The greatest threat to life in isotonic dehydration is:

Hypovolemic shock

Metabolic acidosis

Hypernatremia

Seizures

Answer and Explanation

The Correct Answer is A

Choice A reason: Isotonic dehydration involves equal loss of water and electrolytes, reducing circulating volume. This can lead to hypovolemic shock, characterized by hypotension and organ hypoperfusion, risking multi-organ failure. In children, rapid fluid loss from diarrhea or vomiting makes this the greatest life-threatening complication, requiring urgent fluid resuscitation.

Choice B reason: Metabolic acidosis may occur in dehydration from bicarbonate loss (e.g., diarrhea), but it is less immediately life-threatening than hypovolemic shock. Acidosis causes compensatory tachypnea but rarely leads to rapid death. Shock’s impact on perfusion is the primary threat, making acidosis a secondary concern in isotonic dehydration.

Choice C reason: Hypernatremia occurs in hypertonic dehydration, not isotonic, where sodium levels remain normal. Isotonic dehydration’s primary risk is volume depletion, leading to hypovolemic shock. Hypernatremia causes neurological symptoms but is not the main threat, as isotonic dehydration maintains electrolyte balance, making this incorrect.

Choice D reason: Seizures may occur in dehydration from electrolyte imbalances like hyponatremia, but isotonic dehydration maintains normal sodium levels, reducing seizure risk. Hypovolemic shock, from significant volume loss, is the greatest threat, causing cardiovascular collapse, making seizures a less immediate concern in this scenario.

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Correct Answer is ["C","D"]

Explanation

Choice A reason: A positive antistreptolysin titer suggests post-streptococcal glomerulonephritis, not nephrosis (minimal change disease). Nephrosis is typically idiopathic, not infection-related, and lacks streptococcal association. Edema and proteinuria are hallmark features due to hypoalbuminemia, making this an incorrect characteristic for nephrosis, as it reflects a different renal pathology.

Choice B reason: Bacteriuria indicates urinary tract infection, not a characteristic of nephrosis, which involves sterile proteinuria and hypoalbuminemia. Infections may occur as complications due to immunosuppression, but bacteriuria is not a primary feature. Edema and proteinuria define nephrosis, making bacteriuria an incorrect symptom for this condition.

Choice C reason: Edema is a hallmark of nephrosis, resulting from massive proteinuria causing hypoalbuminemia, reducing plasma oncotic pressure. Fluid leaks into interstitial spaces, causing periorbital or generalized edema. This is a primary symptom, reflecting the pathophysiological fluid shift, making it a key characteristic in children with nephrosis.

Choice D reason: Massive proteinuria is a defining feature of nephrosis, particularly minimal change disease, where glomerular damage allows excessive protein filtration. This leads to hypoalbuminemia, edema, and hyperlipidemia. Proteinuria is a core diagnostic criterion, making it a characteristic symptom essential for identifying and managing nephrosis in children.

A. Abdominal mass B. Diarrhea C. Jaundice D. Swollen joints

Correct Answer is A

Explanation

Choice A reason: Wilms’ tumor, a pediatric kidney malignancy, presents as a painless abdominal mass, often palpable in the flank, due to tumor growth in the renal parenchyma. This disrupts normal kidney structure, causing a firm, non-tender mass. It’s the most common finding, reflecting the tumor’s physical presence in the abdomen.

Choice B reason: Diarrhea is not associated with Wilms’ tumor, which primarily affects the kidney, causing mass effect or hematuria. Gastrointestinal symptoms may occur in other conditions like neuroblastoma, but Wilms’ tumor typically presents with an abdominal mass, making diarrhea an incorrect expected finding in this malignancy.

Choice C reason: Jaundice results from liver dysfunction or biliary obstruction, not Wilms’ tumor, which affects the kidney. While metastasis to the liver is possible, it’s rare and not a primary feature. An abdominal mass is the hallmark sign, making jaundice an incorrect expected manifestation in a 1-year-old.

Choice D reason: Swollen joints suggest rheumatologic or metastatic bone disease, not Wilms’ tumor, which primarily causes a renal mass. Joint involvement is uncommon, as Wilms’ tumor affects the kidney, leading to an abdominal mass. This makes swollen joints an incorrect expected finding in this pediatric malignancy.

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The greatest threat to life in isotonic dehydration is:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a child diagnosed with nephrosis. Symptoms that are characteristic of nephrosis include which of the following? (Select all that apply)

Correct Answer is ["C","D"]

Explanation

A nurse is collecting data from a 1-year-old child who has Wilms’ tumor. Which of the following findings should the nurse expect?

Correct Answer is A

Explanation

The home health nurse is monitoring an 8-month-old child with hypothyroidism taking levothyroxine (Synthroid). Which symptoms does the nurse recognize as signs of overdose? (Select all that apply)

A nurse is planning care for a child who has severe diarrhea. Which of the following actions is the nurse’s priority?

A nurse is reinforcing teaching with a parent of a 1-month-old infant who is to undergo the initial surgery to treat Hirschsprung’s disease. Which of the following statements should indicate to the nurse that the parent understands the goal of the surgery?

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