Answer to Question 1
D
Children need to be allowed to develop their imaginations. Overdirection of play can also leave the child feeling insecure. The child should be reminded of the rules, but should not be continually told to be careful. The child should be allowed to complete tasks on his own.
Answer to Question 2
D
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A Incorrect: Looking at the lab work, the nurse will not likely find hypernatremia and hypochloremia. The child's symptoms occur with hypochloremia; therefore, this should be accompanied by hyponatremia.
B Incorrect: Looking at the lab work, the nurse will not likely find hypercalcemia and hyperchloremia. Hypercalcemia and hypochloremia (not hyperchloremia) are manifested by muscle hypotonicity, bradycardia, and weakness and fatigue.
C Incorrect: Looking at the lab work, the nurse will not likely find hypocalcemia and hypernatremia. Hypocalcemia is manifested by neuromuscular irritability, tetany, and laryngospasm. Hypernatremia is characterized by intense thirst, elevated temperature, and dry, sticky mucous membranes.
D Correct: The nurse assesses a child and finds the child to have hypotonic muscles, decreased respirations, and to be irritable. Looking at the lab work, the nurse will likely find hyponatremia and hypochloremia. A child with a decreased chloride level will exhibit these symptoms. Chloride levels usually parallel sodium levels, meaning if the sodium level is decreasing, chloride levels will decrease and vice versa.