Rosh Pediatrics Practice Exam

Which clinical finding is a sign of severe dehydration in pediatric patients?

1. Decreased urinary output

2. Increased skin turgor

3. Hyperactive bowel sounds

4. Normal heart rate

The correct answer is: Decreased urinary output

Decreased urinary output is a significant indicator of severe dehydration in pediatric patients. When a child is dehydrated, their body prioritizes preserving fluid to maintain vital functions. One of the key responses to severe dehydration is a reduction in the volume of urine produced. This occurs as the kidneys work to conserve water, leading to concentrated urine and less frequent urination. In contrast, increased skin turgor would suggest well-hydrated skin; it is not a sign of dehydration. Hyperactive bowel sounds could indicate other conditions, such as gastrointestinal disturbances, rather than dehydration. A normal heart rate may also mislead clinicians, as tachycardia is often present in cases of dehydration due to compensatory mechanisms. Therefore, decreased urinary output stands out as a clear clinical sign that points to severe dehydration, making it an essential observation in pediatric assessments.