Nokea
A 6-year-old boy with bronchial asthma takes the beta-adrenergic agonist agent albuterol (Proventil). The child's mother tells the nurse that she uses this medication to open her son's airway when he is having trouble breathing. What is the nurse's best response?
- A. Recommend that the mother bring the child in for immediate evaluation
- B. Advise the mother that overuse of the drug may cause chronic bronchitis
- C. Assure the mother that she is using the medication correctly
- D. Confirm that the medication helps to reduce airway inflammation
Correct Answer: C
Rationale: The nurse's priority is to first reassure the mother that she is using albuterol correctly to open her son's airways during episodes of difficulty breathing. This reassurance helps build trust and ensures that the child receives the intended benefit of the medication. Once the mother feels confident in her administration technique, the nurse can then provide further education or address any concerns about the child's asthma management.
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A child who weighs 25 kg is receiving IV ampicillin 300 mg/kg/24 hours in equally divided doses every 4 hours. How many milligrams should the nurse administer to the child for each dose?
- A. 1875 mg
- B. 625 mg
- C. 2000 mg
- D. 1500 mg
Correct Answer: A
Rationale: To calculate the dose for each administration, multiply the child's weight (25 kg) by the dose (300 mg/kg/24 hours) and divide by the number of doses per day (6, as doses are every 4 hours). This gives us (25 kg * 300 mg/kg / 24 hours) / 6 doses = 1875 mg. Therefore, the nurse should administer 1875 mg for each dose.
The heart rate for a 3-year-old with a congenital heart defect has steadily decreased over the last few hours; it is now 76 bpm, whereas the previous reading 4 hours ago was 110 bpm. Which additional finding should be reported immediately to a healthcare provider?
- A. Oxygen saturation of 94%.
- B. Respiratory rate of 25 breaths/minute.
- C. Urine output of 20 mL/hr.
- D. Blood pressure of 70/40.
Correct Answer: D
Rationale: A significant drop in heart rate and blood pressure should be reported immediately as it may indicate worsening of the congenital heart defect. A decrease in blood pressure to 70/40 is a critical finding that suggests potential cardiovascular compromise and requires urgent attention to prevent further deterioration.
A 6-month-old female is scheduled to receive diphtheria, tetanus toxoid, and acellular pertussis vaccine (DTaP) and IPV (inactivated poliovirus vaccine) immunizations. She is recovering from a cold but is otherwise healthy and afebrile. Her 5-year-old sister is receiving chemotherapy. Which considerations should the nurse make for this situation?
- A. DTaP and IPV can be safely given to the infant at the scheduled time.
- B. DTaP and IPV are contraindicated because the infant has a cold.
- C. IPV is contraindicated because her sister is immunocompromised.
- D. DTaP is contraindicated because her sister is immunocompromised.
Correct Answer: A
Rationale: DTaP and IPV can be safely administered to a child with a mild illness like a cold, even if there is an immunocompromised family member, as these vaccines do not contain live viruses. It is important to ensure that the child is otherwise healthy and afebrile before administering the vaccines. The presence of a cold is not a contraindication for receiving DTaP and IPV vaccines.
What is the recommended analgesia for a practical nurse to use in preparing a school-age child for a lumbar puncture (LP)?
- A. Ondansetron (Zofran) 4 mg / 5 ml PO TID.
- B. Codeine 10 mg PO 30 minutes before the procedure.
- C. A transdermal fentanyl (Duragesic) patch immediately before the procedure.
- D. EMLA (eutectic mixtures of local anesthetics) 2.5 hours before the procedure.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
During a routine physical exam, a male adolescent client tells the nurse, 'sometimes, my mother gets angry because I want to be with my own friends.' What is the best initial response by the nurse?
- A. Offer reassurance that his mother's concern is normal
- B. Determine if his friends are engaged in unsafe behaviors
- C. Ask about the client's response to his mother's anger
- D. Offer to discuss his concerns with his mother
Correct Answer: C
Rationale: When a client expresses concerns about family dynamics, it is important to explore their feelings and reactions to the situation. By asking about the client's response to his mother's anger, the nurse can gain insight into the client's emotions, thoughts, and coping mechanisms. Understanding these aspects is crucial in providing appropriate support and guidance.