Pediatrics Baby Fell off Bed Questions

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A client is receiving methotrexate (Mexate), 12g/m2 IV to treat osteogenic carcinoma. During methotrexate therapy, the nurse expects the client to receive which other drug to protect normal cells?

  • A. Probenecid (Benemid)
  • B. Cytarabine (ara-C, cystosine arabinoside [Cytosar-U])
  • C. Thioguanine (6-thioguanine, 6-TG)
  • D. Leucovorin (Citrovorum factor or folinic acid [wellcovirin])
Correct Answer: D

Rationale: Leucovorin, also known as folinic acid, is given concurrently with methotrexate therapy to protect normal cells from the toxic effects of methotrexate. Methotrexate is a folate antagonist that affects both cancer cells and normal cells. Leucovorin is a reduced form of folic acid that bypasses the enzyme targeted by methotrexate, allowing normal cells to continue using folate for DNA synthesis. This rescue therapy helps prevent or reduce the side effects of methotrexate, such as mucositis, myelosuppression, and other toxic effects on normal cells. It is important to administer leucovorin at the appropriate times following methotrexate administration to maximize its protective effect while maintaining the efficacy of the chemotherapy.

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Which of the following actions should the nurse take to maintain patient safety when ambulating a patient for the first time postoperatively?

  • A. Use one person to assist patient.
  • B. Use two people to assist patient.
  • C. Encourage patient to "dangle" self 1 hour before ambulation.
  • D. Give narcotic 15 minutes before ambulation.
Correct Answer: B

Rationale: When ambulating a patient for the first time postoperatively, it is crucial to ensure patient safety by using two people to assist the patient. This helps in providing adequate support and stability, especially if the patient is weak, dizzy, or at risk of falling. Having two people allows for better control over the patient's movement and reduces the risk of accidents or falls during ambulation. Additionally, having an extra person provides assistance in case the patient becomes unsteady or requires immediate support.

An adult has been diagnosed with some type of anemia. The results of his blood tests showed: decreased WBC, normal RBC, decreased HCT, decreased Hgb. Based on these data, which of the following nursing diagnosis should the nurse prioritize as the most important?

  • A. Potential for infection
  • B. Self care deficit
  • C. Alteration in infection
  • D. Fluid volume excess
Correct Answer: A

Rationale: The decreased white blood cell count (WBC) in the blood tests indicates a potential for infection. White blood cells are crucial for fighting off infections in the body. A decrease in WBC count can result in an impaired immune response, making the individual more susceptible to infections. Therefore, the nurse should prioritize the nursing diagnosis of "Potential for infection" to address the heightened risk of infection in the adult with anemia. It is important to monitor for signs and symptoms of infection, provide appropriate hygiene measures, and implement interventions to prevent infections in this individual.

What is the primary nursing intervention to prevent bacterial endocarditis?

  • A. Institute measures to prevent dental procedures.
  • B. Counsel parents of high-risk children about prophylactic antibiotics.
  • C. Observe children for complications, such as embolism and heart failure.
  • D. Encourage restricted mobility in susceptible children.
Correct Answer: B

Rationale: The primary nursing intervention to prevent bacterial endocarditis is to counsel parents of high-risk children about prophylactic antibiotics. This is recommended by the American Heart Association for children with certain heart conditions before dental procedures that could introduce bacteria into the bloodstream. By providing education on the importance of prophylactic antibiotics, nurses can help prevent bacterial endocarditis by reducing the risk of bacterial infection associated with dental procedures in susceptible children. It is important to involve the parents in the decision-making process and ensure they understand the rationale behind the use of prophylactic antibiotics to protect their child's heart health.

Which is the causative agent of scarlet fever?

  • A. Enteroviruses
  • B. Corynebacterium organisms
  • C. Scarlet fever virus
  • D. Group A b-hemolytic streptococci (GABHS)
Correct Answer: D

Rationale: Scarlet fever is caused by Group Aß-hemolytic streptococci (GABHS), particularly Streptococcus pyogenes. This bacteria produces erythrogenic exotoxins that cause the characteristic rash seen in scarlet fever. These toxins also contribute to the other symptoms associated with scarlet fever, such as high fever, sore throat, and a red, bumpy tongue (strawberry tongue). Therefore, the correct causative agent of scarlet fever is Group Aß-hemolytic streptococci (GABHS).

A 4 years old boy presents with low grade fever and malaise. Throat examination reveals a grayish white membrane which is tightly adherent and bleeds on an attempt to remove. The most likely diagnosis is:

  • A. Acute Follicular tonsillitis
  • B. Diphtheria
  • C. Herpetic infection
  • D. Infectious mononucleosis
Correct Answer: B

Rationale: Diphtheria causes a characteristic grayish-white membrane in the throat that bleeds when removed, along with systemic symptoms like fever and malaise.

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