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An 8-month-old infant who will be admitted for surgery
A nurse is reinforcing teaching with the parents of an 8-month-old infant who will be admitted for surgery. Which of the following instructions should the nurse include in the teaching?
- A. You should begin to manipulate the infant's bedtime based on the hospitals visiting hours.
- B. You should bring the infant's favorite blanket to the hospital
- C. You should read the child a story about hospitalization.
- D. You will need to go home when it is not visiting hours.
Correct Answer: B,C
Rationale: The correct answer is B and C. Bringing the infant's favorite blanket to the hospital (B) provides comfort and familiarity in an unfamiliar environment, reducing anxiety. Reading the child a story about hospitalization (C) can help prepare the child for the upcoming experience, easing fears.
Choice A is incorrect because manipulating bedtime based on visiting hours disrupts the infant's routine. Choice D is incorrect as parents are usually allowed to stay with their child in the hospital. Choices E, F, and G are not provided in the question.
In summary, choices B and C are crucial for providing comfort and emotional support to the infant before surgery, while the other options either disrupt the routine or are not necessary for the child's well-being during hospitalization.
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A child who is postoperative following the insertion of a ventriculoperitoneal shunt
A nurse is caring for a child who is postoperative following the insertion of a ventriculoperitoneal shunt. The nurse should place the child in which of the following positions?
- A. A 45 degree head elevation
- B. On the nonoperative side
- C. Prone
- D. Supine
Correct Answer: D
Rationale: The correct answer is D: Supine. Placing the child in a supine position promotes proper drainage and prevents obstruction of the ventriculoperitoneal shunt. Supine position helps maintain a neutral head position, reducing the risk of complications. A 45-degree head elevation (choice A) can increase intracranial pressure, which is contraindicated in this case. Placing the child on the nonoperative side (choice B) or prone (choice C) can potentially cause kinking or obstruction of the shunt tubing.
A child with pneumonia who weighs 20 lb
Primary care provider orders cefazolin (Kefrol) 30 mg/kg in two divided doses per day for a child with pneumonia. Child weighs 20 lb. If the available oral suspension is 125 mg/5ml how many mls per dose should the child receive?
- A. 5.4 mL
Correct Answer: A
Rationale: To calculate the dose, we first convert the child's weight to kg: 20 lb / 2.2 = 9.09 kg. Next, we calculate the total daily dose: 30 mg/kg * 9.09 kg = 272.7 mg/day. Since the dose is divided into 2, each dose is 272.7 mg / 2 = 136.35 mg. To find the volume needed, we divide the dose by the concentration of the suspension: 136.35 mg / 125 mg/5ml = 1.09 ml. However, the dose is divided into two, so each dose is 1.09 ml * 2 = 2.18 ml. Rounded to 1 decimal, the child should receive 2.2 ml per dose, closest to option A: 5.4 ml. Other choices are incorrect as they do not align with the calculated dose.
A hospitalized 2-year-old child who has a tantrum when a parent leaves
A nurse is caring for a hospitalized 2-year-old child who has a tantrum when a parent leaves. Which of the following actions should the nurse take?
- A. Give the child a stuffed animal.
- B. Inform the child that her parent will be back in 2 hr.
- C. Call the parent to return to the child's room.
- D. Leave the child alone in the room for 5 min.
Correct Answer: A
Rationale: The correct answer is A: Give the child a stuffed animal. Offering the child a stuffed animal can provide comfort and a sense of security, helping to calm the child during the parent's absence. This action promotes emotional support and may help to reduce the child's anxiety.
Other choices are incorrect:
B: Informing the child about the parent's return time may not effectively address the immediate emotional distress.
C: Calling the parent back may not be feasible or necessary for every instance of separation anxiety.
D: Leaving the child alone can exacerbate feelings of fear and abandonment, potentially escalating the tantrum.
An infant who has developmental dysplasia of the hip (DDH)
A nurse is collecting data from an infant who has developmental dysplasia of the hip (DDH). Which of the following findings should the nurse expect?
- A. Inwardly turned foot on the affected side
- B. Lengthened thigh on the affected side
- C. Absent plantar reflexes
- D. Asymmetric thigh folds
Correct Answer: A,D
Rationale: The correct answers are A and D. In DDH, an inwardly turned foot on the affected side (A) is expected due to hip dislocation. Asymmetric thigh folds (D) are also common as the affected thigh may appear shorter due to dislocation. Lengthened thigh (B) is incorrect as the thigh may appear shortened. Absent plantar reflexes (C) are not typical in DDH.
An 8-year-old child who has sickle cell anemia and is recovering from a vaso-occlusive crisis
A nurse is caring for an 8-year-old child who has sickle cell anemia and is recovering from a vaso-occlusive crisis. Which of the following precautions should the nurse include in the discharge teaching?
- A. Drink eight glass of fluid daily.
- B. Maintain an updated hemophilus influence type b immunisation
- C. Avoid playground activities at school
- D. Assume postural drainage positions every 6 hrs
Correct Answer: A
Rationale: The correct answer is A: Drink eight glasses of fluid daily. This is crucial for children with sickle cell anemia to prevent dehydration, which can trigger vaso-occlusive crises. Adequate hydration helps maintain blood flow and prevent sickling of red blood cells. Maintaining an updated hemophilus influenzae type b immunization (choice B) is important for preventing infections but is not directly related to vaso-occlusive crises. Avoiding playground activities at school (choice C) is unnecessary as long as the child is careful and stays hydrated. Assuming postural drainage positions every 6 hours (choice D) is not relevant for sickle cell anemia management.