A child who weighs 18 pounds receives a prescription for amoxicillin 25 mg/kg/day by mouth in divided doses every 12 hours. The bottle is labelled, 'Amoxicillin for Oral Suspension, USP 400 mg per 5 mL.' How many mL should the nurse administer with each dose?
- A. 1.3 mL
Correct Answer: A
Rationale: The dose is calculated as 18 lbs ÷ 2.2 = 8.18 kg, 25 mg/kg/day x 8.18 kg = 204.5 mg/day, divided into 102.25 mg/dose. Then, 102.25 mg ÷ (400 mg/5 mL) = 1.3 mL.
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A male adolescent arrives at the clinic and reports intense pain in the testicular area that occurred during football practice at high school. The nurse observes the scrotum and identifies significant erythema and swelling. Which action should the nurse take?
- A. Report the findings immediately to the healthcare provider.
- B. Obtain a swab of secretions from the penis and urethra.
- C. Collect a sterile urine sample for culture and sensitivity.
- D. Provide the adolescent with a urinal for urinary hesitancy.
Correct Answer: A
Rationale: Significant erythema and swelling suggest testicular torsion, a medical emergency requiring immediate reporting.
A child who weighs 30 kg is experiencing a grand mal seizure. The healthcare provider prescribes diazepam 0.3 mg/kg/dose intravenous (IV) STAT. The medication is available in 5 mg/mL vials. How many mL should the nurse administer?
- A. 1.8 mL
Correct Answer: A
Rationale: The dose is calculated as 30 kg x 0.3 mg/kg = 9 mg. Dividing by 5 mg/mL gives 1.8 mL, which is the correct volume to administer.
When starting a peripheral intravenous (IV) infusion on an infant, which intervention should the nurse implement?
- A. Select a site that is least restrictive to the infant.
- B. Assess dorsal surface of feet for an IV site.
- C. Instruct parents to sing or croon to the infant.
- D. Apply soft restraints to all four extremities.
Correct Answer: A
Rationale: Selecting a least restrictive site minimizes discomfort and maintains mobility, ensuring safe and effective IV placement.
The nurse is caring for an adolescent with scoliosis who is recovering after a surgical spinal instrumentation. Which technique should the nurse use when moving this client?
- A. Cross the arms and legs.
- B. Perform a log roll.
- C. Raise the hips.
- D. Flex the knees.
Correct Answer: B
Rationale: The log roll technique maintains spinal alignment, critical after surgical spinal instrumentation.
A 1-year-old child with respiratory syncytial virus (RSV) has been admitted to the pediatric unit. The nurse observes that the child has a fever, rhinorrhea, frequent coughing, and sneezing. Which additional finding should alert the nurse that the child is in acute respiratory distress?
- A. Flaring of the nares.
- B. Bilateral bronchial breath sounds.
- C. Diaphragmatic respirations.
- D. A resting respiratory rate of 35 breaths/min.
Correct Answer: A
Rationale: Nasal flaring indicates increased respiratory effort, a sign of acute respiratory distress.
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