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A nurse is reviewing the child's medical record. Which of the following medications should the nurse expect the provider to prescribe or reconcile from the child's home medication list?
- A. Water-soluble vitamins
- B. Acetaminophen
- C. Dornase alfa
- D. Meperidine
- E. Pancreatic lipase
Correct Answer: A,C,E
Rationale: The correct answers are A, C, and E. A nurse reviewing a child's medical record should expect the provider to prescribe or reconcile water-soluble vitamins (A) for essential nutrients, Dornase alfa (C) for cystic fibrosis to help clear mucus, and Pancreatic lipase (E) for pancreatic insufficiency to aid in digestion. Acetaminophen (B) is a common over-the-counter pain reliever but may not be specifically required based on the child's condition. Meperidine (D) is a narcotic analgesic with potential side effects and is not typically used in pediatric patients.
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Which of the following actions should the nurse take?
- A. Inform the client to contact the pharmacy regarding any questions related to the medication.
- B. Provide instructions to the client's parent with the client present.
- C. Instruct the client's parents to write down the information that is being provided.
- D. Ask how the client prefers to learn new information.
Correct Answer: D
Rationale: The correct answer is D: Ask how the client prefers to learn new information. This action is client-centered and promotes individualized care by understanding the client's preferred learning style. It helps tailor the teaching approach to best meet the client's needs, leading to improved understanding and compliance.
Choice A is incorrect because the nurse should provide medication information directly to the client instead of redirecting to the pharmacy.
Choice B is incorrect as it does not involve the client in the learning process, which is essential for effective education.
Choice C is incorrect as it focuses on the parents rather than the client, missing the opportunity to engage the client directly.
Overall, choice D stands out for its client-focused approach, making it the most appropriate action in this scenario.
Which of the following laboratory findings should the nurse expect?
- A. Decreased prothrombin time
- B. Increased Hgb level
- C. Increased RBC
- D. Decreased platelet count
Correct Answer: D
Rationale: The correct answer is D: Decreased platelet count. This is expected in a patient with thrombocytopenia, which is a condition characterized by low platelet levels. Thrombocytopenia can lead to abnormal bleeding and bruising due to impaired blood clotting.
A: Decreased prothrombin time would not be expected in thrombocytopenia, as it measures the clotting ability of the plasma, not platelets.
B: Increased Hgb level and C: Increased RBC levels are not typically associated with thrombocytopenia.
In summary, a decreased platelet count is the most relevant laboratory finding to expect in a patient with thrombocytopenia.
Which of the following findings should the nurse expect?
- A. Pinpoint pupils
- B. Ataxia
- C. Hyperactive reflexes
- D. Hypothermia
Correct Answer: B
Rationale: The correct answer is B: Ataxia. Ataxia is a neurological finding characterized by lack of coordination and unsteady gait, commonly seen in conditions like cerebellar dysfunction. Pinpoint pupils (A) suggest opioid toxicity, hyperactive reflexes (C) indicate possible hyperthyroidism or CNS injury, and hypothermia (D) is associated with hypothyroidism or hypothermia. Ataxia is the most relevant finding in this context, indicating a potential neurological issue.
Which of the following clients should the nurse assess first?
- A. A toddler who has a new diagnosis of osteomyelitis and is to receive an IV bolus of nafcillin
- B. An adolescent who is in skin traction and reports a pain level of 7 on a scale from 0 to 10
- C. An adolescent who has sickle cell anemia and slurred speech
- D. A toddler who has a partial-thickness burn on his right hand and requires a dressing change
Correct Answer: C
Rationale: The correct choice is C. The nurse should assess the adolescent with sickle cell anemia and slurred speech first because slurred speech could indicate a potential stroke or other serious neurological complication related to sickle cell disease. It is crucial to prioritize neurological symptoms as they may lead to life-threatening complications if not addressed promptly. Assessing for signs of stroke and providing immediate intervention is essential in this situation. Choices A, B, and D involve pain management and wound care, which are important but not as urgent as addressing potential neurological complications. Therefore, assessing the client with slurred speech is the priority to ensure timely and appropriate intervention.
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.
- A. Instruct the parent to ensure the pneumococcal vaccine is current.
- B. Administer folic acid as prescribed.
- C. Monitor oxygen saturation continuously.
- D. Place the client on strict bed rest.
- E. Apply cold compresses to the affected joints.
- F. Administer meperidine IV for pain.
Correct Answer: B,C,E,F,H
Rationale: The correct interventions for the adolescent are B, C, E, F, and H. Administering folic acid (B) is important for growth and development. Monitoring oxygen saturation (C) ensures respiratory function. Applying cold compresses (E) helps reduce inflammation in affected joints. Administering meperidine IV (F) addresses pain management. The rationale for excluding other choices: A is irrelevant for adolescent care, D may worsen joint symptoms, and G is incomplete.