Nokea
Which are appropriate actions to manage a hospitalized child with hemophilia? (Select all that apply).
- A. Administer Factor VII for bleeding crises
- B. Administer platelets for bleeding crises
- C. Avoid unnecessary skin punctures
- D. Administer Ibuprofen for complaints of discomfort
Correct Answer: A,C
Rationale: The correct answers are A and C. Administering Factor VII helps in managing bleeding crises in hemophiliac patients. Factor VII aids in clotting, essential for stopping bleeding. Avoiding unnecessary skin punctures reduces the risk of bleeding episodes in hemophilia patients. Platelets (B) and Ibuprofen (D) are not appropriate for managing hemophilia. Platelets do not address the underlying clotting factor deficiency in hemophilia, and Ibuprofen can worsen bleeding due to its antiplatelet effects.
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The doctor has ordered Synthroid 75 mcg oral daily. The available Synthroid is 0.15 mg tablets. How many tablets will the nurse administer?
- A. 1 tablet
- B. 0.5 tablet
- C. 2 tablets
- D. 1.5 tablets
Correct Answer: B
Rationale: The correct answer is B: 0.5 tablet. To determine the number of tablets needed, convert 75 mcg to mg by dividing by 1000 (75 mcg = 0.075 mg). Then, divide the prescribed dose (0.075 mg) by the tablet strength (0.15 mg) to find the number of tablets needed (0.075 mg / 0.15 mg = 0.5 tablet). This calculation ensures the patient receives the correct dosage. Choice A is incorrect as it does not account for the tablet strength. Choices C and D are incorrect as they result in a higher dose than prescribed.
A sign specific to red blood cell destruction (hemolytic) anemia is:
- A. Jaundice
- B. Pica
- C. Anorexia
- D. Tachycardia
Correct Answer: A
Rationale: Jaundice is the correct answer for red blood cell destruction anemia because it results from the breakdown of red blood cells, causing an increase in bilirubin levels. Jaundice presents as yellowing of the skin and eyes. Pica (eating non-food items), anorexia (loss of appetite), and tachycardia (rapid heart rate) are not specific signs of hemolytic anemia. Jaundice is a key indicator due to the excess bilirubin released from the destruction of red blood cells.
Nurses’ Notes
0640:
Weight 4200 gm (9lb 4 oz), head circumference 35.5cm (14 in)
Respiratory rate 68/min, with mild grunting.
0650:
Respiratory rate 72/min, with mild grunting
0700:
Respiratory rate 76/min, with moderate grunting and mild intercostal retractions
A nurse is caring for a newborn. The client is at risk for developing ------- and --------
- A. hypoglycemia
- B. bronchopulmonary dysplasia
- C. transient tachypnea of the newborn
- D. tachycardia
Correct Answer: A,B
Rationale: The correct answer is A and B. Newborns are at risk for hypoglycemia due to immature glycogen stores and increased glucose utilization after birth. Bronchopulmonary dysplasia can occur in premature infants due to prolonged oxygen therapy and lung immaturity. Transient tachypnea of the newborn is a common self-limiting respiratory condition. Tachycardia can be a normal response to various stimuli in newborns. The other choices are not directly related to newborns' risk factors as stated in the question.
The nurse is providing education to the parents of an infant with cradle cap. Which of the following statements by the parents indicates their understanding?
- A. We should use hydrogen peroxide as shampoo for my child until it is resolved
- B. We should expect that my child will probably have asthma & allergies too
- C. We should brush the loosened crusts out of the hair after shampooing
- D. We should decrease the frequency that I wash my child's hair to once a week
Correct Answer: C
Rationale: The correct answer is C: "We should brush the loosened crusts out of the hair after shampooing." This statement indicates understanding as brushing the loosened crusts helps to remove the scales and prevent further build-up. Hydrogen peroxide (A) is not recommended for cradle cap as it can irritate the skin. Asthma and allergies (B) are not directly related to cradle cap. Decreasing hair wash frequency to once a week (D) can worsen cradle cap by allowing build-up of oils and dead skin cells.
Your patient has just returned from the OR following an arterial septal defect repair. You are reviewing your orders and question the fluid rate ordered. Your patient is 6 years old and weighs 50 pounds. Select the appropriate hourly maintenance fluid rate for your patient.
- A. 63 ml/hr
- B. 64 ml/hr
- C. 65 ml/hr
- D. 107 ml/hr
Correct Answer: A
Rationale: The appropriate hourly maintenance fluid rate for a 6-year-old patient weighing 50 pounds can be calculated using the Holliday-Segar method, which recommends 100 ml/kg/day for the first 10 kg of body weight, 50 ml/kg/day for the next 10 kg, and 20 ml/kg/day for each additional kg. Converting the patient's weight from pounds to kg (50 lbs / 2.2 = 22.73 kg), the calculation would be:
100 ml x 10 kg + 50 ml x 10 kg + 20 ml x 2.73 kg = 1000 ml + 500 ml + 54.6 ml = 1554.6 ml/day
To convert this to an hourly rate, divide by 24 hours: 1554.6 ml/day / 24 hours = 64.775 ml/hr, which rounds down to 63 ml/hr (Option A).
The other choices are incorrect because