1 :

Hint : 🧒 100 mL/kg first 10 kg

Correct Answers:

  • 33 mL/hr


Rationale :

🔹 Pediatric maintenance fluids are calculated using the 100/50/20 rule: 100 mL/kg for first 10 kg, 50 mL/kg for next 10 kg, 20 mL/kg for remaining weight.

🔹 Child weighs 8 kg → 8 × 100 mL = 800 mL/day.

🔹 Convert total daily volume to hourly rate: 800 ÷ 24 = 33.3 mL/hr.

🔹 Maintaining accurate hourly IV rates prevents fluid overload or dehydration.

🔹 Monitoring should include intake/output, vital signs, and signs of edema.


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2 :
  • 1100: Child appears tired and irritable, crying intermittently. Skin turgor slightly decreased. Capillary refill time is slightly prolonged.
  • 1430: Child had two episodes of watery stool since admission. Oral intake is poor. Parent reports child has not been eating well for the last two days.
TimeTemperatureHeart RateRespiratory RateBlood PressureOxygen Saturation
100037.8°C (100.0°F)110/min22/min90/60 mmHg98% (RA)
140037.9°C (100.2°F)115/min24/min88/58 mmHg97% (RA)

 

TimeOral InputIV InputUrine OutputEmesis Output
100020 mL0 mL15 mL0 mL
120010 mL0 mL10 mL0 mL
140015 mL0 mL12 mL0 mL
TOTAL45 mL0 mL37 mL0 mL

A nurse is assessing a toddler with diarrhea in the pediatric ward. Based on the scenario, identify the appropriate nursing actions.


Potential Action Anticipated Contraindicated
Initiate contact precautions
Encourage oral rehydration solutions
Assess skin turgor and capillary refill time
Administer antidiarrheal medication without a prescription

Hint : 💧 Hydration and electrolyte check

Correct Answers

  • Initiate contact precautions [ Anticipated ]
  • Encourage oral rehydration solutions [ Anticipated ]
  • Assess skin turgor and capillary refill time [ Anticipated ]
  • Administer antidiarrheal medication without a prescription [ Contraindicated ]

Rationale :

🔹 Frequent diarrhea increases risk for fluid and electrolyte imbalances.

🔹 Assessing vital signs, skin turgor, and capillary refill provides early detection of dehydration.

🔹 Oral rehydration therapy restores fluid and electrolytes safely in toddlers.

🔹 Close monitoring of intake and output ensures effectiveness of interventions.

🔹 Educating parents about signs of dehydration improves home care and prevents complications.


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3 :

Hint : 🌀 Confirm order before suction

Correct Answers:

  • Verify the prescription for the type and amount of suction.


Rationale :

🔹 Ensures the correct suction type (intermittent/continuous) is used.

🔹 Verifying prescription prevents mucosal damage and complications.

🔹 Confirms patient safety and adherence to orders before connecting tubing.

🔹 Helps plan appropriate patient positioning for optimal suction.

🔹 Supports documentation and legal compliance for nursing interventions.


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4 :

Hint : 💉 Insulin replaces pancreas function

Correct Answers:

  • To replace the insulin that the pancreas is unable to produce.


Rationale :

🔹 Type 1 Diabetes is characterized by autoimmune destruction of beta cells.

🔹 Exogenous insulin is essential for glucose uptake and energy production.

🔹 Prevents hyperglycemia, ketoacidosis, and long-term complications.

🔹 Dosing must match carbohydrate intake and activity levels.

🔹 Early insulin therapy supports growth, development, and metabolic stability in children.


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5 :

Hint : 🏃 Exercise improves insulin response

Correct Answers:

  • Engaging in regular physical activity


Rationale :

🔹 Physical activity improves insulin sensitivity and glucose uptake.

🔹 Reduces risk of cardiovascular complications associated with diabetes.

🔹 Enhances weight management, indirectly improving glycemic control.

🔹 Supports muscle glucose utilization independently of insulin.

🔹 Regular exercise improves overall metabolic health and decreases HbA1c levels.


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6 :

Hint : 💦 Check mucous membranes/fontanels

Correct Answers:

  • Dry mucous membranes and sunken fontanels


Rationale :

🔹 Moderate dehydration presents with dry mucous membranes and decreased skin turgor.

🔹 Sunken fontanels indicate fluid loss in infants and young children.

🔹 Other vital signs may show mild tachycardia or low-normal BP.

🔹 Early recognition allows prompt fluid replacement.

🔹 Prevents progression to severe dehydration, shock, or electrolyte imbalance.


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7 :

Hint : 💉 Insulin manages TPN hyperglycemia

Correct Answers:

  • Administer regular insulin as prescribed.


Rationale :

🔹 TPN delivers high glucose loads, increasing hyperglycemia risk.

🔹 Regular insulin controls blood glucose levels safely.

🔹 Continuous monitoring prevents hyperosmolar complications.

🔹 Adjustments follow physician-prescribed sliding scale or TPN protocol.

🔹 Ensures nutritional therapy continues safely without compromising glucose control.


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8 :

Hint : 📊 Monitor glucose consistency

Correct Answers:

  • Consistently normal blood glucose levels.


Rationale :

🔹 Maintains homeostasis and prevents hyper/hypoglycemia.

🔹 Reduces risk of diabetic ketoacidosis (DKA).

🔹 Supports normal growth, energy levels, and cognitive function.

🔹 Blood glucose logs confirm adequate insulin dosing and adherence.

🔹 Effective therapy improves quality of life and long-term prognosis.


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9 :
  • 0815: Client appears pale and reports feeling more tired than usual. Skin is dry to touch, with reduced turgor. Reports drinking more than usual but still feeling thirsty.
  • 1030: Client states urination is more frequent and feels urgency. No peripheral edema noted. Reports recent weight gain of approximately 10 pounds over the past month.
TimeTemperatureHeart RateRespiratory RateBlood PressureOxygen Saturation
080037.2°C (98.96°F)88/min18/min140/85 mmHg98% (RA)
120037.1°C (98.78°F)90/min18/min138/83 mmHg98% (RA)

 

Test0800 Result1200 ResultReference Range
Glucose210 mg/dL205 mg/dL70-100 mg/dL
Hemoglobin A1C8.2%
 
4.0%-5.6%
BUN16 mg/dL15 mg/dL7-20 mg/dL
Creatinine1.0 mg/dL1.1 mg/dL0.6-1.2 mg/dL


 


Which 3 factors are most strongly associated with the increased prevalence of type 2 diabetes in this client?


Answer Options

Hint : 🧬 Lifestyle, genetics, obesity

Correct Answers:

  • Sedentary lifestyle
  • Family history of diabetes
  • Obesity


Rationale :

🔹 Sedentary lifestyle decreases insulin sensitivity.

🔹 Family history reflects genetic predisposition.

🔹 Obesity increases adipose tissue-mediated insulin resistance.

🔹 These factors synergistically contribute to hyperglycemia and metabolic syndrome.

🔹 Interventions targeting these factors reduce disease risk and improve glycemic control.


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10 :

Hint : 🩹 Barrier, fit, empty

Correct Answers:

  • Apply a skin barrier cream around the stoma.
  • Empty the appliance when it is one-third full.
  • Ensure the ostomy appliance fits snugly around the stoma.


Rationale :

💎 Skin barrier cream protects peristomal skin from irritation caused by the constant contact with digestive effluent.

💎 Emptying the appliance when one-third full prevents leakage and reduces skin contact with output, lowering the risk of irritation and infection.

💎 Proper appliance fit ensures a seal around the stoma, preventing effluent from leaking onto surrounding skin.

💎 Incorrect interventions, such as applying moisturizer directly on the stoma, can interfere with appliance adhesion and do not protect skin effectively.

💎 Regular assessment of the peristomal skin is essential to detect early irritation and maintain skin integrity.


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Total Questions: 10

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