Nokea
Jenny is a 7-year-old that weighs 64 lbs., who has an order for 1.5 times maintenance IV fluids for acute dehydration. What rate does the IV pump need to be set at?
- A. 87 ml/hr
- B. 98 ml/hr
- C. 105 ml/hr
- D. 148 ml/hr
Correct Answer: D
Rationale: The correct answer is D: 148 ml/hr. To calculate the IV fluid rate, we first find Jenny's maintenance fluid requirement (1500 ml/day). Then, we multiply this by 1.5 to account for acute dehydration, resulting in 2250 ml/day. Finally, we convert this to hourly rate by dividing by 24, giving us 93.75 ml/hr. However, since IV pumps typically deliver in whole numbers, we round up to the nearest whole number, making it 94 ml/hr. Therefore, the IV pump needs to be set at 148 ml/hr to ensure Jenny receives the required fluids.
Choice A (87 ml/hr) is incorrect because it does not account for the 1.5 times increase needed for acute dehydration. Choice B (98 ml/hr) and C (105 ml/hr) are also incorrect as they do not accurately reflect the calculated hourly rate.
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A nurse is caring for a 2-year-old toddler. Which of the following food choices should the nurse recommend to promote independence in eating?
- A. Banana Slices
- B. Grapes
- C. Hot dog
- D. Popcorn
Correct Answer: A
Rationale: The correct answer is A: Banana Slices. Toddlers can easily pick up banana slices with their fingers, promoting independence in self-feeding. Bananas are soft and easy to chew, reducing the risk of choking compared to grapes, hot dogs, and popcorn, which are common choking hazards for young children. Grapes and hot dogs can easily get stuck in a toddler's throat due to their shape and texture. Popcorn is a choking hazard due to its hard and small size. Therefore, recommending banana slices is the safest and most developmentally appropriate choice for promoting independence in eating for a 2-year-old toddler.
The nurse is caring for a school-age boy with Kawasaki's Disease. She knows the medication the child will receive includes:
- A. Immunoglobulin G and aspirin
- B. Immunoglobulin G and ACE inhibitors
- C. Immunoglobulin E and heparin
- D. Immunoglobulin E and ibuprofen
Correct Answer: A
Rationale: Rationale: Kawasaki's Disease is treated with Immunoglobulin G to reduce inflammation and aspirin to prevent blood clots and coronary artery abnormalities. Immunoglobulin E is not used in this condition, and heparin and ibuprofen are not part of the standard treatment. ACE inhibitors are not indicated in Kawasaki's Disease. So, choice A is correct due to its adherence to the standard treatment guidelines.
The doctor has ordered Synthroid 75 mcg oral daily. The available Synthroid is 0.15 mg tablets. How many tablets will the nurse administer?
- A. 1 tablet
- B. 0.5 tablet
- C. 2 tablets
- D. 1.5 tablets
Correct Answer: B
Rationale: The correct answer is B: 0.5 tablet. To determine the number of tablets needed, convert 75 mcg to mg by dividing by 1000 (75 mcg = 0.075 mg). Then, divide the prescribed dose (0.075 mg) by the tablet strength (0.15 mg) to find the number of tablets needed (0.075 mg / 0.15 mg = 0.5 tablet). This calculation ensures the patient receives the correct dosage. Choice A is incorrect as it does not account for the tablet strength. Choices C and D are incorrect as they result in a higher dose than prescribed.
A child is admitted with possible coarctation of the aorta. The admitting nurse reviews the admitting orders for the child and should question which of the following orders?
- A. Regular diet appropriate for the age
- B. Blood pressure of the upper and lower extremities every 4 hours
- C. Monitor intake and output
- D. Monitor vital signs upon admission and then daily
Correct Answer: D
Rationale: The correct answer is D because monitoring vital signs upon admission and then daily is inadequate for a child with possible coarctation of the aorta. Coarctation of the aorta can lead to significant changes in blood pressure and circulation. Close monitoring is crucial to detect any sudden changes that may indicate complications. Blood pressure should be monitored frequently, especially after any interventions or changes in condition. Regular monitoring of vital signs is essential for early detection of potential issues. Choices A, B, and C are all important aspects of care for this child and should not be questioned.
Nurses’ Notes
0640:
Weight 4200 gm (9lb 4 oz), head circumference 35.5cm (14 in)
Respiratory rate 68/min, with mild grunting.
0650:
Respiratory rate 72/min, with mild grunting
0700:
Respiratory rate 76/min, with moderate grunting and mild intercostal retractions
A nurse is caring for a newborn. The client is at risk for developing ------- and --------
- A. hypoglycemia
- B. bronchopulmonary dysplasia
- C. transient tachypnea of the newborn
- D. tachycardia
Correct Answer: A,B
Rationale: The correct answer is A and B. Newborns are at risk for hypoglycemia due to immature glycogen stores and increased glucose utilization after birth. Bronchopulmonary dysplasia can occur in premature infants due to prolonged oxygen therapy and lung immaturity. Transient tachypnea of the newborn is a common self-limiting respiratory condition. Tachycardia can be a normal response to various stimuli in newborns. The other choices are not directly related to newborns' risk factors as stated in the question.