Nokea
A nurse is caring for a baby that may have sickle cell disease. Which of the following tests should be performed to distinguish sickle cell trait from sickle cell disease?
- A. Hemoglobin electrophoresis
- B. Sickle solubility test
- C. Complete Blood Count (CBC)
- D. International Normalized Ratio (INR)
Correct Answer: A
Rationale: The correct answer is A: Hemoglobin electrophoresis. This test is used to distinguish sickle cell trait from sickle cell disease by separating different types of hemoglobin based on their electrical charge. Sickle cell trait will show a different hemoglobin pattern compared to sickle cell disease.
B: Sickle solubility test is not specific enough to differentiate between sickle cell trait and disease.
C: Complete Blood Count (CBC) provides general information about blood cells but does not specifically differentiate between sickle cell trait and disease.
D: International Normalized Ratio (INR) is used to monitor blood clotting and is not relevant for distinguishing sickle cell trait from disease.
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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 nurse is caring for an infant who has gastroenteritis. Which of the following assessment findings should the nurse report to the provider?
- A. Pale and a 24-hr fluid deficit of 30 mL
- B. Sunken fontanels and dry mucous membranes
- C. Decreased appetite and irritability
- D. Temperature 38° C (100.4° F) and pulse rate 124/min
Correct Answer: B
Rationale: The correct answer is B: Sunken fontanels and dry mucous membranes. These findings indicate severe dehydration in the infant with gastroenteritis. Sunken fontanels suggest significant fluid loss, while dry mucous membranes also indicate dehydration. Dehydration in infants can lead to serious complications, so it is crucial for the nurse to report these findings to the provider promptly.
The other choices are not as concerning as choice B. Choice A indicates a fluid deficit but does not suggest severe dehydration. Choice C could be expected in a sick infant and does not require immediate provider notification. Choice D shows signs of fever and tachycardia, which are common in gastroenteritis and may not be as urgent as severe dehydration.
What is the purpose of pediatric hospice?
- A. Provide pain relief so the child doesn't know they are dying
- B. Extend the dying process so the child and family can say goodbye
- C. Hasten the dying process to stop the suffering
- D. Support the highest quality of life possible for whatever time remains
Correct Answer: D
Rationale: The correct answer is D: Support the highest quality of life possible for whatever time remains. Pediatric hospice aims to provide comprehensive care to children with life-limiting illnesses, focusing on enhancing their quality of life through physical, emotional, and spiritual support. This approach prioritizes symptom management, comfort, and dignity for the child, ensuring they live as fully as possible until the end. Other choices are incorrect because A does not acknowledge the child's awareness, B may not align with the child's wishes, and C goes against the ethical principles of hospice care.
A nurse is caring for a 2-year-old toddler. Which of the following food choices should the nurse recommend to promote independence in eating?
- A. Banana Slices
- B. Grapes
- C. Hot dog
- D. Popcorn
Correct Answer: A
Rationale: The correct answer is A: Banana Slices. Toddlers can easily pick up banana slices with their fingers, promoting independence in self-feeding. Bananas are soft and easy to chew, reducing the risk of choking compared to grapes, hot dogs, and popcorn, which are common choking hazards for young children. Grapes and hot dogs can easily get stuck in a toddler's throat due to their shape and texture. Popcorn is a choking hazard due to its hard and small size. Therefore, recommending banana slices is the safest and most developmentally appropriate choice for promoting independence in eating for a 2-year-old toddler.
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.