A nurse is assessing an infant who has severe dehydration due to gastroenteritis.
Which of the following findings should the nurse expect?
Hypertension.
Increased urine output.
Capillary refill of 2 seconds.
Increased respiratory rate.
Increased respiratory rate.
The Correct Answer is D
An increased respiratory rate is a sign of severe dehydration in infants.
Dehydration occurs when an infant loses so much body fluid that they are not able to maintain ordinary function.
Choice A is wrong because hypertension is not a sign of severe dehydration in infants.
Choice B is wrong because increased urine output is not a sign of severe dehydration in infants.
In fact, decreased urine output is a sign of dehydration 2.
Choice C is wrong because a capillary refill of 2 seconds is normal and not a sign of severe dehydration in infants.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The nurse should position the opening of the bag over the urethra and the anus.
Choice B is wrong because placing a snug-fitting diaper over the drainage bag is not necessary.
Choice C is wrong because there is no need to apply lidocaine gel to the perineum before attaching the bag.
Choice D is wrong because there is no need to stretch the perineum taut when applying the bag.
Correct Answer is C
Explanation
The nurse should first check the pH of the gastric secretions to confirm the placement of the NG tube before administering the enteral feeding.
Choice A is wrong because flushing the tube with water should be done after confirming the placement of the NG tube.
Choice B is wrong because attaching the feeding bag tubing to the end of the NG tube should be done after confirming the placement of the NG tube.
Choice D is wrong because setting the administration rate on the feeding pump should be done after confirming the placement of the NG tube.
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