A 10-year-old child presents to the outpatient clinic with dehydration. The nurse practitioner administers a bolus of IV fluids. Before adding potassium to the fluids, the nurse practitioner should first assess:
recent fluid intake.
urinary output.
capillary refill.
last bowel movement.
The Correct Answer is B
Rationale:
A. Recent fluid intake provides context for overall hydration but does not directly determine the safety of adding potassium.
B. Urinary output must be assessed before adding potassium to IV fluids because adequate renal function is essential for potassium excretion. Administering potassium to a patient with low or absent urine output can lead to hyperkalemia, which can cause life-threatening cardiac arrhythmias.
C. Capillary refill helps assess perfusion and dehydration but does not indicate the patient’s ability to excrete potassium.
D. Last bowel movement is not relevant to potassium administration in IV fluids, as potassium is primarily excreted via the kidneys rather than the gastrointestinal tract.
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Related Questions
Correct Answer is D
Explanation
Rationale:
A. While café-au-lait spots can appear as benign birthmarks, the presence of six or more spots greater than 0.5 cm in prepubertal children is a diagnostic criterion for neurofibromatosis type 1 (NF1). Reassurance alone is inappropriate in this scenario.
B. Topical hydrocortisone is not indicated, as café-au-lait spots are pigmented lesions, not inflammatory or eczematous conditions.
C. Antifungal cream is irrelevant, as café-au-lait spots are not caused by fungal infections.
D. Referral to a neurologist or pediatric geneticist is warranted for further evaluation, as NF1 can be associated with neurologic, skeletal, and ophthalmologic complications. Early identification allows for monitoring and management of potential systemic involvement.
Correct Answer is B
Explanation
Rationale:
A. Small, flat warts are classified as verruca plana, not verruca vulgaris.
B. Verruca vulgaris refers to the common wart, which is a dry, rough, hyperkeratotic lesion typically found on the hands and fingers. These warts are caused by human papillomavirus (HPV) and are usually painless unless irritated.
C. Small, tender warts on the feet are plantar warts (verruca plantaris), which differ from verruca vulgaris.
D. Domed-shaped, fleshy lesions located anywhere on the skin may describe other types of warts but do not specifically define verruca vulgaris.
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