Nokea
A child has been diagnosed with classic hemophilia. A nurse teaches the child's parents how to administer the plasma component factor VIII through a venous port. It is to be given 3 times a week. What should the nurse tell them about when to administer this therapy?
- A. Whenever a bleed is suspected
- B. In the morning on scheduled days
- C. At bedtime while the child is lying quietly in bed
- D. On a regular schedule at the parents' convenience
Correct Answer: B
Rationale: Administering factor VIII in the morning on scheduled days is the correct choice. This timing ensures that the factor VIII levels remain stable throughout the day when the child is active and at risk of bleeding. Choice A is incorrect because factor VIII should be given on a regular schedule rather than only when a bleed is suspected. Choice C is not ideal as the child may be more active during the day, increasing the risk of bleeding. Choice D is also incorrect as the administration should follow a specific schedule to maintain therapeutic levels of factor VIII in the child's system.
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A healthcare professional is preparing to administer an oral medication to a 4-year-old child. What is the best approach to gain the child's cooperation?
- A. Explain the importance of the medication to the child
- B. Allow the child to play with a favorite toy while taking the medication
- C. Offer a reward after the medication is taken
- D. Give the medication mixed with a small amount of the child's favorite food
Correct Answer: B
Rationale: Allowing the child to play with a favorite toy while taking the medication is the best approach to gain cooperation. This strategy can help distract and calm the child during the medication administration process. Choice A may not be as effective with a young child who may not fully understand the explanation. Offering a reward (choice C) may reinforce negative behavior and create a dependency on rewards for cooperation. Giving the medication with food (choice D) may not always be appropriate and may not address the cooperation aspect.
A parent calls the outpatient clinic requesting information about the appropriate dose of acetaminophen for a 16-month-old child who has signs of an upper respiratory tract infection and fever. The directions on the bottle of acetaminophen elixir are 120 mg every 4 hours when needed. At the toddler's 15-month visit, the health care provider prescribed 150 mg. What is the nurse's best response to the parent?
- A. "The dose is close enough, and it doesn't really matter which one is given."
- B. "From your description, the medications are not necessary. They should be avoided at this age."
- C. "It is appropriate to use dosages based on age. Children typically have weights consistent for their age groups."
- D. "The prescribed dose of the drug was based on weight, and this is a more accurate way of determining a therapeutic dose."
Correct Answer: D
Rationale: The most accurate way to determine a therapeutic dose for children is based on their weight rather than age. Weight-based dosing helps ensure that the child receives the appropriate amount of medication for their body size, which is crucial for safety and effectiveness. Age-based dosing can lead to underdosing or overdosing, as children of the same age can have significantly different weights. Choice A is incorrect because even small variations in dosages can have significant effects on a child's health. Choice B is incorrect as acetaminophen can be appropriate when used correctly for fever management in children. Choice C is incorrect as children's weights can vary greatly within the same age group, making weight-based dosing more precise and individualized.
At 0345, you receive a call for a woman in labor. Upon arriving at the scene, you are greeted by a very anxious man who tells you that his wife is having her baby 'now.' This man escorts you into the living room where a 25-year-old woman is lying on the couch in obvious pain. Which of the following statements regarding crowning is true?
- A. Crowning represents the end of the second stage of labor.
- B. Crowning always occurs immediately after the amniotic sac has ruptured.
- C. It is safe to transport the patient during crowning if the hospital is close.
- D. Gentle pressure should be applied to the baby's head during crowning.
Correct Answer: D
Rationale: During crowning, it is essential to apply gentle pressure to the baby's head to prevent rapid delivery, which can lead to potential injuries to both the mother and the baby. Choice A is incorrect because crowning signifies the beginning, not the end, of the second stage of labor. Choice B is incorrect as crowning can occur before or after the amniotic sac ruptures. Choice C is incorrect as transporting the patient during crowning, even if the hospital is close, can be unsafe due to the risk of rapid delivery and complications.
Surgical repair for patent ductus arteriosus (PDA) is done to prevent the complication of
- A. pulmonary infection
- B. right-to-left shunt of blood
- C. decreased workload on left side of the heart
- D. increased pulmonary vascular congestion
Correct Answer: D
Rationale: The correct answer is D: increased pulmonary vascular congestion. Surgical repair of patent ductus arteriosus (PDA) aims to prevent the complications associated with increased pulmonary vascular congestion, such as pulmonary hypertension and heart failure. Choice A, pulmonary infection, is not a direct complication of PDA but can occur secondary to other conditions. Choice B, right-to-left shunt of blood, is a feature of some congenital heart defects but not a direct complication of PDA. Choice C, decreased workload on the left side of the heart, is not a primary reason for surgical repair of PDA, as the main concern is the impact on pulmonary circulation.
A 3-year-old child is admitted to the hospital with a diagnosis of Kawasaki disease. What is the priority nursing intervention?
- A. Administering IV immunoglobulin
- B. Monitoring for coronary artery aneurysms
- C. Encouraging fluid intake
- D. Providing nutritional support
Correct Answer: B
Rationale: The priority nursing intervention for a 3-year-old child with Kawasaki disease is monitoring for coronary artery aneurysms. Kawasaki disease can lead to coronary artery complications, making early detection crucial in preventing serious outcomes. Administering IV immunoglobulin is a standard treatment for Kawasaki disease but does not take precedence over monitoring for potential complications. Encouraging fluid intake and providing nutritional support are important aspects of care but are not the priority when compared to monitoring for coronary artery aneurysms to prevent long-term cardiac issues.