Nokea
What action should the nurse implement when the infusion is complete for a 16-year-old with acute myelocytic leukemia receiving chemotherapy via an implanted medication port at the outpatient oncology clinic?
- A. Administer Zofran
- B. Obtain blood samples for RBCs, WBCs, and platelets
- C. Flush the mediport with saline and heparin solution
- D. Initiate an infusion of normal saline
Correct Answer: C
Rationale: After completing the chemotherapy infusion via the implanted medication port, the nurse should flush the mediport with saline and heparin solution. This action helps prevent clot formation in the port, ensuring its patency for future use and reducing the risk of complications associated with catheter occlusion.
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A child with Graves' disease who is taking propranolol (Inderal) is seen in the clinic. The nurse should monitor the child for which therapeutic response?
- A. Increased weight gain
- B. Decreased heart rate
- C. Reduced headaches
- D. Diminished fatigue
Correct Answer: B
Rationale: When a child with Graves' disease is prescribed propranolol (Inderal), the nurse should monitor for a decreased heart rate as a therapeutic response. Propranolol is a beta-blocker that acts to slow down the heart rate, which is beneficial in managing the symptoms of Graves' disease, such as tachycardia and other cardiovascular manifestations.
What is the recommended analgesia for a practical nurse to use in preparing a school-age child for a lumbar puncture (LP)?
- A. Ondansetron (Zofran) 4 mg / 5 ml PO TID.
- B. Codeine 10 mg PO 30 minutes before the procedure.
- C. A transdermal fentanyl (Duragesic) patch immediately before the procedure.
- D. EMLA (eutectic mixtures of local anesthetics) 2.5 hours before the procedure.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
When developing a behavior modification program for an extremely aggressive 10-year-old boy, what should the nurse do first?
- A. Determine what activities, foods, and toys the child enjoys
- B. Evaluate the child's previous reactions to punishment
- C. Provide the child with positive feedback
- D. Encourage other children on the unit to describe the token system
Correct Answer: A
Rationale: The first step in developing a behavior modification program for an aggressive child is to determine what activities, foods, and toys the child enjoys. By understanding the child's preferences, the nurse can tailor the program to be more engaging and effective, increasing the likelihood of success in modifying the aggressive behavior.
The nurse is conducting an admission assessment of an 11-month-old infant with CHF who is scheduled for repair of restenosis of coarction of the aorta that was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower extremities, pounding brachial pulses, and slightly palpable femoral pulses. What pathophysiologic mechanisms support these findings?
- A. The aortic semilunar valve obstructs blood flow into the systemic circulation
- B. The lumen of the aorta reduces the volume of the blood flow to the lower extremities
- C. The pulmonic valve prevents adequate blood volume into the pulmonary circulation
- D. An opening in the atrial septum causes a murmur due to a turbulent left to right shunt
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A two-year-old child with heart failure is admitted for replacement of a graft for coarctation of the aorta. Prior to administering the next dose of digoxin (Lanoxin), the nurse obtains an apical heart rate of 128 bpm. What action should the nurse take?
- A. Determine the pulse deficit.
- B. Administer the scheduled dose.
- C. Calculate the safe dose range.
- D. Review the serum digoxin level.
Correct Answer: B
Rationale: Administering the scheduled dose is appropriate in this scenario as the heart rate of 128 bpm falls within the acceptable range for a two-year-old child with heart failure. It indicates that the child may benefit from the therapeutic effects of digoxin. Monitoring the heart rate closely after administration is essential to ensure the medication's effectiveness and safety.