Obstructive shock is characterized by which of the following:

Correct Answer: A

Rationale: In pediatric nursing, understanding the types of shock is crucial for providing effective care. Obstructive shock is characterized by a mechanical obstruction of ventricular outflow. This can occur due to conditions like cardiac tamponade or pulmonary embolism, leading to impaired cardiac function and reduced blood flow. Option A is correct because it directly relates to the definition of obstructive shock, where there is a physical blockage to blood flow out of the heart. Recognizing this characteristic is essential in prompt diagnosis and management to prevent further complications. Option B, airway obstruction, is associated with respiratory distress rather than obstructive shock. While airway issues can lead to hypoxia and potentially shock, it is not the defining feature of obstructive shock. Option C, generalized vasoconstriction, is more indicative of distributive shock, such as septic shock, where there is widespread vasodilation rather than obstruction of blood flow. Option D, hypovolemia, is characteristic of hypovolemic shock, caused by inadequate circulating blood volume rather than a physical obstruction of blood flow. Educationally, understanding the distinctions between different types of shock is vital for nurses caring for pediatric patients. This knowledge enables timely recognition of the underlying cause of shock, leading to appropriate interventions and improved patient outcomes. Remembering the specific features of each type of shock aids in critical thinking and clinical decision-making during pediatric emergencies.

Correct Answer: B

Rationale: Anaphylactic shock is a severe, life-threatening allergic reaction. The correct answer, option B, "Decreased systemic vascular resistance," is characteristic of anaphylactic shock. During anaphylaxis, there is a widespread release of histamine and other mediators, causing vasodilation and increased capillary permeability, leading to decreased systemic vascular resistance. This results in a drop in blood pressure and impaired tissue perfusion. Option A, "Airway obstruction," can occur in anaphylactic shock due to swelling of the airways, but it is not the defining characteristic. Option C, "Generalized vasoconstriction," is incorrect as anaphylactic shock is characterized by vasodilation, not vasoconstriction. Option D, "Hypovolemia," is not the primary issue in anaphylactic shock; while fluid shifts can occur, the main concern is the systemic vasodilation leading to shock. In an educational context, understanding the pathophysiology of anaphylactic shock is crucial for nurses caring for pediatric patients. Recognizing the signs and symptoms early, such as decreased systemic vascular resistance leading to shock, can prompt quick intervention with epinephrine and other treatments to stabilize the child's condition. Nurses must be prepared to assess, intervene, and monitor pediatric patients experiencing anaphylactic shock to ensure positive outcomes.

Correct Answer: D

Rationale: In the context of pediatric acute lymphoblastic leukemia (ALL), the correct answer is D) Male sex being a bad prognostic criterion. Male sex is associated with a poorer prognosis in pediatric ALL due to biological differences in how the disease presents and responds to treatment between males and females. Males tend to have a higher risk of relapse and poorer outcomes compared to females. Option A) Leukocytes 2000 /mm³ is not a bad prognostic criterion, as a lower leukocyte count is generally considered a favorable prognostic factor in pediatric ALL. Option B) Age 5 years is not a bad prognostic criterion either, as younger age at diagnosis is typically associated with a better prognosis in pediatric ALL. Option C) White race is not a bad prognostic criterion in pediatric ALL. Race does not inherently impact prognosis in ALL; rather, factors such as genetics and access to healthcare may play a role. In an educational context, understanding prognostic factors in pediatric ALL is crucial for healthcare providers caring for children with this condition. Recognizing these factors helps guide treatment decisions and allows for better prognostication and management of the disease. By knowing which factors are associated with poorer outcomes, healthcare providers can tailor treatment plans to optimize patient outcomes.

Correct Answer: A

Rationale: In the context of treating metabolic acidosis, the expected change in serum potassium level is a key concept that nurses and healthcare providers must understand. Correct answer (A): It will drop - In metabolic acidosis, there is an excess of acid in the body leading to a shift of potassium from the intracellular to extracellular space. As treatment corrects the acid-base imbalance, potassium is taken back into the cells, causing a decrease in serum potassium levels. Option B: It will initially drop then rise - This option is incorrect because the primary effect of treating metabolic acidosis is the reduction of serum potassium levels due to the movement of potassium back into the cells. There is no subsequent rise in potassium levels expected during treatment. Option C: It will initially rise then drop - This option is incorrect as metabolic acidosis would not cause serum potassium levels to rise. The correction of acidosis leads to a decrease in serum potassium levels as potassium re-enters the cells. Option D: It will remain the same - This option is inaccurate because in the context of treating metabolic acidosis, the serum potassium level is expected to decrease as acidosis is corrected and potassium shifts intracellularly. Educational context: Understanding the relationship between acid-base balance and electrolyte levels is crucial in pediatric nursing practice. Nurses need to be able to anticipate changes in electrolyte levels during the treatment of acid-base imbalances to provide safe and effective care to pediatric patients. By comprehending the expected changes in serum potassium levels during metabolic acidosis treatment, nurses can monitor patients for potential electrolyte disturbances and intervene promptly if needed.

Correct Answer: C

Rationale: In pediatric nursing, accurate blood pressure measurement is crucial for assessing a child's health status. The appropriate cuff width is essential to obtain an accurate reading. In this case, the correct answer is C) 6 cm. This cuff width is suitable for a child with a mid-arm circumference of 15 cm because the cuff should cover about 80% of the arm's circumference. Using a cuff that is too narrow (options A and B) can lead to falsely elevated blood pressure readings as it increases the pressure in the artery. On the other hand, using a cuff that is too wide (option D) can result in falsely low readings due to inadequate compression of the artery. Educationally, understanding the correct cuff size for blood pressure measurement in children is vital for nurses and healthcare providers. It ensures accurate assessment and appropriate intervention if needed. Proper training and practice are necessary to master this skill and provide quality care to pediatric patients.