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The nurse is caring for a preschool age child who just received chemotherapy. The child's mother asks the nurse when it is safe for the child to attend his cousin's birthday party. Which is the correct response:
- A. The best time to attend the party is 7 to 10 days from now.
- B. Any time is a good time, especially if it makes him happy.
- C. About three weeks from today would be the safest time for him to attend a party.
- D. He may need to wait until he's completely finished with chemotherapy.
Correct Answer: C
Rationale: The correct response is C: About three weeks from today would be the safest time for him to attend a party. This answer is correct because chemotherapy can weaken the child's immune system, making him more susceptible to infections. Attending a party with a large number of people increases the risk of exposure to germs. Waiting for about three weeks allows the child's immune system to recover to a safer level before being exposed to a potentially infectious environment.
Choice A is incorrect because 7 to 10 days may not provide enough time for the child's immune system to recover adequately. Choice B is incorrect as it disregards the child's health and safety by prioritizing immediate happiness over well-being. Choice D is incorrect as it may be too restrictive; attending a party may be possible before completing chemotherapy if the child's immune system has recovered sufficiently.
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Signs of digoxin toxicity include of the following (Select all that apply):
- A. Vomiting
- B. Poor feeding
- C. Constipation
- D. Bradycardia
Correct Answer: A,B,D
Rationale: The correct signs of digoxin toxicity are vomiting, poor feeding, and bradycardia. Vomiting is a common early sign due to the drug's effect on the gastrointestinal system. Poor feeding can occur as a result of nausea and anorexia. Bradycardia is a classic sign of digoxin toxicity due to its effect on cardiac function. Constipation is not typically associated with digoxin toxicity. In summary, A, B, and D are correct as they align with the expected symptoms of digoxin toxicity, whereas C is incorrect as constipation is not a common sign.
Which is the correct positioning of a child experiencing epistaxis:
- A. The child should be placed in a prone position
- B. The child should be placed in a supine position
- C. The child should be sitting with their head tilted back
- D. The child should sit up and lean forward
Correct Answer: D
Rationale: The correct positioning for a child experiencing epistaxis (nosebleed) is option D: the child should sit up and lean forward. This position helps prevent blood from flowing down the throat, reducing the risk of choking or aspiration. Sitting up also helps to reduce blood pressure in the vessels of the nose, aiding in the clotting process. Placing the child in a prone position (option A) can lead to blood flowing down the throat, causing potential airway obstruction. Placing the child in a supine position (option B) can also lead to blood going down the throat and may increase the risk of aspiration. Sitting with the head tilted back (option C) is not recommended as it can lead to blood running down the back of the throat and potentially into the airway. Therefore, option D is the correct choice for managing epistaxis in a child.
A 15-year-old with type 1 diabetes mellitus presents with a fever and 48-hour history of vomiting. As the nurse, you note the child's breath has a fruity odour, his breathing is deep and rapid, and mom states he has become less arousable. You recognize these are the signs of:
- A. Acute Hypoglycemia
- B. Diabetic Ketoacidosis
- C. Hyperglycemia
- D. Polydipsia
Correct Answer: B
Rationale: The correct answer is B: Diabetic Ketoacidosis (DKA). The fruity odor of breath, deep and rapid breathing (Kussmaul breathing), and altered mental status are classic signs of DKA. In DKA, the body produces excess ketones due to lack of insulin, leading to metabolic acidosis. Acute Hypoglycemia (A) presents with low blood sugar levels, not high as in DKA. Hyperglycemia (C) is a general term for high blood sugar without the specific ketone production seen in DKA. Polydipsia (D) refers to excessive thirst, not the symptoms described in the scenario.
An 18-month-old patient with Down's Syndrome has a history of mild pulmonary hypertension which requires a daily dose of Furosemide (Lasix). The mother is questioning if the new dose is correct after an adjustment at the child's last Cardiology visit. The child weighs 22 pounds and the dosing for furosemide (Lasix) for this child 2mg/kg/dose. What is the appropriate dose of Furosemide Lasix for this child?
- A. 44 mg/dose
- B. 28 mg/dose
- C. 20 mg/dose
- D. 10 mg/dose
Correct Answer: C
Rationale: The correct dose of Furosemide (Lasix) for this child is 20 mg/dose. To calculate the appropriate dose, we first convert the child's weight from pounds to kilograms (22 lbs ÷ 2.2 = 10 kg). Then, we multiply the weight by the recommended dose of 2 mg/kg (10 kg x 2 mg/kg = 20 mg/dose). This calculation ensures proper dosing based on the child's weight. Choices A, B, and D are incorrect because they do not reflect the correct dosage calculation based on the child's weight.
Fentanyl 30mcg IV is ordered. The vial contains 0.05mg/ml. How many ml should the nurse administer?
- A. 0.3 ml
- B. 3 ml
- C. 0.06 ml
- D. 0.6 ml
Correct Answer: D
Rationale: To calculate the amount of Fentanyl to administer, first convert 30mcg to mg by dividing by 1000 (30mcg = 0.03mg). Then, divide the dose by the concentration of the vial (0.03mg ÷ 0.05mg/ml = 0.6ml). The correct answer is D (0.6ml). Choice A (0.3ml) is incorrect because it doesn't account for the correct dosage calculation. Choice B (3ml) is incorrect as it is too high, leading to potential overdose. Choice C (0.06ml) is incorrect as it miscalculates the dosage based on the vial concentration.