Nokea
During a routine health assessment, the nurse notes that an 8-month-old infant has a significant head lag. Which is the most appropriate action?
- A. Recheck head control at the next visit
- B. Teach the parents appropriate exercises
- C. Schedule the child for further evaluation
- D. Refer the child for further evaluation if the anterior fontanel is still open
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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The nurse is caring for a child with the following order: Methylprednisolone (Solu-Medrol) 20 mg IV, every 6 hours. The nurse has Methylprednisolone 100 mg in 2 mL available. How many mL should the nurse administer with each dose?
- A. 0.4 mL
- B. 0.2 mL
- C. 0.5 mL
- D. 0.6 mL
Correct Answer: A
Rationale: The correct dosage to administer 20 mg is 0.4 mL, calculated by dividing the dose (20 mg) by the concentration (100 mg in 2 mL). This calculation ensures the accurate administration of the prescribed medication. Choices B, C, and D are incorrect as they do not reflect the correct calculation based on the provided concentration of the medication.
The nurse is assessing a child's capillary refill time. This can be accomplished by doing what?
- A. Inspect the chest
- B. Auscultate the heart
- C. Palpate the apical pulse
- D. Palpate the nail bed with pressure to produce a slight blanching
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is performing an oral examination on a preschool child. Which strategies should the nurse use to encourage the child to open the mouth for the examination? (Select all that apply.)
- A. Lightly brush the palate with a cotton swab
- B. Perform the examination in front of a mirror
- C. Let the child examine someone else's mouth first
- D. All of the above
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
At what age is binocularity, the ability to fixate on one visual field with both eyes simultaneously, typically achieved?
- A. 1 month
- B. 3 to 4 months
- C. 6 to 8 months
- D. 12 months
Correct Answer: B
Rationale: Binocularity, the ability to fixate on one visual field with both eyes simultaneously, is typically achieved by the age of 3 to 4 months. Achieving binocularity at 1 month is too early for most infants as their visual system is still developing. Similarly, 6 to 8 months and 12 months are beyond the normal age range for achieving binocularity, and delayed achievement could indicate potential issues like strabismus, which may lead to visual impairment if not addressed.
Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?
- A. Codeine sulfate (Codeine)
- B. Morphine (Roxanol)
- C. Methadone (Dolophine)
- D. Meperidine (Demerol)
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.