Nursing Elites

1. A child who weighs 25 kg is receiving IV ampicillin at a dose of 300 mg/kg/24 hours in equally divided doses every 4 hours. How many milligrams should the nurse administer to the child for each dose?

• A. 1875 mg
• B. 625 mg
• C. 2000 mg
• D. 1500 mg

Correct answer: A

Rationale: To calculate the correct dose for each administration, you first need to find the total daily dose: 300 mg/kg * 25 kg = 7500 mg/day. Since this total dose is divided into equally divided doses every 4 hours, there are 6 doses in 24 hours. Therefore, 7500 mg ÷ 6 doses = 1250 mg per dose. The nurse should administer 1250 mg every 4 hours, resulting in a total of 1875 mg for each dose in a 24-hour period. Choice A, 1875 mg, is the correct answer. Choice B, 625 mg, is incorrect as it does not consider the total daily dose and the frequency of administration. Choice C, 2000 mg, is incorrect as it is not the calculated dosage based on the given parameters. Choice D, 1500 mg, is also incorrect as it does not reflect the correct dosage calculation for each dose.

2. A child with leukemia is admitted for chemotherapy, and the nursing diagnosis 'altered nutrition, less than body requirements related to anorexia, nausea, and vomiting' is identified. Which intervention should the nurse include in this child's plan of care?

• A. Encourage a variety of large portions of food at every meal.
• B. Allow the child to eat any food desired and tolerated.
• C. Recommend eating the food as siblings eat at home.
• D. Restrict food brought from fast food restaurants.

Correct answer: B

Rationale: Allowing the child to eat any food desired and tolerated is the most appropriate intervention for a child with altered nutrition due to anorexia, nausea, and vomiting. It is crucial to prioritize maintaining adequate nutritional intake, and by allowing the child to choose foods they desire and can tolerate, the chances of improving their nutritional status increase. This approach helps in ensuring that the child receives necessary nutrients during chemotherapy, even if their appetite is affected by the treatment. Encouraging a variety of large portions of food at every meal (Choice A) may overwhelm the child and worsen their symptoms. Recommending eating the food as siblings eat at home (Choice C) may not align with the child's preferences and tolerances. Restricting food brought from fast food restaurants (Choice D) is not suitable as it may limit the child's options and preferences during a challenging time.

3. The mother of a 14-year-old who had a below-the-knee amputation for osteosarcoma tells the nurse that her child is angry and blaming her for allowing the amputation to occur. Which response is best for the nurse to provide?

• A. I will ask the HCP for a psychiatric consult for your child
• B. This type of acting out behavior is normal for adolescents
• C. It is important to focus on your child's needs at this difficult time
• D. A reaction of anger is your child's attempt to cope with this loss

Correct answer: D

Rationale: Acknowledging the child's anger as a coping mechanism helps validate their feelings and can open a dialogue for further support.

4. When caring for a 4-year-old child diagnosed with celiac disease, the parent asks about foods to avoid. Which response by the nurse is correct?

• A. Avoid all dairy products
• B. Avoid foods containing wheat, barley, and rye
• C. Avoid all foods high in sugar
• D. Avoid foods with artificial coloring

Correct answer: B

Rationale: Celiac disease is managed with a strict gluten-free diet, necessitating the avoidance of foods containing wheat, barley, and rye. Gluten is found in these grains and can trigger an immune response in individuals with celiac disease, leading to damage to the small intestine. Therefore, it is essential for individuals with celiac disease, including children, to carefully avoid gluten-containing foods to maintain their health and well-being.

5. The healthcare provider is assessing an infant with diarrhea and lethargy. Which finding should the provider identify that is consistent with early dehydration?

• A. Tachycardia
• B. Bradycardia
• C. Dry mucous membranes
• D. Decreased skin turgor

Correct answer: A

Rationale: Tachycardia is a common early sign of dehydration in infants. It is important for healthcare providers to be vigilant in monitoring infants with these symptoms, as prompt intervention is crucial to prevent further complications.

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