Situational Identification Questions:

1. A 6-month-old infant is admitted with vomiting and diarrhea. The nurse observes sunken eyes, dry mucous membranes, weak pulse, and lethargy. What is the degree of dehydration?

2. A 7-year-old child presents with cola-colored urine, facial swelling, and high blood pressure following a recent throat infection. What condition is most likely the cause?

3. An 8-year-old child has been diagnosed with a urinary tract infection. The parents report the child frequently wakes up at night to urinate, complains of lower abdominal pain, and has foul-smelling urine. What type of urinary tract infection does this suggest?

4. A 5-year-old child presents with blisters, severe pain, and a wet appearance on the affected skin area after accidentally touching a hot iron. What type of burn is most likely?

5. A nurse is treating a child with acute glomerulonephritis. The child’s urine is foamy, and there is edema present in the hands and face. Which abnormality in the urine is expected based on these symptoms?

6. A 2-year-old patient is brought in after ingesting a household cleaning chemical. The child has redness and burns around the mouth. What type of burn has occurred?

7. A 4-year-old child presents with diarrhea but no visible signs of dehydration. The nurse provides oral rehydration therapy and educates the parents on how to prevent dehydration. What would be the best dietary recommendation for this child?

8. A child presents with first-degree burns after prolonged exposure to the sun. The skin appears red and is tender to the touch, but there are no blisters. What is the likely prognosis for healing time?

9. A 10-year-old child with a urinary tract infection is prescribed antibiotics. The urine culture reveals the presence of E. coli. What is the most likely mode of bacterial entry into the urinary tract?

10. A 3-year-old child is diagnosed with severe dehydration after experiencing diarrhea for three days. Upon examination, the nurse finds a weak radial pulse, delayed skin turgor, and poor drinking ability. What immediate treatment should be prioritized?

Multiple Choice Situational Questions:

1. A nurse is assessing a 2-year-old with diarrhea and vomiting for signs of dehydration. Which of the following findings would indicate severe dehydration? a) Moist mucous membranes
   b) Normal radial pulse
   c) Lethargy and sunken eyes
   d) Capillary refill of less than 2 seconds

2. Which of the following is a key factor in pediatric dehydration compared to adults? a) Larger intracellular fluid proportion in children
   b) Lower body surface area
   c) Greater extracellular fluid proportion in infants
   d) Slower metabolic rate in infants

3. A child with acute glomerulonephritis presents with pink-colored urine. Which symptom is most likely associated with this condition? a) Proteinuria
   b) Polyuria
   c) Hematuria
   d) Hypotension

4. A pediatric patient with urinary tract infection (UTI) complains of increased urgency to urinate. What would be an expected finding during urinalysis? a) Low urine pH
   b) Presence of nitrites
   c) High glucose
   d) Negative leukocytes

5. What should the nurse prioritize when treating a child with severe dehydration? a) Administer antibiotics
   b) Provide zinc supplements
   c) Monitor intravenous fluid therapy
   d) Check for respiratory complications

6. Which clinical manifestation distinguishes second-degree burns from first-degree burns in children? a) Redness and pain
   b) Absence of blisters
   c) Presence of blisters and wet appearance
   d) Dry, waxy skin

7. A 6-year-old child presents with a urinary tract infection after being on antibiotics for another condition. Which risk factor most likely contributed to this? a) Dehydration
   b) Genetic predisposition
   c) Altered periurethral flora
   d) Poor toilet hygiene

8. A child with glomerulonephritis is admitted. Which intervention is most appropriate for managing fluid retention? a) Administering digitalis
   b) Monitoring daily weight
   c) Providing potassium supplements
   d) Encouraging increased fluid intake

9. What is the most likely cause of burns in a 3-year-old who presents with blisters on their hands and arms? a) Electrical burns
   b) Chemical burns
   c) Thermal burns from hot liquids
   d) Radiation burns

10. What treatment is recommended for children with diarrhea and no dehydration? a) Administering intravenous fluids
    b) Encouraging breastfeeding
    c) Providing anti-diarrheal medication
    d) Limiting fluid intake

11. Which of the following bacteria is most commonly associated with urinary tract infections in children? a) Staphylococcus saprophyticus
    b) Streptococcus group A
    c) Escherichia coli
    d) Klebsiella species

12. A nurse is reviewing lab results for a child with suspected acute glomerulonephritis. What would be a likely finding? a) Hypoproteinemia
    b) Hyperglycemia
    c) Hematuria
    d) Hyperkalemia

13. For a pediatric patient with second-degree burns, which is the most appropriate nursing intervention during the initial phase of treatment? a) Breaking open blisters
    b) Administering silver sulfadiazine
    c) Applying ice directly to the burn
    d) Encouraging early ambulation

14. What would you expect to find in a 5-year-old patient with severe dehydration? a) Restlessness and rapid pulse
    b) Normal urine output
    c) Moist mucous membranes
    d) Rapid capillary refill

15. Which action should the nurse take when a child presents with an acute UTI? a) Administer diuretics
    b) Administer cranberry juice
    c) Encourage frequent voiding
    d) Provide a high-protein diet

16. In a child with dehydration and sunken fontanels, what is the most appropriate nursing action? a) Limit oral fluids
    b) Begin oral rehydration therapy
    c) Apply cold compresses
    d) Increase protein intake

17. When treating a burn victim with circumferential burns, which complication should the nurse monitor for? a) Hypovolemia
    b) Compartment syndrome
    c) Hyperglycemia
    d) Increased cardiac output

18. A child with acute glomerulonephritis is on a low-protein diet. The rationale for this is to: a) Increase energy levels
    b) Reduce proteinuria
    c) Prevent muscle wasting
    d) Improve fluid retention

19. Which of the following electrolyte imbalances is common in pediatric dehydration? a) Hypernatremia
    b) Hypocalcemia
    c) Hyperkalemia
    d) Hyponatremia

20. Which of the following clinical findings is most suggestive of UTI in a young child? a) Jaundice
    b) Increased thirst
    c) Foul-smelling urine
    d) Blood in stool

Key to Correction:

1. Severe dehydration

2. Acute glomerulonephritis

3. Symptomatic bacteriuria

4. Second-degree burn (partial-thickness)

5. Proteinuria

6. Chemical burn

7. BRAT diet (Banana, Rice, Apple, Toast)

8. 3 to 6 days

9. Fecal-perineal-urethral route

10. Intravenous rehydration (IV fluids)

Key to Correction:

1. c

2. c

3. c

4. b

5. c

6. c

7. c

8. b

9. c

10. b

11. c

12. c

13. b

14. a

15. c

16. b

17. b

18. b

19. a

20. c