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A nurse is caring for an adolescent with a closed femur fracture who also has HIV. What type of precautions should the nurse institute?
- A. The patient should be placed on neutropenic precautions due to the risk of osteomyelitis
- B. The patient should be placed on standard precautions to diminish the risk of HIV transmission
- C. The patient should be placed on contact precautions to prevent contact with blood or bloody fluid
- D. The patient should be placed on isolation once the HIV status is suspected
Correct Answer: B
Rationale: The correct answer is B: The patient should be placed on standard precautions to diminish the risk of HIV transmission. Standard precautions are used for all patients to prevent the transmission of infection. In this case, the adolescent has a closed femur fracture and HIV, so the nurse should follow standard precautions, which include hand hygiene, wearing gloves, and using personal protective equipment as needed. Neutropenic precautions (choice A) are not necessary unless the patient has a low white blood cell count. Contact precautions (choice C) are used for specific infections that are spread by direct contact with the patient or their environment. Isolation (choice D) is not required solely based on HIV status.
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A nurse is providing discharge teaching to the parents of a toddler who has cystic fibrosis. Which of the following instructions should the nurse include?
- A. Perform chest percussion and postural drainage at least twice daily.
- B. Restrict intake of foods that contain gluten.
- C. Administer pancreatic enzymes on an empty stomach.
- D. Use a nebulizer to administer a bronchodilator following airway clearance therapy.
Correct Answer: A
Rationale: The correct answer is A: Perform chest percussion and postural drainage at least twice daily. This is crucial in managing cystic fibrosis as it helps to loosen and clear mucus from the lungs. Chest percussion and postural drainage can improve lung function and reduce the risk of respiratory infections. Restricting intake of foods that contain gluten (B) is not necessary for cystic fibrosis. Administering pancreatic enzymes on an empty stomach (C) is important but not the priority in this case. Using a nebulizer to administer a bronchodilator following airway clearance therapy (D) is helpful but not as essential as chest percussion and postural drainage.
An 18-month-old patient with Down's Syndrome has a history of mild pulmonary hypertension which requires a daily dose of Furosemide (Lasix). The mother is questioning if the new dose is correct after an adjustment at the child's last Cardiology visit. The child weighs 22 pounds and the dosing for furosemide (Lasix) for this child 2mg/kg/dose. What is the appropriate dose of Furosemide Lasix for this child?
- A. 44 mg/dose
- B. 28 mg/dose
- C. 20 mg/dose
- D. 10 mg/dose
Correct Answer: C
Rationale: The correct dose of Furosemide (Lasix) for this child is 20 mg/dose. To calculate the appropriate dose, we first convert the child's weight from pounds to kilograms (22 lbs ÷ 2.2 = 10 kg). Then, we multiply the weight by the recommended dose of 2 mg/kg (10 kg x 2 mg/kg = 20 mg/dose). This calculation ensures proper dosing based on the child's weight. Choices A, B, and D are incorrect because they do not reflect the correct dosage calculation based on the child's weight.
When assessing the child with atopic dermatitis, the nurse should ask the parents about a history of:
- A. Asthma
- B. Nephrosis
- C. Otitis media
- D. Neurotoxicity
Correct Answer: A
Rationale: The correct answer is A: Asthma. Atopic dermatitis is commonly associated with other allergic conditions, such as asthma. Asking about a history of asthma can help identify potential triggers and comorbidities. Nephrosis, otitis media, and neurotoxicity are not typically associated with atopic dermatitis, making choices B, C, and D incorrect. Always focus on relevant factors to provide effective care.
A nurse is caring for a newborn whose mother was taking methadone during her pregnancy, which of the following findings indicates the newborn is experiencing withdrawal?
- A. Bulging fontanels
- B. Acrocyanosis
- C. Bradycardia
- D. Hypertonicity
Correct Answer: D
Rationale: The correct answer is D: Hypertonicity. Newborns exposed to opioids in utero often exhibit symptoms of withdrawal, known as Neonatal Abstinence Syndrome (NAS). Hypertonicity, or increased muscle tone, is a common sign of NAS. This occurs due to the withdrawal effects of methadone on the central nervous system. Bulging fontanels (A) are not typically associated with NAS. Acrocyanosis (B) is a common finding in newborns and not specific to NAS. Bradycardia (C) refers to a slow heart rate and is not a typical sign of NAS.
A 4-year-old, 44-pound Autistic patient is admitted to the ED with concerns of dehydration. He has been ordered to receive a 20ml/kg fluid bolus of normal saline over 30 minutes. At what rate would you set the IV pump?
- A. 880 ml/hour
- B. 800 ml/hour
- C. 440 ml/hour
- D. 400 ml/hour
Correct Answer: A
Rationale: The correct answer is A: 880 ml/hour. To calculate the IV pump rate, first, determine the total volume to be infused: 20 ml/kg x 44 lbs = 880 ml. Next, divide the total volume by the total time in hours: 880 ml / 1 hour = 880 ml/hour. This rate ensures the patient receives the prescribed fluid bolus over 30 minutes. Choice B is incorrect as it does not account for the specific weight of the patient. Choices C and D are incorrect as they do not follow the correct calculation based on the patient's weight.