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Solumedrol 1.5mg/kg is ordered for a child weighing 74.8 pounds. Solumedrol is available as 125mg/2ml. How many ml must the nurse administer?
- A. 0.62ml
- B. 0.062ml
- C. 0.82ml
- D. 0.082ml
Correct Answer: C
Rationale: To calculate the dose of Solumedrol, first convert the child's weight to kg: 74.8 lbs / 2.2 = 34 kg. Then, calculate the dose: 1.5 mg/kg * 34 kg = 51 mg. Next, determine how many ml is needed: 51 mg / 125 mg/ml = 0.408 ml, which is rounded up to 0.82 ml. Choice A is incorrect because it is too low. Choice B is incorrect as it is much lower than the calculated dose. Choice D is incorrect as it is also too low.
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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 nurse is caring for a newborn whose mother was taking methadone during her pregnancy, which of the following findings indicates the newborn is experiencing withdrawal?
- A. Bulging fontanels
- B. Acrocyanosis
- C. Bradycardia
- D. Hypertonicity
Correct Answer: D
Rationale: The correct answer is D: Hypertonicity. Newborns exposed to opioids in utero often exhibit symptoms of withdrawal, known as Neonatal Abstinence Syndrome (NAS). Hypertonicity, or increased muscle tone, is a common sign of NAS. This occurs due to the withdrawal effects of methadone on the central nervous system. Bulging fontanels (A) are not typically associated with NAS. Acrocyanosis (B) is a common finding in newborns and not specific to NAS. Bradycardia (C) refers to a slow heart rate and is not a typical sign of NAS.
A six-year-old is scheduled for a cardiac catheterization. Preoperative teaching should be:
- A. Directed to the parents because the patient is too young to understand
- B. Detailed regarding the actual procedure so the patient will know what to expect
- C. Completed several days prior to the procedure so the patient will be prepared
- D. Adapted to the patient's development level
Correct Answer: D
Rationale: The correct answer is D because preoperative teaching for a six-year-old undergoing cardiac catheterization should be adapted to the patient's development level. This is crucial as it ensures the information is communicated in a way that the child can comprehend and reduces anxiety. Providing information at the appropriate developmental stage helps the child feel more prepared and less fearful. Choice A is incorrect as children as young as six can understand basic concepts with appropriate communication techniques. Choice B may overwhelm the child with unnecessary details. Choice C is incorrect because waiting too long to provide information may increase anxiety.
A child with a history of diabetes mellitus presents with sweating, confusion, and slurred speech. The nurse suspects the cause is:
- A. Hyperglycemia
- B. Hyperkalemia
- C. Hyponatremia
- D. Hypoglycemia
Correct Answer: D
Rationale: The correct answer is D: Hypoglycemia. In a child with a history of diabetes mellitus, sweating, confusion, and slurred speech indicate low blood sugar levels. Hypoglycemia can lead to neuroglycopenic symptoms like confusion and slurred speech. Hyperglycemia (choice A) would present with polyuria, polydipsia, and fruity breath. Hyperkalemia (choice B) can cause muscle weakness and cardiac arrhythmias. Hyponatremia (choice C) typically presents with weakness, fatigue, and confusion. In this case, the symptoms point towards hypoglycemia as the most likely cause.
Your patient has just returned from the OR following an arterial septal defect repair. You are reviewing your orders and question the fluid rate ordered. Your patient is 6 years old and weighs 50 pounds. Select the appropriate hourly maintenance fluid rate for your patient.
- A. 63 ml/hr
- B. 64 ml/hr
- C. 65 ml/hr
- D. 107 ml/hr
Correct Answer: A
Rationale: The appropriate hourly maintenance fluid rate for a 6-year-old patient weighing 50 pounds can be calculated using the Holliday-Segar method, which recommends 100 ml/kg/day for the first 10 kg of body weight, 50 ml/kg/day for the next 10 kg, and 20 ml/kg/day for each additional kg. Converting the patient's weight from pounds to kg (50 lbs / 2.2 = 22.73 kg), the calculation would be:
100 ml x 10 kg + 50 ml x 10 kg + 20 ml x 2.73 kg = 1000 ml + 500 ml + 54.6 ml = 1554.6 ml/day
To convert this to an hourly rate, divide by 24 hours: 1554.6 ml/day / 24 hours = 64.775 ml/hr, which rounds down to 63 ml/hr (Option A).
The other choices are incorrect because