Nokea
A nurse is preparing to administer a dexamethasone 1.5 mg/kg/day PO to divide equally every 6 hr to a preschool-age child who weighs 22 lb. Available is dexamethasone oral solution 1 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
- A. 3.8 mL
- B. 2.8 mL
- C. 4.8 mL
- D. 1.8 mL
Correct Answer: 3.8
Rationale: Calculation: 22 lb ÷ 2.2 = 10 kg; 1.5 mg/kg/day × 10 kg = 15 mg/day; 15 mg ÷ 4 doses = 3.75 mg/dose; 3.75 mg × 1 mL/1 mg = 3.8 mL.
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Medical History
Nurses Notes
Infant has been feeding poorly and has had difficulty gaining weight. Admitted for feeding support and management.
Infant has Tetralogy of Fallot.
A nurse is assisting in the care of an infant who has congenital heart disease.
- A. Place the infant in a knee-chest position.
- B. Administer morphine via IV bolus.
- C. Provide 100% oxygen by face mask.
- D. Request a prescription for a diuretic.
- E. Perform nasopharyngeal suctioning for a maximum of 5 seconds.
- F. Prepare to assist with the insertion of a chest tube.
Correct Answer: A,B,C
Rationale: The knee-chest position morphine and oxygen are indicated for managing tet spells in Tetralogy of Fallot to improve oxygenation and reduce symptoms.
A nurse is caring for an adolescent client who is receiving carbamazepine (Tegretol) for partial seizure disorder. Which of the following statements by the adolescent's parent is the priority for the nurse to address?
- A. He takes his medication between meals with water.
- B. He only sleeps about 5 hours each night.
- C. He seems to be getting a lot more bumps and bruises lately.
- D. He has not been eating as much lately.
Correct Answer: C
Rationale: Increased bruising can indicate thrombocytopeniaa potential side effect of carbamazepine which can lead to serious bleeding issues.
A nurse is caring for a 7-year-old client who has an upper respiratory infection and a history of type 1 diabetes mellitus. Which of the following statements by the mother indicates a need for further instruction?
- A. I will notify the doctor if his temperature is not controlled with acetaminophen.
- B. I will continue to check his blood sugar two times every day.
- C. I will report a change in breathing or signs of confusion.
- D. I will encourage him to drink a half a cup of water or sugar-free fluid every 30 minutes.
Correct Answer: B
Rationale: Checking blood sugar only twice a day is insufficient during illness especially for a child with type 1 diabetes. Blood glucose levels can fluctuate significantly due to infection and more frequent monitoring (at least 4 times a day or as recommended) is necessary.
A nurse is reinforcing discharge instructions with a parent of a child who has cystic fibrosis. Which of the following statements by the parent Indicates an understanding of the teaching?
- A. I will provide low-fat meals for my child.
- B. I will restrict the amount of salt in my child's meals.
- C. I will put my child in daycare to ensure that she socializes with other children.
- D. I will make sure my child washes her hands before eating.
Correct Answer: D
Rationale: Hand hygiene is crucial for preventing infections which are a significant risk for children with cystic fibrosis.
A nurse on a medical-surgical unit is caring for a group of children. Which of the following findings should alert the nurse that one of the children is a potential victim of abuse?
- A. A school-age child who cries when the nurse is giving him an injection
- B. A toddler who has multiple bruises on the shins of both legs and his parents report that he is clumsy
- C. A preschooler who has a BMI indicating obesity
- D. An adolescent who asks to stay in the hospital because he likes the room
Correct Answer: D
Rationale: This might indicate that the adolescent is not feeling safe or comfortable at home which could be a sign of abuse or neglect.