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The parent of an 11-year-old client who has juvenile idiopathic arthritis tells the nurse, 'I really don't want my child to become dependent on pain medication, so I only allow taking the medication when the pain is really bad.' Which information is most important for the nurse to provide this parent?
- A. Giving pain medication around the clock helps control the pain.
- B. The use of hot baths can be used as an alternative for pain medication.
- C. The child should be encouraged to rest when experiencing pain.
- D. Encourage quiet activities such as watching television as a pain distracter.
Correct Answer: A
Rationale: Scheduled pain medication maintains consistent pain control, reduces inflammation, and prevents severe pain episodes in juvenile idiopathic arthritis, improving mobility and preventing joint damage.
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A child who weighs 25 kg receives a prescription for isoniazid 10 mg/kg/day by mouth once a day. The bottle is labeled 'Isoniazid Oral Solution, USP 50 mg per 5 mL.' How many mL should the nurse administer?
- A. 25 mL
Correct Answer: A
Rationale: For a 25 kg child, the dose is 250 mg/day (25 kg × 10 mg/kg). With a concentration of 50 mg/5 mL (10 mg/mL), the volume is 250 mg ÷ 10 mg/mL = 25 mL.
A 34-week gestation multigravida comes to the clinic for her bimonthly appointment. Which assessment finding should the nurse report to the healthcare provider (HCP)?
- A. 1+ edema on her lower extremities.
- B. Fundal height of 30 cm.
- C. Weight gain of 2 pounds (0.91 kg).
- D. Fetal heart rate of 110 beats/minute.
Correct Answer: B
Rationale: Fundal height of 30 cm is below the expected range (32-36 cm) for 34 weeks gestation, suggesting possible intrauterine growth restriction (IUGR) or oligohydramnios, which requires further evaluation. Mild edema is common, weight gain is normal, and a fetal heart rate of 110 bpm is within the acceptable range.
A preschool-aged child who is experiencing respiratory distress is brought to the emergency department by the parents. The child is anxious, has a temperature of 102.8° F (39.3° C), and is drooling from the mouth while leaning forward when sitting. Which action should the nurse implement next?
- A. Begin prescribed intravenous antibiotic administration.
- B. Schedule the child for a STAT magnetic resonance imaging (MRI) of the neck.
- C. Obtain bedside trays for intubation or tracheotomy by the healthcare provider.
- D. Provide a nebulizer treatment with bronchodilators.
Correct Answer: C
Rationale: Symptoms suggest epiglottitis, requiring immediate airway management. Intubation/tracheotomy trays are critical to address potential airway obstruction.
The nurse is providing discharge instructions to the caregiver of an infant with recurrent otitis media. Which statement made by the caregiver should the nurse recognize as needing additional education about minimizing subsequent infections?
- A. Avoid any smoking inside the house.
- B. Give infant the full course of antibiotics.
- C. Schedule visit for pneumococcal vaccine.
- D. Instill benzocaine otic drops regularly.
Correct Answer: D
Rationale: Benzocaine otic drops provide pain relief but do not prevent infections. Regular use may mask symptoms, delaying treatment. Avoiding smoke, completing antibiotics, and vaccinating reduce infection risk.
A nurse is speaking with a client who is addicted to heroin and who just learned that she is pregnant. The client states, 'I just started taking methadone. Is there anything else I can do to make sure my baby is healthy?' Which information should the nurse provide?
- A. Describe genetic testing protocols.
- B. Sign up for group therapy sessions.
- C. Start a prenatal care plan as soon as possible.
- D. Discontinue the methadone right away.
Correct Answer: C
Rationale: Early prenatal care monitors methadone effects, fetal development, and complications like neonatal abstinence syndrome, ensuring a healthy pregnancy.