Which of the following findings in a pediatric patient would most strongly indicate dehydration?
A coarse, red rash on the trunk.
Crying when asked to swallow.
Dark yellow urine with a strong odor.
A temperature of 39.9 degrees C (103.8 degrees F).
The Correct Answer is C
Assessing dehydration in pediatric patients requires knowledge of renal physiology and fluid balance indicators. The nurse must apply understanding of how the body compensates for fluid loss through urine concentration, skin changes, and vital sign alterations to identify severity.
Choice A rationale
A coarse, red rash is generally indicative of an infectious process, such as scarlet fever, or an allergic reaction rather than fluid volume deficit. Rashes do not provide direct clinical data regarding the patient's hydration or perfusion status.
Choice B rationale
Pain with swallowing, or odynophagia, is typically associated with pharyngitis or tonsillitis. While this can lead to decreased oral intake and subsequent dehydration, the act of crying during swallowing itself is not a direct sign of dehydration.
Choice C rationale
Concentrated, dark urine with a high specific gravity indicates that the kidneys are conserving water in response to hypovolemia. Normal urine color should be light yellow, and dark urine suggests significant fluid depletion and reduced renal output.
Choice D rationale
A high fever can cause increased insensible fluid loss, leading to dehydration, but the fever itself is a sign of infection or inflammation. It is a potential cause of fluid loss rather than a definitive physical finding of dehydration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Celiac disease is an autoimmune enteropathy triggered by the ingestion of gluten in genetically predisposed individuals. Clinical management requires strict adherence to a gluten-free diet, necessitates the identification of hidden gluten sources in processed wheat, barley, and rye products.
Choice A rationale
Potatoes are naturally gluten-free tubers containing complex carbohydrates. They do not contain the gliadin proteins that trigger the autoimmune inflammatory response in the small intestine, making them a safe starch replacement for celiac patients.
Choice B rationale
Graham crackers are manufactured using wheat flour, which contains gluten. In celiac disease, gluten ingestion leads to villous atrophy in the small intestine, causing malabsorption, steatorrhea, and nutritional deficiencies, necessitating total avoidance of wheat-based snacks.
Choice C rationale
Wild rice is a gluten-free grain that is safe for patients with celiac disease. Despite its name, it is a grass seed unrelated to wheat, providing essential fiber and nutrients without damaging the intestinal mucosa.
Choice D rationale
Canned pears are typically processed with water or sugar syrup and are naturally gluten-free. Unless cross-contamination occurs during packaging, fruit provides safe vitamins and minerals without containing the harmful proteins found in wheat, barley, or rye.
Correct Answer is ["A","B"]
Explanation
Reviewing transmission-based precautions requires understanding how specific pathogens spread between hosts. Knowledge of microbiology, environmental stability of organisms, and infection control protocols is essential to determine whether contact, droplet, or airborne barriers are necessary to prevent healthcare-associated infections.
Choice A rationale
MRSA is a bacterium spread primarily through physical contact with infected skin or contaminated surfaces. Contact precautions, including gown and gloves, are required to prevent the transmission of this resistant organism to other patients and staff members.
Choice B rationale
VRE is highly resistant to antibiotics and colonizes the gastrointestinal tract or wounds. It survives well on environmental surfaces, making strict contact precautions essential to limit the spread of this organism within the pediatric healthcare environment.
Choice C rationale
Pertussis is caused by Bordetella pertussis and is transmitted via large respiratory droplets during coughing or sneezing. This requires droplet precautions, not contact precautions, as the primary mode of transmission is through the air over short distances.
Choice D rationale
Influenza viruses are primarily spread through respiratory droplets when an infected person speaks or coughs. While some surface contamination occurs, standard droplet precautions are the indicated protocol for pediatric patients suspected of having the seasonal influenza infection.
Choice E rationale
Group A Streptococcus is typically spread through large respiratory droplets or direct contact with secretions. In most clinical settings, droplet precautions are implemented for the first 24 hours of effective antibiotic therapy to prevent healthcare-associated transmission.
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