Nursing Elites

1. When administering IV fluids to a dehydrated infant, what intervention is most important at this time?

• A. Continuing the prescribed flow rate
• B. Monitoring the intravenous drop rate
• C. Calculating the total necessary intake
• D. Maintaining the fluid at body temperature

Correct answer: B

Rationale: Monitoring the intravenous drop rate is the most crucial intervention when administering IV fluids to a dehydrated infant. This ensures that the correct amount of fluids is being delivered to the infant at the appropriate rate. While continuing the prescribed flow rate (Choice A) may be important, it does not allow for real-time adjustments that may be necessary during the infusion. Calculating the total necessary intake (Choice C) should have been determined before initiating IV therapy. Maintaining the fluid at body temperature (Choice D) is important for patient comfort but is not as critical as ensuring the proper administration of fluids.

2. A parent calls the outpatient clinic requesting information about the appropriate dose of acetaminophen for a 16-month-old child who has signs of an upper respiratory tract infection and fever. The directions on the bottle of acetaminophen elixir are 120 mg every 4 hours when needed. At the toddler’s 15-month visit, the healthcare provider prescribed 150 mg. What is the nurse’s best response to the parent?

• A. “The dose is close enough, and it doesn’t really matter which one is given.”
• B. “From your description, the medication is not necessary. It should be avoided at this age.”
• C. “It is appropriate to use dosages based on age. Children typically have weights consistent for their age groups.”
• D. “The prescribed dose of the drug was based on weight, and this is a more accurate way of determining a therapeutic dose.”

Correct answer: D

Rationale: The most accurate way to determine a therapeutic dose for children is based on their weight rather than age. Weight-based dosing accounts for individual variations in drug metabolism and distribution, ensuring a more precise and safer medication administration. Choices A, B, and C are incorrect as they do not address the importance of weight-based dosing in children, potentially leading to inappropriate dosing and safety concerns.

3. A child with diabetes insipidus is being treated with vasopressin. The nurse would assess the child closely for signs and symptoms of which condition?

• A. Syndrome of inappropriate antidiuretic hormone (SIADH)
• B. Thyroid storm
• C. Cushing syndrome
• D. Vitamin D toxicity

Correct answer: A

Rationale: When a child with diabetes insipidus is treated with vasopressin, the nurse should closely monitor for signs and symptoms of Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Vasopressin, also known as antidiuretic hormone, helps retain water in the body. Excessive vasopressin administration can lead to water retention, dilutional hyponatremia, and potentially result in SIADH. Choices B, C, and D are incorrect because they are not directly associated with the use of vasopressin in treating diabetes insipidus.

4. .A child with type 1 diabetes mellitus is being discharged from the hospital. What is important for the nurse to include in the discharge teaching?

• A. Monitor blood glucose levels once a day
• B. Follow a strict meal plan
• C. Administer insulin only when blood glucose is high
• D. Recognize signs of hypoglycemia

Correct answer: D

Rationale: Recognizing signs of hypoglycemia is crucial for managing type 1 diabetes mellitus and preventing complications.

5. A child has been admitted to the pediatric unit with a severe asthma attack. What type of acid-base imbalance should the nurse expect the child to develop?

• A. metabolic alkalosis caused by decreased acid metabolites production
• B. respiratory alkalosis caused by decreased respiratory rate and carbon dioxide retention
• C. respiratory acidosis caused by impaired respirations and increased carbonic acid formation
• D. metabolic acidosis caused by the kidneys' inability to compensate for increased carbonic acid production

Correct answer: C

Rationale: In a severe asthma attack, the child is likely to develop respiratory acidosis due to impaired respirations leading to the retention of carbon dioxide, which combines with water to form carbonic acid. This results in the pH imbalance characterized by an excess of carbonic acid. Choices A, B, and D are incorrect. Metabolic alkalosis (Choice A) is not typically associated with severe asthma attacks; respiratory alkalosis (Choice B) would involve a decrease, not an increase, in carbon dioxide levels; and metabolic acidosis (Choice D) is not the primary acid-base imbalance seen in severe asthma attacks.

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