Nokea
The parents of the child with juvenile rheumatoid arthritis (JRA) ask the nurse why the child cannot have aspirin. The parents further explain that they have heard that aspirin is used in the elderly for arthritis and the use of the patients. The nurse correctly explains that children with JRA are given different medications than adults with arthritis and explains that the toxic effects of aspirin include which manifestations?
- A. Constipation, weight gain, and fluid retention
- B. Ringing in the ears, nausea, and vomiting
- C. Anorexia, weight loss, and double vision
- D. Headache, dry mouth, and dental cavities
Correct Answer: B
Rationale: Aspirin in children can cause toxicity, including tinnitus, nausea, and vomiting, and is avoided due to the risk of Reye's syndrome, especially in children with viral infections.
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A child weighs 22 kg and is prescribed a medication at 5 mg/kg/day in two divided doses. How many milligrams should the nurse administer per dose?
Correct Answer: 55 mg
Rationale: Calculation: 22 kg × 5 mg/kg/day = 110 mg/day. Divided into two doses: 110 ÷ 2 = 55 mg per dose. Since no options are provided, the calculated dose is noted for accuracy.
The nurse evaluates a preterm infant after a gavage feeding. The nurse determines that feeding intolerance has developed when which finding is noted during assessment?
- A. The infant immediately falls asleep after feeding.
- B. The gastric residual is zero prior to the next feeding.
- C. The infant’s abdominal girth has increased in size.
- D. The infant is having soft,loose stools.
Correct Answer: C
Rationale: Increased abdominal girth indicates feeding intolerance suggesting issues like paralytic ileus or NEC. Sleeping zero residual and loose stools are normal.
The primiparous client,who delivered a term newborn is a lesbian,achieved her pregnancy via artificial insemination and is in a monogamous relationship with a female partner. Which intervention should the nurse add to the newborn’s care plan?
- A. Avoid acknowledging the client’s lesbian relationship.
- B. Encourage the client’s partner to participate in newborn cares.
- C. Ask the partner to leave the room when the newborn is present.
- D. Avoid telling the newborn’s caregivers about the client’s situation.
Correct Answer: B
Rationale: Encouraging the partner to participate in newborn care shows respect and promotes bonding similar to heterosexual partners. Ignoring the relationship or excluding the partner is disrespectful.
Which of the following is a priority for the nurse to assess when testing the child's urine?
- A. Blood in the urine
- B. Bilirubin in the urine
- C. Ketones in the urine
- D. White blood cells in the urine
Correct Answer: C
Rationale: In DKA, assessing for ketones in the urine is a priority, as ketonuria confirms the presence of ketones, a hallmark of DKA resulting from fat metabolism due to insulin deficiency.
While supervising the LPN,the RN determines that the LPN needs additional instruction in newborn care. Which action by the LPN prompted the nurse’s conclusion?
- A. Assessed the newborn’s heart rate apically
- B. Covered the newborn’s head with a stocking cap
- C. Checked the newborn’s temperature rectally
- D. Positioned the newborn supine while sleeping
Correct Answer: C
Rationale: Rectal temperature checks risk mucosal irritation or perforation. Apical HR assessment stocking caps and supine positioning (to reduce SIDS risk) are correct practices.