Nokea
A child with acetaminophen (Tylenol) poisoning has been admitted to the emergency department. What antidote does the nurse anticipate being prescribed?
- A. Carnitine (Carnitor)
- B. Fomepizole (Antizol)
- C. Deferoxamine (Desferal)
- D. N-acetylcysteine (Mucomyst)
Correct Answer: D
Rationale: The antidote for acetaminophen (Tylenol) poisoning is N-acetylcysteine (Mucomyst). Carnitine (Carnitor) is an antidote for valproic acid (Depakote), fomepizole (Antizol) is the antidote for methanol poisoning, and deferoxamine (Desferal) is the antidote for iron poisoning.
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A father calls the clinic because he found his young daughter squirting Visine eyedrops into her mouth. What is the most appropriate nursing action?
- A. Reassure the father that Visine is harmless.
- B. Direct him to seek immediate medical treatment.
- C. Recommend inducing vomiting with ipecac.
- D. Advise him to dilute Visine by giving his daughter several glasses of water to drink.
Correct Answer: B
Rationale: Visine is a sympathomimetic and if ingested may cause serious consequences. Medical treatment is necessary. Inducing vomiting is no longer recommended for ingestions. Dilution will not decrease risk.
What is an important nursing consideration when a child is hospitalized for chelation therapy to treat lead poisoning?
- A. Maintain bed rest.
- B. Maintain isolation precautions.
- C. Keep an accurate record of intake and output.
- D. Institute measures to prevent skeletal fracture.
Correct Answer: C
Rationale: The iron chelates are excreted though the kidneys. Adequate hydration is essential. Periodic measurement of renal function is done. Bed rest is not necessary. Often the chelation therapy is done on an outpatient basis. Chelation therapy is not infectious or dangerous. Isolation is not indicated. Skeletal weakness does not result from high levels of lead.
What is the most common form of child maltreatment?
- A. Sexual abuse
- B. Child neglect
- C. Physical abuse
- D. Emotional abuse
Correct Answer: B
Rationale: Child neglect, which is characterized by the failure to provide for the childs basic needs, is the most common form of child maltreatment. Sexual abuse, physical abuse, and emotional abuse are individually not as common as neglect.
What is probably the most important criterion on which to base the decision to report suspected child abuse?
- A. Inappropriate response of child
- B. Inappropriate parental concern for the degree of injury
- C. Absence of parents for questioning about childs injuries
- D. Incompatibility between the history and injury observed
Correct Answer: D
Rationale: Conflicting stories about the accident are the most indicative red flags of abuse. The child or caregiver may have an inappropriate response, but this is subjective. Parents should be questioned at some point during the investigation.
A child is admitted with a suspected diagnosis of Munchausen syndrome by proxy (MSBP). What is an important consideration in the care of this child?
- A. Monitoring the parents whenever they are with the child
- B. Reassuring the parents that the cause of the disorder will be found
- C. Teaching the parents how to obtain necessary specimens
- D. Supporting the parents as they cope with diagnosis of a chronic illness
Correct Answer: A
Rationale: MSBP refers to an illness that one person fabricates or induces in another. The child must be continuously observed for development of symptoms to determine the cause. MSBP is caused by an individual harming the child for the purpose of gaining attention. Nursing staff should obtain all specimens for analyzing. This minimizes the possibility of the abuser contaminating the sample. The child must be supported through the diagnosis of MSBP. The abuser must be identified and the child protected from that individual.