Nursing Elites

1. A healthcare provider is preparing to administer ibuprofen 5 mg per kg every 6 hours PRN for temperatures above 38.0 degrees Celsius or 100.5 degrees Fahrenheit to an infant who weighs 17.6 lb. The infant has a temperature of 38.4 degrees Celsius or 101.2 degrees Fahrenheit. Available is ibuprofen liquid 100 mg/5 ml. How many milliliters should the healthcare provider administer to the infant?

• A. 12 ml
• B. 6 ml
• C. 2 ml
• D. 1 ml

Correct answer: C

Rationale: To calculate the correct dosage, first convert the infant's weight to kilograms: 17.6 lb = 8 kg. The prescribed dose is 5 mg/kg, so for an 8 kg infant, the total dose required is 40 mg. Since the available ibuprofen liquid is 100 mg/5 ml, to find out how many milliliters to administer, divide the total dose (40 mg) by the concentration of the liquid (100 mg/5 ml), which equals 2 ml. Therefore, the healthcare provider should administer 2 ml of ibuprofen to the infant.

2. When caring for a child with hyponatremia, a nurse delegates care to a licensed vocational nurse (LVN) and instructs the LVN to promptly report which clinical manifestation?

• A. Seizures
• B. Respiratory distress
• C. Hyperthermia
• D. Bradycardia

Correct answer: A

Rationale: Seizures are a significant concern in severe hyponatremia as they indicate potential neurological complications and the need for urgent intervention to prevent further harm to the child. Prompt reporting of seizures allows for timely assessment and appropriate treatment to ensure the child's safety and well-being.

3. During a physical assessment of a hospitalized 5-year-old child, the healthcare provider notes that the foreskin has been retracted and is very tight on the shaft of the penis; they are unable to return it over the head of the penis. What action should the healthcare provider implement?

• A. Forcibly push the foreskin down over the head of the penis.
• B. Place a warm compress on the penis.
• C. Notify the healthcare provider in charge.
• D. Wait a few hours and try again.

Correct answer: C

Rationale: The correct action is to notify the healthcare provider in charge of this occurrence of paraphimosis. Paraphimosis is a urologic emergency where the foreskin is retracted and becomes tight, potentially impeding blood flow to the penis. It is crucial to seek medical intervention promptly to prevent complications.

4. The caregiver is providing care to a pediatric client diagnosed with inflammatory bowel disease, who is prescribed daily prednisone. Which caregiver statement regarding administration of this drug indicates correct understanding of the teaching provided by the healthcare provider?

• A. I will administer this medication between meals.
• B. I will administer this medication at bedtime.
• C. I will administer this medication one hour before meals.
• D. I will administer this medication with meals.

Correct answer: D

Rationale: The correct answer is D. Prednisone should be administered with meals to reduce gastrointestinal upset. Taking prednisone with food helps to minimize stomach irritation and other gastrointestinal side effects associated with the medication.

5. A neonate with a meningomyelocele is scheduled for surgery in the morning. Which nursing action is appropriate for this neonate?

• A. Applying a diaper to prevent contamination of the sac
• B. Positioning the newborn in a side-lying position
• C. Encouraging the mother to hold the newborn because she will not be able to pick him up after surgery
• D. Positioning the newborn in a prone position

Correct answer: D

Rationale: Positioning the newborn in a prone position is appropriate for a neonate with a meningomyelocele before surgery. Placing the newborn in this position helps prevent pressure on the sac, reducing the risk of damaging it and promoting optimal surgical outcomes. Applying a diaper (choice A) may not be recommended as it can increase pressure on the sac. Positioning the newborn in a side-lying position (choice B) or encouraging the mother to hold the newborn (choice C) are not ideal actions before surgery as they do not address the specific needs of a neonate with a meningomyelocele.

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