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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.
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After receiving a stem cell transplant, the patient develops a rash and diarrhea. This most likely indicates:
- A. Neutropenia
- B. Radiation toxicity
- C. Gastroenteritis
- D. Graft Vs. Host disease
Correct Answer: D
Rationale: The correct answer is D: Graft Vs. Host disease. This occurs when donor immune cells attack the recipient's tissues, leading to symptoms like rash and diarrhea. Neutropenia (A) is low neutrophil count, not typically causing rash and diarrhea. Radiation toxicity (B) would cause different symptoms, not typically rash and diarrhea. Gastroenteritis (C) typically presents with nausea, vomiting, and abdominal pain, not necessarily rash.
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 16-year-old with a chronic illness has recently become rebellious and is taking risks such as missing doses of his medication. What is the best explanation for this behavior?
- A. The child needs more discipline
- B. The child needs more socialization with peers
- C. The child is exhibiting normal adolescent behavior
- D. The child is demonstrating a need for more parental control
Correct Answer: C
Rationale: The correct answer is C. The child is exhibiting normal adolescent behavior. Adolescence is a period of identity formation, autonomy-seeking, and risk-taking. It is common for teenagers to rebel against authority figures, including parents and healthcare providers, as they strive for independence and self-discovery. This rebellious behavior, such as missing medication doses, can be a way for the teenager to assert control over their own life and make their own decisions. It is crucial for healthcare providers to recognize this normal developmental stage and approach the situation with understanding and support rather than punitive measures.
Other choices are incorrect because:
A: The child needing more discipline implies that the behavior is solely due to a lack of control or structure, which overlooks the developmental aspect of adolescence.
B: While socialization with peers is important, it may not address the underlying reasons for the rebellious behavior.
D: Imposing more parental control may exacerbate the rebellion and hinder the adolescent's autonomy development.
The emergency room nurse is caring for a patient with severe burns knows that the priority immediate intervention is which of the following?
- A. Cover the burns to prevent infection
- B. Provide anti-inflammatory medication
- C. Stop the burning process
- D. Provide anti-cyanide medication
Correct Answer: C
Rationale: The correct answer is C: Stop the burning process. This is the priority immediate intervention for a patient with severe burns because stopping the burning process helps prevent further tissue damage. It involves removing the patient from the source of the burn, extinguishing any flames, and cooling the burn with water. This action is crucial in minimizing the extent of the injury and improving outcomes.
A: Covering the burns to prevent infection is important but not the immediate priority.
B: Providing anti-inflammatory medication can be considered later but is not the primary immediate intervention.
D: Providing anti-cyanide medication is not relevant for severe burns.
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