Which of the following causes normal anion gap metabolic acidosis?

Correct Answer: B

Rationale: Normal anion gap metabolic acidosis refers to a condition where there is an excess of non-carbonic acids in the body with a normal anion gap. In this case, the correct answer is option B) Renal tubular acidosis. Renal tubular acidosis is a condition where the kidneys are unable to effectively excrete acids into the urine, leading to an accumulation of acids in the blood and subsequent metabolic acidosis with a normal anion gap. Option A) Diabetic ketoacidosis causes an increased anion gap metabolic acidosis due to the accumulation of ketones in the blood. Option C) Lactic acidosis results in an increased anion gap metabolic acidosis due to the accumulation of lactic acid. Option D) Salicylate poisoning leads to an increased anion gap metabolic acidosis due to the presence of salicylic acid. In an educational context, understanding the different causes of metabolic acidosis is crucial for pediatric nurses to accurately assess and manage pediatric patients with acid-base disorders. Knowledge of the specific characteristics of each type of metabolic acidosis is essential for providing appropriate and timely interventions to optimize patient outcomes.

Correct Answer: C

Rationale: The Look-Listen-Feel procedure is used in pediatric nursing to assess a child's breathing. This technique involves first looking for chest rise and fall to determine if the child is breathing, then listening for breath sounds, and finally feeling for air movement. This systematic approach allows nurses to quickly and accurately assess a child's respiratory status, which is crucial in pediatric care. Option A, assessing for responsiveness, is not the correct answer because the Look-Listen-Feel procedure specifically focuses on evaluating breathing, not the child's level of consciousness or responsiveness. Option B, assessing for airway patency, is also incorrect as this procedure does not directly address the patency of the airway, but rather the presence or absence of breathing. Option D, assessing for circulation, is incorrect as well as the Look-Listen-Feel procedure does not involve assessing for circulation but rather focuses solely on the assessment of breathing. In an educational context, understanding the Look-Listen-Feel procedure is essential for pediatric nurses as respiratory distress is a common and potentially life-threatening issue in pediatric patients. By mastering this technique, nurses can promptly identify respiratory problems and initiate appropriate interventions, thereby improving patient outcomes. It is crucial for nursing students to grasp the significance of this assessment tool to provide safe and effective care to pediatric patients.

Correct Answer: D

Rationale: In pediatric nursing, understanding the use of inotropic drugs in acute shock is crucial for providing safe and effective care to pediatric patients. In this question, the correct answer is D) Milrinone, as it is a phosphodiesterase inhibitor that is not typically used as a first-line inotrope in acute shock situations in pediatric patients. A) Digitalis is a cardiac glycoside that can be used in certain cases of heart failure but is not a primary choice for acute shock due to its slower onset of action and potential toxicities in pediatric patients. B) Dopamine is a commonly used inotrope in pediatric patients with acute shock as it helps improve cardiac output and blood pressure. C) Dobutamine is another inotropic agent commonly used in pediatric patients with acute shock to improve cardiac contractility and output. Milrinone, the correct answer, is not typically the first choice in pediatric patients with acute shock due to its potential for causing hypotension and arrhythmias, especially in patients with underlying cardiac issues. Educationally, understanding the appropriate use of inotropic drugs in pediatric patients is essential for nurses caring for critically ill children. It is important to know the indications, contraindications, side effects, and appropriate dosages of these medications to ensure safe and effective care. By grasping the differences between various inotropic agents, nurses can make informed decisions in managing pediatric patients with acute shock, ultimately improving patient outcomes.

Correct Answer: A

Rationale: In pediatric nursing, understanding the causes of hyperkalemia is crucial for providing safe and effective care to children. In this scenario, the correct answer is A) Tumor lysis syndrome. Tumor lysis syndrome occurs when a large number of cancer cells are destroyed rapidly, releasing intracellular components like potassium into the bloodstream, leading to hyperkalemia. Metabolic acidosis (option B) can lead to hyperkalemia due to the shift of potassium out of cells in exchange for hydrogen ions. However, in the context of the question, tumor lysis syndrome is a more direct cause. Addison's disease (option C) is associated with hypocortisolism and hypoadrenalism, which can lead to electrolyte imbalances, including hyperkalemia. However, it is not directly related to K+ excess as in tumor lysis syndrome. Rhabdomyolysis (option D) is a condition where damaged skeletal muscle tissue breaks down rapidly, releasing myoglobin into the bloodstream. While rhabdomyolysis can lead to hyperkalemia due to the release of potassium from damaged muscle cells, it is not specifically related to K+ excess as in tumor lysis syndrome. Educationally, understanding the specific causes of hyperkalemia in pediatric patients is vital for nurses to recognize symptoms, provide appropriate interventions, and prevent potential complications associated with electrolyte imbalances. This knowledge ensures safe and effective care delivery in pediatric nursing practice.

Correct Answer: A

Rationale: In pediatric nursing, understanding the physiological responses to serious illness is crucial for providing effective care. In this scenario, the correct answer is A) Blood pressure. During serious illness, the body's sympathetic nervous system is often activated, leading to an increase in heart rate (B), respiratory rate (C), and the action of accessory respiratory muscles (D) to meet increased metabolic demands and oxygen needs. Blood pressure, however, may not always increase in response to serious illness in children. In conditions like septic shock, hypovolemic shock, or certain neurologic conditions, blood pressure can actually decrease as a compensatory mechanism. Educationally, this question highlights the importance of understanding the nuances of physiological responses in pediatric patients. Nurses must be able to recognize and interpret these changes to provide timely and appropriate interventions. By grasping these concepts, nurses can better assess and manage pediatric patients in critical conditions, ensuring optimal outcomes.