In renal tubular acidosis, acidosis is associated with which of the following?

Correct Answer: A

Rationale: In renal tubular acidosis (RTA), acidosis is associated with hyperchloremia (Option A) due to the impaired ability of the renal tubules to reabsorb bicarbonate. The correct answer is A because in RTA, there is a failure of the kidneys to acidify the urine leading to decreased excretion of acid and subsequent retention of chloride ions. This results in an increased serum chloride level, leading to hyperchloremic metabolic acidosis. Option B, hyperkalemia, is not directly associated with RTA. Hyperkalemia may occur in some types of RTA due to impaired potassium excretion, but it is not a consistent finding in all cases of RTA. Option C, hypernatremia, is not typically associated with RTA. RTA primarily affects acid-base balance rather than sodium balance. Option D, an increase in unmeasured cations, is not a characteristic feature of RTA. RTA primarily involves disturbances in acid-base balance and electrolyte levels. Educationally, understanding the acid-base disturbances in RTA is crucial for pediatric nurses as they care for children with renal disorders. Knowing the specific electrolyte imbalances associated with RTA helps nurses to assess, diagnose, and plan appropriate interventions for these patients. This knowledge is essential for providing safe and effective care to pediatric patients with renal tubular acidosis.

Correct Answer: A

Rationale: In pediatric nursing, understanding the different types of shock is crucial for providing effective care to children in critical conditions. Obstructive shock is characterized by a mechanical obstruction to ventricular outflow, making option A the correct answer. This obstruction impedes the heart's ability to effectively pump blood, leading to decreased cardiac output and tissue perfusion. Option B, airway obstruction, is more commonly associated with respiratory emergencies rather than obstructive shock. Option C, generalized vasoconstriction, is a hallmark of distributive shock, such as septic shock, where there is widespread vasodilation leading to decreased systemic vascular resistance. Option D, hypovolemia, is characteristic of hypovolemic shock, which results from a significant decrease in intravascular volume rather than a mechanical obstruction. Educationally, understanding the specific characteristics of different types of shock is essential for accurate and timely diagnosis, as well as for implementing appropriate interventions. By knowing the distinguishing features of obstructive shock, nurses can initiate targeted treatments such as relieving the mechanical obstruction or providing inotropic support to improve cardiac function. This knowledge enhances the quality of care provided to pediatric patients in shock states, improving outcomes and reducing complications.

Correct Answer: C

Rationale: Metabolic acidosis with a high anion gap occurs when there is an excess of acid in the body due to the accumulation of acids like lactic acid or ketoacids. In this scenario, renal tubular acidosis (RTA) does not cause a high anion gap acidosis. RTA is a condition where the kidneys are unable to effectively excrete acid, leading to a normal anion gap acidosis. Diabetic ketoacidosis (DKA) is caused by the accumulation of ketones in the blood due to uncontrolled diabetes, leading to a high anion gap metabolic acidosis. Salicylate poisoning also leads to high anion gap acidosis by causing an increase in the production of acids. Renal failure can cause high anion gap acidosis as the kidneys are unable to excrete acids properly. In an educational context, understanding the causes of metabolic acidosis is crucial in pediatric nursing to provide appropriate care for children with these conditions. Recognizing the differences between RTA and other causes of high anion gap acidosis is essential for accurate diagnosis and treatment. Nurses must be able to differentiate between various types of acid-base disorders to deliver effective care to pediatric patients.

Correct Answer: C

Rationale: In pediatric nursing, providing basic life support to a child requires specific knowledge and skills. The correct answer, option C, states that an Ambu bag can be used with or without oxygen during basic life support of a 10-year-old child. This is the correct statement because when providing rescue breaths to a child in cardiac arrest, using an Ambu bag is essential to deliver oxygen to the child's lungs and vital organs. Option A, stating that the priority is to intubate the child, is incorrect. Intubation is not typically a first-line intervention during basic life support in a child. It is a more advanced airway management technique that may be considered later in the resuscitation process if needed. Option B, suggesting that chest compressions are indicated if heart sounds are weak, is also incorrect. In pediatric basic life support, chest compressions are initiated if the child is unresponsive, not breathing normally, and has no pulse. The presence of weak heart sounds alone does not indicate the need for chest compressions. Option D, mentioning the encircling technique for chest compressions, is incorrect. The encircling technique is not recommended in current pediatric basic life support guidelines. Instead, the two-thumb or two-finger technique is used to perform chest compressions on a child. Educationally, understanding the correct interventions and techniques for pediatric basic life support is crucial for healthcare providers working with pediatric populations. It is essential to follow current guidelines and protocols to provide effective and timely care in emergency situations involving children. Practicing scenarios and staying up to date with pediatric resuscitation guidelines can help healthcare providers feel more confident and competent in delivering life-saving interventions to pediatric patients.

Correct Answer: C

Rationale: The Look-Listen-Feel procedure is a fundamental component of pediatric nursing assessment used to evaluate breathing in a pediatric patient. The correct answer is C) To assess for breathing. When a pediatric patient is unresponsive, the first step is to assess their breathing by observing for chest rise and fall (Look), listening for breath sounds (Listen), and feeling for airflow (Feel) on the patient's face. This rapid assessment helps determine if the child is breathing adequately or if there is a need for immediate intervention to support their airway and breathing. Option A) To assess for responsiveness is incorrect because the AVPU (Alert, Verbal, Pain, Unresponsive) scale is typically used to assess responsiveness in pediatric patients. Option B) To assess for airway patency is not the primary purpose of the Look-Listen-Feel procedure, although it is an essential component of pediatric assessment. Option D) To assess for circulation involves checking for a pulse and is a separate step in pediatric assessment, not part of the Look-Listen-Feel sequence. In an educational context, understanding the Look-Listen-Feel procedure is crucial for pediatric nurses as it provides a systematic approach to quickly evaluate a child's breathing status during emergency situations. By mastering this skill, nurses can promptly identify respiratory distress in pediatric patients and initiate appropriate interventions to ensure optimal outcomes.