Nokea
A nurse is assessing a child who has bacterial pneumonia. Which of the following manifestations should the nurse expect?
- A. Drooling
- B. Malaise
- C. Tinnitus
- D. Rhinorrhea
Correct Answer: B
Rationale: The correct answer is B: Malaise. In bacterial pneumonia, the body's immune response leads to systemic symptoms like malaise, fatigue, and weakness. This is due to the infection fighting process. Drooling (A) is not a common manifestation of bacterial pneumonia. Tinnitus (C) refers to ringing in the ears and is not associated with pneumonia. Rhinorrhea (D) is more commonly seen in viral respiratory infections.
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A 7-year-old obese child was diagnosed at his 6-year primary care visit with idiopathic hypertension. The family was instructed to modify his diet and begin an exercise program to control the hypertension. At this visit, it was decided the child should begin a low dose of Lisinopril (Zestril) at 0.07 mg/kg/day. The child weighs 99 pounds. What is the correct dose for this child?
- A. 70 mg/day
- B. 30 mg/day
- C. 6 mg/day
- D. 3 mg/day
Correct Answer: D
Rationale: The correct dose for this child is 3 mg/day. To calculate the dose, we first need to convert the child's weight from pounds to kilograms by dividing by 2.2 (99 lbs / 2.2 = 45 kg). Next, we multiply the weight in kg by the prescribed dosage of 0.07 mg/kg/day (45 kg x 0.07 mg/kg/day = 3.15 mg/day). Since the dosing is typically rounded down for safety reasons, the correct dose is 3 mg/day.
Choice A (70 mg/day) is incorrect because it is too high for a child of this weight and could lead to adverse effects. Choice B (30 mg/day) is also too high. Choice C (6 mg/day) is incorrect as it does not reflect the calculated dosage based on the weight of the child. Therefore, the correct answer is D (3 mg/day) based on the calculated dosage per kg for this specific child.
A home health nurse is caring for a child who has lyme disease. Which of the following is an appropriate action for the nurse to take
- A. Ensure the state health department has been notified
- B. Administer antitoxin
- C. Educate the family to avoid sharing personal belongings
- D. Assess for skin necrosis
Correct Answer: B
Rationale: The correct answer is B: Administer antitoxin. Lyme disease is caused by a bacterium, not a toxin, so administering antitoxin is not appropriate. Option A is incorrect because notifying the state health department is not a direct action for the nurse to take in caring for the child. Option C is incorrect as educating the family to avoid sharing personal belongings is a preventive measure but not a direct action for the child's care. Option D is incorrect as skin necrosis is not a typical manifestation of Lyme disease. Administering appropriate antibiotics to treat the bacterial infection is the most appropriate action for the nurse to take in caring for the child with Lyme disease.
Solumedrol 1.5mg/kg is ordered for a child weighing 74.8 pounds. Solumedrol is available as 125mg/2ml. How many ml must the nurse administer?
- A. 0.62ml
- B. 0.062ml
- C. 0.82ml
- D. 0.082ml
Correct Answer: C
Rationale: To calculate the dose of Solumedrol, first convert the child's weight to kg: 74.8 lbs / 2.2 = 34 kg. Then, calculate the dose: 1.5 mg/kg * 34 kg = 51 mg. Next, determine how many ml is needed: 51 mg / 125 mg/ml = 0.408 ml, which is rounded up to 0.82 ml. Choice A is incorrect because it is too low. Choice B is incorrect as it is much lower than the calculated dose. Choice D is incorrect as it is also too low.
The expected finding of Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) include:
- A. Low urine output & increased levels of antidiuretic hormone
- B. Low urine output & decreased levels of antidiuretic hormone
- C. Increased urine output & decreased levels of antidiuretic hormone
- D. Increased urine output & increased levels of antidiuretic hormone
Correct Answer: A
Rationale: The correct answer is A: Low urine output & increased levels of antidiuretic hormone. In SIADH, there is an excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. This results in low urine output as the body retains water. Increased levels of ADH cause the kidneys to reabsorb more water, further contributing to low urine output. The other choices are incorrect because in SIADH, urine output is typically low, and ADH levels are elevated due to the dysregulation of the feedback mechanism that controls ADH release. Increased urine output and decreased levels of ADH (choice C) would be more indicative of diabetes insipidus, a condition characterized by decreased ADH production or kidney insensitivity to ADH.
A child with a history of diabetes mellitus presents with sweating, confusion, and slurred speech. The nurse suspects the cause is:
- A. Hyperglycemia
- B. Hyperkalemia
- C. Hyponatremia
- D. Hypoglycemia
Correct Answer: D
Rationale: The correct answer is D: Hypoglycemia. In a child with a history of diabetes mellitus, sweating, confusion, and slurred speech indicate low blood sugar levels. Hypoglycemia can lead to neuroglycopenic symptoms like confusion and slurred speech. Hyperglycemia (choice A) would present with polyuria, polydipsia, and fruity breath. Hyperkalemia (choice B) can cause muscle weakness and cardiac arrhythmias. Hyponatremia (choice C) typically presents with weakness, fatigue, and confusion. In this case, the symptoms point towards hypoglycemia as the most likely cause.