomen to dislodge an obstructing object from the airway. It is crucial in clearing the airway obstruction and allowing the child to breathe again. Option A) Back blows are used in infants, not children, to clear airway obstructions. Option B) Chest compressions are used in CPR for cardiac arrest, not for choking. Option D) Finger sweep is used to clear the mouth of an unconscious child, not for a child who is choking, as it can push the obstruction further down. In an educational context, understanding the correct technique for the Heimlich maneuver in pediatric nursing is essential for healthcare providers working with children. Properly addressing choking incidents can be life-saving, making it imperative for nurses to know and practice this skill correctly. Training and regular practice in pediatric emergency procedures like the Heimlich maneuver are crucial for ensuring the best outcomes for pediatric patients in emergency situations.