A nurse is instructing a school-age child who has asthma about the use of a peak expiratory flow meter. Which of the following instructions should the nurse include?
- A. Place tongue on the mouthpiece of the meter.
- B. Maintain a semi-Fowler's position during testing.
- C. Record the average of the readings.
- D. Blow into the meter as hard and quickly as possible.
Correct Answer: D
Rationale: The correct answer is D: Blow into the meter as hard and quickly as possible. This instruction is correct because when using a peak expiratory flow meter, the individual needs to blow out as forcefully as possible to get an accurate reading of their peak expiratory flow rate. This helps in assessing the severity of asthma symptoms and monitoring the effectiveness of treatment.
A: Placing the tongue on the mouthpiece is incorrect as it may interfere with the airflow and affect the accuracy of the reading.
B: Maintaining a semi-Fowler's position is not necessary for using a peak flow meter.
C: Recording the average of the readings is not typically done with peak flow meters as the focus is on the individual's peak expiratory flow rate.
E, F, G: No other choices were provided.
In summary, blowing into the meter as hard and quickly as possible is the correct instruction for using a peak expiratory flow meter, as it ensures an accurate measurement of peak expir
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The nurse is caring for a preschool age child who just received chemotherapy. The child's mother asks the nurse when it is safe for the child to attend his cousin's birthday party. Which is the correct response:
- A. The best time to attend the party is 7 to 10 days from now.
- B. Any time is a good time, especially if it makes him happy.
- C. About three weeks from today would be the safest time for him to attend a party.
- D. He may need to wait until he's completely finished with chemotherapy.
Correct Answer: C
Rationale: The correct response is C: About three weeks from today would be the safest time for him to attend a party. This answer is correct because chemotherapy can weaken the child's immune system, making him more susceptible to infections. Attending a party with a large number of people increases the risk of exposure to germs. Waiting for about three weeks allows the child's immune system to recover to a safer level before being exposed to a potentially infectious environment.
Choice A is incorrect because 7 to 10 days may not provide enough time for the child's immune system to recover adequately. Choice B is incorrect as it disregards the child's health and safety by prioritizing immediate happiness over well-being. Choice D is incorrect as it may be too restrictive; attending a party may be possible before completing chemotherapy if the child's immune system has recovered sufficiently.
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.
When should children with cognitive impairments be referred for stimulation and educational programs?
- A. As young as possible
- B. As soon as they have the ability to demonstrate verbal communication
- C. At age 3 when schools are required to provide services
- D. At age 5 when schools are required to provide services
Correct Answer: A
Rationale: The correct answer is A: As young as possible. Early intervention for children with cognitive impairments is crucial for optimal development. Early stimulation and educational programs can significantly improve outcomes. The brain's plasticity is highest in early childhood, making it the most effective time for interventions. Waiting until age 3 or 5 (choices C and D) may lead to missed opportunities for crucial development. Choice B limits the intervention to verbal communication, overlooking other important areas. Therefore, referring children as young as possible (choice A) is the best approach to ensure they receive the necessary support and resources early on.
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 preparing your pediatric patient for his cardiac assessment, which element would you start with for the assessment?
- A. Assess peripheral pulses
- B. Auscultate heart rate and rhythm
- C. Evaluate chest rise
- D. Palpate liver margins
Correct Answer: B
Rationale: The correct answer is B: Auscultate heart rate and rhythm. This is the first step in a pediatric cardiac assessment because it provides crucial information about the heart's function. Listening to the heart helps identify any abnormalities in heart sounds, such as murmurs or irregular rhythms, which can indicate underlying cardiac issues. Assessing peripheral pulses (choice A) may be important but comes after evaluating the heart. Evaluating chest rise (choice C) is important for respiratory assessment, not specifically for cardiac assessment. Palpating liver margins (choice D) is more relevant for assessing hepatomegaly, not typically the initial step in a cardiac assessment.