Maintenance fluid for a child weighing 20kg?

Correct Answer: B

Rationale: In pediatric nursing, calculating maintenance fluid requirements accurately is crucial to prevent complications like dehydration or fluid overload. For a child weighing 20kg, the correct maintenance fluid calculation is 4 mL/kg/hour for the first 10kg, then 2 mL/kg/hour for the next 10kg. So for a 20kg child: - First 10kg: 10kg x 4mL/kg/hour = 40mL/hour - Next 10kg: 10kg x 2mL/kg/hour = 20mL/hour - Total: 40mL + 20mL = 60mL/hour Over a 24-hour period: - 60mL/hour x 24 hours = 1440mL Among the options provided: A) 1000: This is lower than the calculated 1440mL, which would be insufficient to meet the child's fluid needs. C) 2000: This is higher than the calculated 1440mL, which could potentially lead to fluid overload in the child. D) 2500: This is also higher than the calculated 1440mL and would exceed the child's maintenance fluid requirements, risking fluid overload. Educational Context: Understanding pediatric fluid calculations is fundamental in pediatric nursing to provide safe and effective care. Nurses must be able to accurately calculate and administer fluids to prevent complications. This question reinforces the importance of applying accurate pediatric fluid calculations based on weight, ensuring optimal patient outcomes.

Correct Answer: D

Rationale: In pediatric nursing, understanding common airway foreign bodies is crucial for providing prompt and effective care. The correct answer is D) Vegetable matter. This is because young children are more likely to inhale or ingest small pieces of vegetable matter, such as nuts or seeds, due to their size and consistency. Vegetables can easily become lodged in a child's airway, leading to respiratory distress or choking. Option A) Small plastic toys may also pose a risk, but they are less common than vegetable matter. Metallic foreign bodies (Option B) are concerning due to their potential for causing injury, but they are less likely to be aspirated into the airway. Hot dogs (Option C) are a well-known choking hazard, but they are not typically classified as airway foreign bodies. Educationally, this question highlights the importance of vigilance in pediatric care to prevent and manage airway obstructions. Nurses need to be aware of common foreign bodies, their risks, and appropriate interventions. Teaching parents and caregivers about choking hazards and safe eating practices can also help reduce the risk of airway emergencies in children.

Correct Answer: D

Rationale: The correct answer is D) Vitamin B12 deficiency. Macrocytosis is a condition characterized by larger than normal red blood cells. This occurs in Vitamin B12 deficiency anemia due to impaired DNA synthesis in red blood cell precursors, leading to larger and ineffective red blood cells. Option A) Sickle cell anemia is not associated with macrocytosis. Sickle cell anemia causes microcytosis, where red blood cells are smaller than normal due to the abnormal hemoglobin structure. Option B) Aplastic anemia is not associated with macrocytosis. Aplastic anemia is a condition where the bone marrow doesn't produce enough blood cells, leading to pancytopenia rather than macrocytosis. Option C) Congenital spherocytosis is not associated with macrocytosis. Congenital spherocytosis is a hemolytic anemia characterized by spherical-shaped red blood cells, not larger cells. Understanding the association between specific types of anemia and their corresponding red blood cell characteristics is crucial in pediatric nursing. Recognizing macrocytosis in Vitamin B12 deficiency anemia can guide appropriate diagnostic and treatment interventions to manage the condition effectively.

Correct Answer: C

Rationale: In pediatric nursing, understanding the interpretation of a tuberculin skin test is crucial for accurate diagnosis and treatment of tuberculosis. A false positive result occurs when the test indicates tuberculosis infection when the individual is not actually infected. In this case, the correct answer is C) Infection with atypical mycobacteria. Atypical mycobacteria are non-tuberculosis mycobacteria that can cause infections similar to tuberculosis but do not cause true tuberculosis disease. These mycobacteria can cross-react with the tuberculin skin test, leading to a false positive result. It is important for healthcare providers to be aware of this possibility, especially when interpreting tuberculin tests in regions where atypical mycobacterial infections are more common. Option A) Disseminated infection and option D) Active infection are incorrect because they both suggest true tuberculosis infection, which would not result in a false positive tuberculin test. Option B) Live viral vaccine is also incorrect as it does not relate to the mechanism of false positive tuberculin tests. Educationally, understanding the nuances of tuberculin testing and potential causes of false results is essential for pediatric nurses to accurately assess and manage tuberculosis infections in children. By knowing which conditions can lead to false positives, nurses can provide appropriate care and prevent unnecessary treatments based on incorrect test results.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Von Willebrand disease. Von Willebrand disease is a bleeding disorder characterized by a deficiency or dysfunction of von Willebrand factor, which plays a crucial role in platelet adhesion and clot formation. Therefore, even though the platelet count may be normal, the prolonged bleeding time is a result of the impaired clotting mechanism due to the deficiency of von Willebrand factor. Option A) Hemophilia A is incorrect because hemophilia is a deficiency of specific clotting factors, usually factor VIII or IX, leading to prolonged bleeding time with a decreased platelet plug formation. Option C) Leukemia is incorrect as it is a cancer of the blood and bone marrow, which may present with thrombocytopenia (low platelet count) leading to bleeding tendencies, but not with a normal platelet count and prolonged bleeding time. Option D) Hypersplenism is incorrect because it is a condition where the spleen removes blood cells, including platelets, leading to thrombocytopenia and increased bleeding risk, not a normal platelet count with prolonged bleeding time. Educationally, understanding the relationship between platelet function, clotting factors, and specific bleeding disorders is crucial in pediatric nursing practice. Recognizing the signs and symptoms of various bleeding disorders and their underlying pathophysiology is essential for accurate diagnosis and appropriate management to provide optimal care for pediatric patients with bleeding disorders.