Nokea
Which is an effective strategy to reduce the stress of burn dressing procedures for a 6-year-old child?
- A. Give the child as many choices as possible
- B. Reassure the child that dressing changes are not painful
- C. Explain to the child why analgesics cannot be used
- D. Encourage the child to master stress with controlled passivity
Correct Answer: A
Rationale: The correct answer is A: Give the child as many choices as possible. By providing the child with choices, you empower them and give them a sense of control over the situation, reducing feelings of helplessness and stress. This strategy helps the child feel more involved and less anxious during the burn dressing procedure. Choices B, C, and D are incorrect because reassuring the child about pain, explaining why analgesics cannot be used, or encouraging controlled passivity may not directly address the child's emotional distress and lack of control in the situation. It is essential to prioritize the child's emotional well-being and sense of autonomy in managing stress during medical procedures.
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A 4-year-old, 44-pound Autistic patient is admitted to the ED with concerns of dehydration. He has been ordered to receive a 20ml/kg fluid bolus of normal saline over 30 minutes. At what rate would you set the IV pump?
- A. 880 ml/hour
- B. 800 ml/hour
- C. 440 ml/hour
- D. 400 ml/hour
Correct Answer: A
Rationale: The correct answer is A: 880 ml/hour. To calculate the IV pump rate, first, determine the total volume to be infused: 20 ml/kg x 44 lbs = 880 ml. Next, divide the total volume by the total time in hours: 880 ml / 1 hour = 880 ml/hour. This rate ensures the patient receives the prescribed fluid bolus over 30 minutes. Choice B is incorrect as it does not account for the specific weight of the patient. Choices C and D are incorrect as they do not follow the correct calculation based on the patient's weight.
A nurse is caring for a school-age child who is postoperative and received morphine via IV bolus for pain 10 min ago. Which of the following findings is the nurse's priority?
- A. Constipation
- B. Sedation
- C. Bradypnea
- D. Euphoria
Correct Answer: C
Rationale: The correct answer is C: Bradypnea. This is the priority finding because morphine, an opioid, can cause respiratory depression leading to bradypnea or slow breathing. Monitoring the child's respiratory status is crucial to prevent respiratory compromise or arrest. A: Constipation is a common side effect but not an immediate concern. B: Sedation is expected after receiving morphine but not as critical as respiratory depression. D: Euphoria is a possible side effect but not as concerning as respiratory depression. Thus, the priority is to monitor for signs of respiratory depression to ensure the child's safety.
To help the adolescent deal with diabetes, the nurse must consider which developmental characteristic of adolescence?
- A. Desire to be unique
- B. Preoccupation with the future
- C. Need to be perfect and similar to peers
- D. Need to make peers aware of the seriousness of hypoglycemic reactions
Correct Answer: C
Rationale: The correct answer is C: Need to be perfect and similar to peers. During adolescence, individuals often have a strong desire to fit in and be accepted by their peers, leading to a need to conform and be similar to their peers. This characteristic is important to consider when helping an adolescent deal with diabetes as it may impact their adherence to treatment and management of their condition. Choices A, B, and D are incorrect because while adolescents may have a desire to be unique or preoccupied with the future, these characteristics are not specifically related to managing diabetes. Additionally, the need to make peers aware of hypoglycemic reactions may not be the most effective or appropriate way to manage the condition.
Which explanation regarding cardiac catheterization is appropriate for a preschool child?
- A. Postural drainage will be performed every 4 to 6 hours after the test
- B. It is necessary to be completely asleep during the test
- C. The test is short, usually taking less than 1 hour
- D. When the procedure is done, you will have to keep your leg straight until after dinnertime
Correct Answer: D
Rationale: The correct answer is D because preschool children may not fully understand the importance of keeping still after cardiac catheterization. Keeping the leg straight helps prevent bleeding at the insertion site. Choice A is incorrect as postural drainage is not related to cardiac catheterization. Choice B is incorrect as sedation, not complete sleep, is usually used. Choice C is incorrect as the procedure can take longer than an hour.
You are the nurse caring for a 3-year-old, 33-pound child on digoxin. The safe dose range for digoxin is 20-40 mcg/kg/day. The order is for digoxin to be given IV every 12 hours, what is the maximum safe single dose the child should receive?
- A. 300 mcg
- B. 600 mcg
- C. 660 mcg
- D. 1320 mcg
Correct Answer: A
Rationale: The correct answer is A: 300 mcg. To determine the maximum safe single dose, we first need to calculate the total daily safe dose range for the child. The child's weight is 33 pounds, which is approximately 15 kg (1 kg = 2.2 lbs). The safe dose range is 20-40 mcg/kg/day, so for a 15 kg child, the total daily safe dose range would be 300-600 mcg/day. Since the medication is given every 12 hours, the maximum safe single dose would be half of the total daily dose, which is 300 mcg. This ensures that the child stays within the safe dose range for digoxin. Choice B (600 mcg) exceeds the maximum daily safe dose, choice C (660 mcg) exceeds the daily safe dose range, and choice D (1320 mcg) is way above the safe dose range for the child's weight.