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A 14-year-old was brought to the school nurse's office due to a reported suicide threat. Which one of the following findings puts the patient at the greatest risk for suicide completion?
- A. History of suicide attempt
- B. History of drug and alcohol use
- C. History of divorced parents
- D. Bisexual orientation
Correct Answer: A
Rationale: The correct answer is A: History of suicide attempt. This finding puts the patient at the greatest risk for suicide completion because individuals with a history of suicide attempts are more likely to attempt suicide again. This indicates underlying mental health issues and distress, increasing the risk of completing suicide. Choice B is incorrect as drug and alcohol use is a risk factor but not as strong as a previous suicide attempt. Choices C and D are not direct risk factors for suicide completion.
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The nurse is educating parents of a sickle cell patient regarding infection prevention. Which statement best indicates the parent understands the child's risk for infection?
- A. If the child has a fever, they need to stay home from school
- B. Antibiotics should be administered sparingly to prevent resistant infections in this population
- C. Children with sickle cell disease are at risk for infection due to impaired splenic function
- D. If the child is showing signs of crisis, a cup of hot tea can prevent the red blood cells from clumping rapidly
Correct Answer: C
Rationale: The correct answer is C. Children with sickle cell disease are at risk for infection due to impaired splenic function. This is because the spleen plays a crucial role in fighting infections, and individuals with sickle cell disease often have impaired splenic function, making them more susceptible to infections.
Explanation for other choices:
A: If the child has a fever, they need to stay home from school - While it is important for sickle cell patients to avoid exposure to infections, staying home from school only when the child has a fever does not address the overall risk of infection in these patients.
B: Antibiotics should be administered sparingly to prevent resistant infections in this population - While antibiotic resistance is a concern, the statement does not specifically address the child's risk for infection due to impaired splenic function.
D: If the child is showing signs of crisis, a cup of hot tea can prevent the red blood cells from clumping rapidly - This statement is incorrect as hot tea does not prevent
A child being administered a new medication displays signs of an adverse drug reaction. The nurse would expect treatment of the reaction to include (Select all that apply):
- A. Administering antibiotics
- B. Discontinuing the drug
- C. Administering antihistamines
- D. Administering corticosteroids
Correct Answer: B,C,D
Rationale: The correct answer is B, C, and D. Discontinuing the drug is essential to stop the adverse reaction. Administering antihistamines helps manage symptoms like itching and hives. Corticosteroids can reduce inflammation and allergic responses caused by the reaction. Antibiotics (choice A) are not indicated unless there is a specific infection requiring treatment. No other choices were provided, but it's crucial to focus on stopping the offending drug, managing symptoms, and addressing inflammation in the case of an adverse drug reaction.
Which actions by the school nurse is important in the prevention of rheumatic fever?
- A. Encourage routine cholesterol screenings
- B. Conduct routine blood pressure screenings
- C. Refer children with sore throats for throat cultures
- D. Recommend aspirin instead of acetaminophen for minor discomforts
Correct Answer: C
Rationale: The correct answer is C: Refer children with sore throats for throat cultures. This is important in preventing rheumatic fever as it helps identify and treat streptococcal infections promptly, which can lead to rheumatic fever if left untreated. Encouraging routine cholesterol screenings (A) and conducting routine blood pressure screenings (B) are not directly related to preventing rheumatic fever. Recommending aspirin instead of acetaminophen (D) can actually be harmful in children with viral infections, increasing the risk of Reye's syndrome.
You are the nurse caring for a 3-year-old, 33-pound child on digoxin. The safe dose range for digoxin is 20-40 mcg/kg/day. The order is for digoxin to be given IV every 12 hours, what is the maximum safe single dose the child should receive?
- A. 300 mcg
- B. 600 mcg
- C. 660 mcg
- D. 1320 mcg
Correct Answer: A
Rationale: The correct answer is A: 300 mcg. To determine the maximum safe single dose, we first need to calculate the total daily safe dose range for the child. The child's weight is 33 pounds, which is approximately 15 kg (1 kg = 2.2 lbs). The safe dose range is 20-40 mcg/kg/day, so for a 15 kg child, the total daily safe dose range would be 300-600 mcg/day. Since the medication is given every 12 hours, the maximum safe single dose would be half of the total daily dose, which is 300 mcg. This ensures that the child stays within the safe dose range for digoxin. Choice B (600 mcg) exceeds the maximum daily safe dose, choice C (660 mcg) exceeds the daily safe dose range, and choice D (1320 mcg) is way above the safe dose range for the child's weight.
When preparing your pediatric patient for his cardiac assessment, which element would you start with for the assessment?
- A. Assess peripheral pulses
- B. Auscultate heart rate and rhythm
- C. Evaluate chest rise
- D. Palpate liver margins
Correct Answer: B
Rationale: The correct answer is B: Auscultate heart rate and rhythm. This is the first step in a pediatric cardiac assessment because it provides crucial information about the heart's function. Listening to the heart helps identify any abnormalities in heart sounds, such as murmurs or irregular rhythms, which can indicate underlying cardiac issues. Assessing peripheral pulses (choice A) may be important but comes after evaluating the heart. Evaluating chest rise (choice C) is important for respiratory assessment, not specifically for cardiac assessment. Palpating liver margins (choice D) is more relevant for assessing hepatomegaly, not typically the initial step in a cardiac assessment.