A nurse is caring for a 15-year-old adolescent.
Drag words from the choices below to fill in each blank in the following sentence.
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
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}
Rationale for correct options:
Anemia: The hemoglobin (11 g/dL) is below the stated reference range (12–18 g/dL) and hematocrit is at the low end (32%). Whether chronic or acute, this low Hgb reduces the blood’s oxygen-carrying capacity.
In the setting of pneumonia (impaired gas exchange, increased work of breathing, fever), reduced oxygen delivery from anemia increases the risk of tissue hypoxia, worsened dyspnea, tachycardia (compensatory), and clinical deterioration even if the pulse oximeter reads near-normal saturation.
Dehydration: The adolescent has not eaten in 2 days and has a fever and tachypnea, both increase insensible fluid losses and reduce intake. An elevated BUN (22 mg/dL) and hypernatremia (Na 148 mEq/L) are classic biochemical markers of volume depletion / free-water deficit. Relative hypotension and tachycardia are consistent with decreased intravascular volume/compensated hypovolemia.
Rationale for Incorrect options:
Pleural effusion: Parapneumonic effusion is a known complication of pneumonia; however, the chest x-ray here is described as showing small infiltrates with minimal lobar consolidation and no mention of effusion. There are also no exam findings documented (e.g., dullness to percussion, markedly decreased breath sounds) to suggest effusion at this time.
Muscle cramps: Muscle cramps are most commonly associated with electrolyte disturbances (notably hypokalemia, hypocalcemia) or severe dehydration with specific electrolyte shifts. In this case, potassium is normal (4.1 mEq/L) and the primary electrolyte abnormality is hypernatremia, which more commonly causes neurologic signs than isolated cramps.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Hearing screening is important, but not the immediate priority in a child who has missed routine visits.
B. Dental care should begin early, but updating immunizations takes precedence to prevent serious communicable diseases.
C. Updating vaccinations is the priority because the child is significantly behind on the recommended immunization schedule, placing them at risk for preventable infections.
D. Growth and development assessment is essential but can be done after addressing the urgent need for immunization.
Correct Answer is ["A","B","C"]
Explanation
Rationale:
A. Infants have a higher proportion of extracellular fluid, which leads to more rapid fluid loss compared to adults.
B. Excessive intake of dilute formula can cause water intoxication, leading to electrolyte imbalances.
C. Immature renal function in infants under 2 years affects their ability to concentrate urine and regulate fluid/electrolyte balance.
D. Infants have a higher (not lower) basal metabolic rate than adults, which increases fluid needs and losses.
E. Infants actually have a greater proportion of water in their bodies compared to adults, not less.
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