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A 36 pound almost 3-year-old arrives to the ED with dehydration. The provider orders an IV fluid bolus, 15 ml/kg over 30 minutes. How many ml will the nurse administer?
- A. 164 ml
- B. 246 ml
- C. 460 ml
- D. 640 ml
Correct Answer: B
Rationale: The correct answer is B: 246 ml. To calculate the IV fluid bolus amount, first, we need to determine the child's weight in kilograms: 36 lbs ÷ 2.2 = 16.36 kg. Next, multiply the weight in kg by the ordered dose of 15 ml/kg: 16.36 kg x 15 ml/kg = 245.4 ml. Since it is recommended to round up in pediatric dosing, the nurse will administer 246 ml. Choice A is incorrect as it underestimates the dose. Choices C and D are incorrect as they overestimate the dose.
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The nurse is caring for a child with frostbite would expect the patient to display:
- A. Redness and swelling of the hands
- B. Blisters that appear 24 to 48 hours after rewarming
- C. Itching and burning that persists after rewarming
- D. Fever
Correct Answer: B
Rationale: The correct answer is B because blisters appearing 24 to 48 hours after rewarming is a common symptom of frostbite. This occurs due to damage to the blood vessels and tissues. A: Redness and swelling are more indicative of mild frostbite. C: Itching and burning are not typical symptoms of frostbite. D: Fever is not a common symptom of frostbite.
When caring for a newborn with Down syndrome, what should the nurse be aware is the most common congenital anomaly associated with Down syndrome?
- A. Diabetes insipidus
- B. Pyloric stenosis
- C. Congenital heart disease
- D. Congenital hip dysplasia
Correct Answer: C
Rationale: The correct answer is C: Congenital heart disease. Down syndrome is commonly associated with congenital heart defects, such as atrioventricular septal defects or ventricular septal defects. This is important for the nurse to be aware of because these heart anomalies can impact the newborn's health and require monitoring or intervention.
Choice A: Diabetes insipidus is not a common congenital anomaly associated with Down syndrome.
Choice B: Pyloric stenosis is not typically associated with Down syndrome.
Choice D: Congenital hip dysplasia is not a common anomaly seen with Down syndrome.
In summary, the nurse should prioritize monitoring for congenital heart disease in a newborn with Down syndrome due to its high prevalence and potential impact on the baby's health.
Ringworm, frequently found in school children, is caused by which of the following?
- A. Virus
- B. Fungus
- C. Allergic reaction
- D. Bacterial infection
Correct Answer: B
Rationale: Ringworm is caused by a fungus, specifically dermatophytes that infect the skin, hair, or nails. Fungi thrive in warm, moist environments, making schools a common place for transmission. Viruses, allergic reactions, and bacterial infections do not cause ringworm. Ringworm is a fungal infection, not a result of an allergic reaction or bacterial infection.
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.
Jenny is a 7-year-old that weighs 64 lbs., who has an order for 1.5 times maintenance IV fluids for acute dehydration. What rate does the IV pump need to be set at?
- A. 87 ml/hr
- B. 98 ml/hr
- C. 105 ml/hr
- D. 148 ml/hr
Correct Answer: D
Rationale: The correct answer is D: 148 ml/hr. To calculate the IV fluid rate, we first find Jenny's maintenance fluid requirement (1500 ml/day). Then, we multiply this by 1.5 to account for acute dehydration, resulting in 2250 ml/day. Finally, we convert this to hourly rate by dividing by 24, giving us 93.75 ml/hr. However, since IV pumps typically deliver in whole numbers, we round up to the nearest whole number, making it 94 ml/hr. Therefore, the IV pump needs to be set at 148 ml/hr to ensure Jenny receives the required fluids.
Choice A (87 ml/hr) is incorrect because it does not account for the 1.5 times increase needed for acute dehydration. Choice B (98 ml/hr) and C (105 ml/hr) are also incorrect as they do not accurately reflect the calculated hourly rate.