A nurse is caring for a 15-year-old adolescent.
The nurse reviews the EMR and determines that the adolescent is at risk for developing which of the following complications?
The adolescent is at risk for developing ___ and ___
muscle cramps
pneumothorax
dehydration
anemia
Correct Answer : B,C
The adolescent is at risk for developing Target 1: dehydration and Target 2: pneumothorax.
Rationale:
- Dehydration: The adolescent's fever, increased respiratory rate, and decreased oral intake put them at risk for dehydration.
- Pneumothorax: In severe pneumonia, there is a risk of lung collapse or pneumothorax, especially in adolescents.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
A. Cyanosis of the lips and tongue is not a typical finding in coarctation of the aorta; rather, it is more associated with cyanotic congenital heart defects.
B. Weak or absent femoral pulses are expected due to reduced blood flow to the lower body, as the coarctation typically occurs distal to the left subclavian artery.
C. Bounding pulses in the upper extremities are common because the blood flow to the upper body is increased, leading to stronger pulses.
D. High blood pressure in the lower extremities is not typical; instead, there is often lower blood pressure in the lower body due to the obstruction.
E. Poor feeding and irritability are common symptoms in infants with heart conditions, as they may be in distress or not getting enough blood flow to meet their metabolic needs.
Correct Answer is ["C"]
Explanation
A. The meningococcal (MCV4) vaccine is typically recommended for preteens and adolescents, usually starting at age 11.
B. The hepatitis B vaccine is typically administered at birth, 1-2 months, and 6-18 months, so a 4-year-old may already have received this vaccine.
C. The varicella (VAR) vaccine is recommended for children at ages 12-15 months and again at 4-6 years, making it appropriate for a 4-year-old child.
D. The Haemophilus influenza type b (Hib) vaccine is usually given to children in a series before 5 years of age, but it is more commonly completed by age 2-3 years. The 4-year-old may already be up to date with this vaccine.
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