A nurse is assisting with the care of a preschooler who sustained a major burn injury 5 days ago. Which of the following findings should the nurse identify as a manifestation of sepsis?

Polyuria

Disorientation

Hyperactive bowel sounds

Hypoglycemia

Answer and Explanation

The Correct Answer is B

A. Polyuria is not typically associated with sepsis; it may be seen in other conditions such as diabetes. In sepsis, urine output is often decreased due to impaired kidney function and shock.
B. Disorientation is a sign of sepsis, indicating that the infection may have spread to the bloodstream and is affecting the central nervous system. Altered mental status is a critical indicator of severe infection.
C. Hyperactive bowel sounds are not associated with sepsis. In sepsis, bowel sounds may actually be decreased due to decreased perfusion to the gastrointestinal tract.
D. Hypoglycemia can occur in sepsis, but it is not as specific an indicator as disorientation. Monitoring blood glucose levels is important, but disorientation provides a clearer sign of systemic infection.

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Correct Answer is C

Explanation

A. Drawing a blood culture is not indicated for suspected Clostridium difficile, as it is a gastrointestinal infection.
B. A stool specimen for occult blood is not specific for diagnosing Clostridium difficile.
C. Obtaining a stool specimen for culture is the appropriate action to diagnose Clostridium difficile, as it will identify the presence of the bacteria.
D. A tape test is used to detect pinworms, not Clostridium difficile.

A. "You should limit your intake of calcium-fortified orange juice." B. "You should drink rice milk instead of cow's milk." C. "You should gradually increase lactose products in your diet." D. "You should eat flavored yogurt instead of plain yogurt."

Correct Answer is B

Explanation

A. Calcium-fortified orange juice can be a good alternative source of calcium for those with lactose intolerance.
B. Rice milk is a suitable alternative to cow's milk for individuals with lactose intolerance as it does not contain lactose.
C. Gradually increasing lactose products in the diet is not typically recommended for those with lactose intolerance as it can lead to symptoms.
D. Yogurt, particularly flavored types, may still contain lactose and can cause symptoms in those with lactose intolerance. Lactose-free or dairy-free alternatives are better options.

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A nurse is assisting with the care of a preschooler who sustained a major burn injury 5 days ago. Which of the following findings should the nurse identify as a manifestation of sepsis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a toddler whose guardian reports multiple episodes of diarrhea. The provider suspects Clostridium difficile. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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