Which of the following is a likely cause of metabolic acidosis with a large anion gap?

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: 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.

Correct Answer: D

Rationale: In pediatric nursing, advanced life support is a critical aspect of providing emergency care to children. The correct answer, D) Treatment of life-threatening arrhythmias, is not typically a component of basic pediatric advanced life support protocols. Basic life support focuses on the immediate interventions like chest compressions, airway management, and breathing support. Treatment of life-threatening arrhythmias requires a higher level of training and expertise, usually beyond the scope of basic pediatric life support. Option A) Vascular access is essential in advanced life support to administer medications and fluids rapidly. Option B) Fluid administration is crucial in managing shock and maintaining perfusion. Option C) Breathing support involves interventions like bag-mask ventilation and advanced airway management, which are fundamental in resuscitating a child in distress. Understanding the components of advanced life support is vital for pediatric nurses to effectively respond to emergencies and improve patient outcomes. It is important to prioritize interventions based on the situation and level of training to provide the best possible care for pediatric patients in critical situations.

Correct Answer: A

Rationale: The correct answer is A) Chromosomal breakage test. In this case, the patient's presentation of multiple congenital anomalies suggests a chromosomal abnormality, possibly a genetic disorder like Fanconi Anemia. The Chromosomal breakage test is used to diagnose conditions like Fanconi Anemia, which is characterized by sensitivity to DNA damage and chromosomal breakage. This test can identify the specific genetic mutation responsible for the patient's symptoms. Option B) Hemoglobin electrophoresis is used to diagnose hemoglobinopathies like sickle cell disease or thalassemia, not genetic syndromes presenting with multiple congenital anomalies as in this case. Option C) The Schilling test is used to diagnose pernicious anemia or vitamin B12 deficiency, not genetic disorders presenting with congenital anomalies. Option D) Osmotic fragility test is used to diagnose conditions like hereditary spherocytosis, a hemolytic anemia, which does not explain the patient's constellation of symptoms. In an educational context, understanding the rationale behind selecting the appropriate diagnostic test based on the patient's presentation is crucial for nurses caring for pediatric patients. This question reinforces the importance of considering a patient's complete clinical picture and choosing diagnostic tests that align with the suspected underlying etiology to provide accurate and timely care.