Nokea
The physician orders an intravenous infusion of 5% dextrose in 0.25 normal saline to be infused at 2 mL/kg/hour in an infant who weighs 9 lb. How many milliliters per hour of the solution should the nurse infuse? Round to one decimal.
- A. 8.2 mL/hour
- B. 9.0 mL/hour
- C. 7.4 mL/hour
- D. 6.8 mL/hour
Correct Answer: A
Rationale: 9 lb = 4.08 kg; 2 mL/kg/hour × 4.08 kg = 8.16 mL/hour, rounded to 8.2.
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A father of a child with a urinary tract infection calls the clinic and explains, "My wife and I are concerned because our child refuses to obey us concerning the preventions you told us about. Our child refuses to take the medication unless we buy a present. We don't want to use discipline because of the illness, but we're worried about the behavior." Which response by the nurse is best?
- A. I sympathize with your difficulties
- B. but just ignore the behavior for now.
- C. I understand it's hard to discipline a child who is ill
- D. but things need to be kept as normal as possible.
- E. I understand that things are difficult for you right now
- F. but your child is ill and deserves special treatment.
- G. I understand your concern
Correct Answer: B
Rationale: Maintaining routines is essential.
A nurse is reviewing a hospital's protocol for managing pediatric ingestions. Which step should be prioritized in the protocol?
- A. Administer an antidote immediately.
- B. Obtain a detailed history of the ingestion.
- C. Perform a physical examination.
- D. Order laboratory tests.
Correct Answer: B
Rationale: A detailed history (substance, amount, time) guides management decisions. Antidotes, exams, or labs follow based on history findings.
Discharge teaching for a 3-month-old infant with a cardiac defect who is to receive digoxin (Lanoxin) should include which of the following?
- A. Give the medication at regular intervals.
- B. Mix the medication with a small volume of breast milk or formula.
- C. Repeat the dose one time if the child vomits immediately after administration.
- D. Notify the primary care provider of poor feeding or vomiting.
- E. Make up any missed doses as soon as realized.
- F. Notify the primary care provider if more than 2 consecutive doses are missed.
- G. Keep medication in a safe place, preferably a locked cabinet.
Correct Answer: A,C,D,F,G
Rationale: Digoxin requires regular dosing, safe storage, and monitoring for side effects like vomiting or poor feeding. Vomiting doses should not be repeated due to toxicity risks, and missed doses should not be made up.
The school nurse develops a plan with an adolescent to provide relief of dysmenorrhea to aid in her development of which of the following?
- A. Positive peer relations.
- B. Positive self-identity.
- C. A sense of autonomy.
- D. A sense of independence.
Correct Answer: C
Rationale: Managing dysmenorrhea supports autonomy by empowering the adolescent to control her health.
A 14-year-old is using glargine (Lantus) and lispro (Humolog) to manage type I diabetes. The order for sliding scale lispro reads: Lispro subcutaneous give units according to sliding scale: Blood glucose: 70-150 mg/dL = 0 units, 151-200 mg/dL = 1 unit, 201-250 mg/dL = 2 units, 251-300 mg/dL = 3 units, 301-350 mg/dL = 4 units, Call for Blood glucose >350. In addition give 1 unit for every 15 grams of carbohydrate. The morning blood glucose is $202 \mathrm{mg} / \mathrm{dL}$ and the client is going to eat 2 carbohydrate exchanges. The nurse has the client administer how many units of lispro?
Correct Answer: 4
Rationale: Blood glucose of 202 mg/dL requires 2 units (sliding scale). Two carbohydrate exchanges (30 g) require 2 units (1 unit/15 g). Total: 2 + 2 = 4 units of lispro.