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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.
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A newborn with a repaired gastroschisis is transferred to the paediatric unit after several days in the paediatric intensive care unit. The infant is receiving parenteral nutrition and continuous enteral feedings. To maintain normal growth and development of the infant, which action should the nurse include in the plan of care?
- A. Offer a pacifier for non-nutritive sucking.
- B. Use sterile technique during feedings.
- C. Ensure placement of the enteral tube with an abdominal x-ray.
- D. Speak to the healthcare provider about instituting physical therapy.
Correct Answer: A
Rationale: Non-nutritive sucking via a pacifier promotes oral motor skill development, supporting normal feeding behaviors critical for growth.
A breastfeeding infant, screened for congenital hypothyroidism, is found to have low levels of thyroxine (T4) and high levels of thyroid stimulating hormone (TSH). Which is the best explanation for this finding?
- A. The TSH is high because of the low production of T4 by the thyroid.
- B. The thyroxine level is low because the TSH level is high.
- C. The thyroid gland does not produce normal levels of thyroxine for several weeks after birth.
- D. High thyroxine levels normally occur in breastfeeding infants.
Correct Answer: A
Rationale: High TSH levels are a compensatory response to low T4 production, indicating congenital hypothyroidism, which requires prompt treatment to prevent developmental delays.
The nurse is assessing the growth and development of a 3-year-old child. Which speech and language skills should the nurse identify as normal developmental milestones for this child?
- A. Speaks in simple sentences with four or more words.
- B. Recognizes most letters and numbers.
- C. Uses gestures with 1-to-2-word sentences.
- D. Uses 1-word sentences.
Correct Answer: A
Rationale: Speaking in simple sentences with four or more words is a normal milestone for a 3-year-old.
A mother brings her 3-month-old infant to the clinic because the baby does not sleep through the night. Which finding is most significant in planning care for this family?
- A. The mother states the baby is irritable during feedings.
- B. The mother is a single parent and lives with her parents.
- C. The infant's formula has been changed twice.
- D. The diaper area shows severe skin breakdown.
Correct Answer: D
Rationale: Severe skin breakdown can cause discomfort, disrupting sleep, and requires immediate intervention to improve the infant's comfort.
The nurse begins collecting the medical history of a child when the child screams and tries to hide behind the parent, dropping a stuffed toy. Which intervention should the nurse implement?
- A. Obtain the essential information as quickly as possible.
- B. Document interactions between the parent and the child.
- C. Ignore the child's behavior, directing questions to a parent.
- D. Include the child's toy in the collection of information.
Correct Answer: D
Rationale: Including the child's toy can comfort and engage the child, facilitating a more effective medical history collection.