A nurse is caring for an infant who has rotavirus. Which of the following findings indicates that the infant is moderately dehydrated?

Respiratory rate 28/min

Capillary refill 1 second

Weight loss 7%

Bradycardia

Answer and Explanation

The Correct Answer is A

A. A respiratory rate of 28 breaths per minute indicates increased respiratory effort, which can be a sign of moderate dehydration. The infant may be trying to compensate for fluid
loss.

B. Capillary refill of 1 second is within the normal range (less than 2 seconds). It is not indicative of moderate dehydration.

C. Weight loss of 7% is a significant amount of weight loss and is indicative of severe dehydration, not moderate dehydration. Moderate dehydration is usually defined as 5- 10% weight loss.

D. Bradycardia (slow heart rate) is not typically associated with dehydration. In fact, tachycardia (fast heart rate) is a more common sign of dehydration.

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Correct Answer is D

Explanation

A. Bilateral cool extremities can be common after a cardiac catheterization due to transient vasoconstriction but is not necessarily an immediate concern if perfusion remains adequate.
B. Blood pressure of 102/58 mm Hg is within the normal range for a toddler and does not require reporting.
C. Serum glucose of 90 mg/dL is within normal limits for a toddler and does not indicate a complication.
D. Weak pedal pulse distal to the site should be reported because it may indicate arterial occlusion or compromised circulation following the procedure. While pulses may initially be weak due to swelling, they should not be absent or significantly diminished over time.

A. Avoid removing the cream prior to the procedure. B. Gently rub the cream into the skin. C. Wash the site with alcohol prior to applying the cream. D. Apply the cream 1 hr before the procedure.

Correct Answer is D

Explanation

A. The cream should be removed after it has been on the skin for the recommended amount of time. It is typically wiped off before the procedure.

B. The medication should applied repeatedly to provide analgesia

C. Washing the site with alcohol before applying the cream is not necessary and may cause unnecessary skin irritation.

D. Lidocaine and prilocaine cream typically require about 60 minutes to take effect.

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A nurse is caring for an infant who has rotavirus. Which of the following findings indicates that the infant is moderately dehydrated?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a toddler who is 8 hr postoperative following a cardiac catheterization procedure. Which of the following findings should the nurse report to the provider?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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