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A child weighs 6 lbs and is to receive Ampicillin 50 mg/kg/24 hrs and then it's divided into q hr doses. How many mg will he receive with each dose?
- A. 90 mg
- B. 60 mg
- C. 36 mg
- D. 290 mg
Correct Answer: C
Rationale: Step 1: Convert the child's weight from lbs to kg. Since 1 lb is approximately 0.45 kg, a child who weighs 6 lbs weighs approximately 2.72 kg (6 lbs × 0.45 =2.72 kg). Step 2: Calculate the total daily dose of Ampicillin. The total daily dose is 50 mg/kg/day, so for a child who weighs 2.72 kg, the total daily dose would be approximately 136 mg (50 mg/kg/day × 2.72 kg = 136 mg/day). Step 3: Since the total daily dose is divided into q hr doses (4 doses per day), each dose would be approximately 34 mg (136 mg/day ÷ 4 doses/day = 34 mg/dose). So, the child will receive approximately 34 mg of Ampicillin with each dose.
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A nurse is reinforcing teaching about manifestations of hypoglycemia with an adolescent who has type 1 diabetes mellitus. Which of the following manifestations should the nurse include in the teaching?
- A. Rapid respirations
- B. Diminished reflexes
- C. Acetone breath
- D. Diaphoresis
Correct Answer: D
Rationale: Rapid respirations are not typically a manifestation of hypoglycemia. They are more commonly associated with conditions that cause metabolic acidosis, such as diabetic ketoacidosis. Diminished reflexes are not a typical manifestation of hypoglycemia. They may be seen in conditions affecting the nervous system. Acetone breath is not a manifestation of hypoglycemia. It is a sign of ketoacidosis, which is a complication of hyperglycemia, not hypoglycemia. Diaphoresis, or sweating, is a common symptom of hypoglycemia. The body produces sweat as part of the sympathetic nervous system's response to hypoglycemia.
A nurse is providing care to a group of children at a pediatric clinic. Which of the following children meets the criteria to receive a varicella vaccine?
- A. A child who received a blood transfusion 1 month ago.
- B. A child currently receiving immunoglobulins.
- C. A child currently receiving chemotherapy.
- D. A child who has a cold and nasal discharge.
Correct Answer: D
Rationale: A child who received a blood transfusion 1 month ago is not recommended to receive the varicella vaccine. This is because blood transfusions can introduce new antibodies into the body that may interfere with the immune response to the vaccine. A child currently receiving immunoglobulins should not receive the varicella vaccine. Immunoglobulins are proteins in the blood that function as antibodies. They can interfere with the body's immune response to the vaccine. A child currently receiving chemotherapy should not receive the varicella vaccine. Chemotherapy can weaken the immune system, making it less effective at responding to vaccines. A child who has a cold and nasal discharge can receive the varicella vaccine. Mild illnesses, such as a cold, do not interfere with the immune response to the vaccine.
Which statement from a parent of a 1-month-old infant undergoing initial surgery for Hirschsprung's disease indicates understanding of the surgery's goal?
- A. I'm glad that the ostomy is only temporary.'
- B. The operation will straighten out the kink in the intestine.'
- C. I want to learn how to use the feeding tube as soon as possible.'
- D. I'm glad my child will have normal bowel movements now.'
Correct Answer: A
Rationale: The goal of surgery for Hirschsprung disease is to remove the diseased section of the intestine and then pull the healthy portion of this organ down to the anus. This is typically achieved through a type of surgery called a pull-through procedure. In some cases, doctors recommend ostomy surgery of the bowel followed by a pull-through procedure. During ostomy surgery, surgeons create a stoma on a child's abdomen and connect the stoma to the large or small intestine. After ostomy surgery, waste will leave the child's body through the stoma. The stoma is usually temporary. In most cases, surgeons can later close the stoma and connect the healthy part of the intestine to the anus. Waste will move through the intestines, and stool will pass through the anus again. Therefore, the statement 'I'm glad that the ostomy is only temporary' indicates understanding of the surgery's goal. The operation for Hirschsprung's disease does not involve straightening out a kink in the intestine. Instead, it involves removing the part of the large intestine that is missing nerve cells and then connecting the healthy part of the large intestine to the anus. The use of a feeding tube is not typically associated with the initial surgery for Hirschsprung's disease. The surgery involves removing the diseased section of the intestine and then pulling the healthy portion of this organ down to the anus. While the ultimate goal of the surgery is to enable normal bowel movements, it is important to note that about half of children may have ongoing problems after surgery. These problems may include constipation and, in some cases, other symptoms of intestinal obstruction, such as a swollen abdomen or vomiting.
A nurse is caring for a toddler who has intussusception. Which of the following manifestations should the nurse expect?
- A. Mucus and blood in stools.
- B. Increased appetite.
- C. Jaundice.
- D. Drooling.
Correct Answer: A
Rationale: Mucus and blood in stools, often described as 'currant jelly' stools, are a common symptom of intussusception. Increased appetite is not typically associated with intussusception. In fact, children with this condition may experience decreased appetite due to abdominal pain. Jaundice is not a symptom of intussusception. Jaundice, a yellowing of the skin and eyes, is more commonly associated with liver conditions. Drooling is not a typical symptom of intussusception. Symptoms of intussusception are primarily gastrointestinal, including abdominal pain and bloody stools.
A nurse is collecting data from a child and notes the presence of bruises on her arms and legs. Which of the following actions should the nurse take first?
- A. Tell the child what will happen to her when the abuse is reported.
- B. Request a social services referral.
- C. Report the suspected abuse to the authorities.
- D. Obtain a detailed history.
Correct Answer: D
Rationale: Telling the child what will happen when the abuse is reported is not the first action a nurse should take. It is important to first gather all necessary information and report the suspected abuse to the appropriate authorities. Requesting a social services referral is an important step when abuse is suspected, but it should come after obtaining a detailed history and reporting the suspected abuse. Reporting the suspected abuse to the authorities is crucial when child abuse is suspected. However, it is important to first obtain a detailed history to provide as much information as possible to the authorities. When a nurse notes the presence of bruises on a child's arms and legs, the first action should be to obtain a detailed history. This can provide important context for the bruises and help determine whether they are likely the result of accidental injury or possible abuse.