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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.
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A 4-year-old child with a history of frequent ear infections is brought to the clinic by the parents who are concerned about the child's hearing. What is the nurse's priority action?
- A. Perform a hearing test
- B. Inspect the child's ears for drainage
- C. Refer the child to an audiologist
- D. Ask the parents about the child's speech development
Correct Answer: B
Rationale: The nurse's priority action should be to inspect the child's ears for drainage. This immediate assessment can provide valuable information about the presence of infection or fluid accumulation, which can directly impact the child's hearing. By identifying any signs of drainage, the nurse can promptly address any current issues affecting the child's ear health and hearing abilities.
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.
What action should the nurse implement when the infusion of chemotherapy via an implanted medication port is complete for a 16-year-old with acute myelocytic leukemia at the outpatient oncology clinic?
- A. Administer Zofran
- B. Obtain blood samples for RBCs, WBCs, and platelets
- C. Flush mediport with saline and heparin solution
- D. Initiate an infusion of normal saline
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The parents of a 2-year-old child with a history of febrile seizures are being taught by the healthcare provider. Which statement by the parents indicates a need for further teaching?
- A. We should give our child acetaminophen when they have a fever.
- B. We should place our child in a cool bath during a seizure.
- C. We should call 911 if the seizure lasts longer than 5 minutes.
- D. We should try to keep our child's fever under control.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A 16-year-old female student with a history of asthma controlled with both an oral antihistamine and an albuterol (Proventil) metered-dose inhaler (MDI) comes to the school nurse. The student complains that she cannot sleep at night, feels shaky and her heart feels like it is 'beating a mile a minute.' Which information is most important for the nurse to obtain?
- A. When she last took the antihistamine.
- B. When her last asthma attack occurred.
- C. Duration of most asthma attacks.
- D. How often the MDI is used daily.
Correct Answer: D
Rationale: The most important information for the nurse to obtain in this scenario is how often the MDI is used daily. This is crucial to assess if the symptoms the student is experiencing, such as insomnia, shakiness, and tachycardia, could be related to overuse of the inhaler. Overuse of albuterol can lead to side effects like tremors, palpitations, and difficulty sleeping, so understanding the frequency of MDI use is key in determining a potential cause for the student's symptoms.