Nokea
A child is receiving maintenance intravenous (IV) fluids at the rate of 1000 mL for the first 10 kg of body weight, plus 50 mL/kg per day for each kilogram between 10 and 20. How many milliliters per hour should the nurse program the infusion pump for a child who weighs 19.5 kg?
- A. 24
- B. 61
- C. 73
- D. 58
Correct Answer: B
Rationale: To calculate the IV fluids for a 19.5 kg child:
1. For the first 10 kg: 1000 mL
2. For the weight between 10-20 kg: (19.5 kg - 10 kg) * 50 mL/kg = 475 mL
Total IV fluids = 1000 mL + 475 mL = 1475 mL
To convert to mL per hour: 1475 mL / 24 hours = ~61 mL/hr
Therefore, the correct answer is B (61 mL/hr).
Incorrect Choices:
A (24 mL/hr): Incorrect, as it doesn't consider the additional fluids for the weight between 10-20 kg.
C (73 mL/hr) and D (58 mL/hr): Incorrect, as these values are not obtained from the correct calculation based on the given formula.
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Which therapeutic interventions may be withdrawn or withabhirebl.dco mfr/otemst the terminally ill client? (Select all that apply.)
- A. Antibiotics
- B. Dialysis
- C. Nutrition
- D. Pain medications
Correct Answer: B
Rationale: The correct answer is B: Dialysis. In the context of terminally ill clients, withdrawing dialysis is appropriate as it can be burdensome without providing significant benefit towards the end of life. Dialysis does not cure terminal conditions and can prolong suffering unnecessarily.
Antibiotics (A) may be necessary for managing infections in terminally ill clients. Nutrition (C) is important for comfort and quality of life. Pain medications (D) are essential for managing pain and should not be withdrawn unless no longer beneficial or requested by the patient.
A patient who has been declared brain dead is considered a potential organ donor. In order to proceed with donation, the nurse must understand that applicable concept?
- A. A signed donor card mandates that organs be retrieved in the event of brain death.
- B. After brain death has been determined, perfusion and o xygenation of organs is maintained until organs can be removed in the operatin ag bi rbro .co omm /t. e st
- C. The healthcare proxy does not need to give consent for the retrieval of organs.
- D. Once a patient has been established as brain dead, life support is withdrawn and organs are retrieved.
Correct Answer: B
Rationale: The correct answer is B because after brain death is confirmed, maintaining perfusion and oxygenation of organs is crucial to ensure their viability for donation. This process allows organs to be retrieved in optimal condition during the operation. Choice A is incorrect because a signed donor card is not a legal mandate for organ retrieval. Choice C is incorrect as the healthcare proxy's consent is typically required for organ donation. Choice D is incorrect because life support is not immediately withdrawn upon brain death confirmation; instead, organ preservation measures are initiated.
Which action is best for the nurse to take to ensure culturally competent care for an alert, terminally ill Filipino patient?
- A. Ask the patient and family about their preferences for care during this time.
- B. Let the family decide whether to tell the patient about the terminal diagnosis.
- C. Obtain information from Filipino staff members about possible cultural needs.
- D. Remind family members that dying patients prefer to have someone at the bedside.
Correct Answer: A
Rationale: The correct answer is A because it promotes patient-centered care by involving the patient and family in decision-making, respecting their autonomy and preferences. This approach acknowledges the importance of cultural beliefs and values in end-of-life care. Choice B undermines patient autonomy by bypassing direct communication with the patient. Choice C assumes all Filipino individuals have the same cultural needs, which is not accurate. Choice D generalizes preferences without considering individual patient needs and wishes. Overall, choice A is the most appropriate as it aligns with the principles of patient-centered care and cultural competence.
The nurse recognizes that which patient is likely to benefit most from patient-controlled analgesia?
- A. 21-year-old with a C4 fracture and quadriplegia
- B. 45-year-old with femur fracture and closed head injury
- C. 59-year-old postoperative elective bariatric surgery
- D. 70-year-old postoperative cardiac surgery; mild demen tia
Correct Answer: A
Rationale: The correct answer is A, the 21-year-old with a C4 fracture and quadriplegia. This patient is likely to benefit most from patient-controlled analgesia (PCA) due to the inability to self-administer traditional pain medications. With quadriplegia, the patient may have limited mobility and sensation, making it challenging to communicate pain levels effectively. PCA allows the patient to control their pain relief within preset limits, enhancing autonomy and optimizing pain management.
Summary:
- Choice B: The 45-year-old with femur fracture and closed head injury may benefit from PCA, but the severity of the head injury could affect their ability to use the device effectively.
- Choice C: The 59-year-old postoperative elective bariatric surgery patient can typically manage pain with traditional methods postoperatively.
- Choice D: The 70-year-old postoperative cardiac surgery patient with mild dementia may have the cognitive ability to use PCA but could potentially benefit more from other pain management strategies due
Which statement about resuscitation is true?
- A. Family members should never be present during resusc itation.
- B. It is not necessary for a physician to write “do not resu scitate” orders in the chart if a patient has a healthcare surrogate.
- C. “Slow codes” are ethical and should be considered in f utile situations if advanced directives are not available.
- D. Withholding “extraordinary” resuscitation is legal anda ebtirhbi.ccoaml /tiefs ts pecified in advance directives and physician orders.
Correct Answer: D
Rationale: The correct answer is D because it accurately states that withholding "extraordinary" resuscitation is legal and should be based on specified criteria in advance directives and physician orders. This is in line with medical ethics and patient autonomy.
A is incorrect because family presence during resuscitation can be beneficial for emotional support and decision-making. B is incorrect as it is still necessary for a physician to document "do not resuscitate" orders even with a healthcare surrogate. C is incorrect as "slow codes" are not ethical and go against the principle of beneficence.