Nursing Elites

1. The healthcare provider prescribes Amoxicillin 500mg PO every 8hrs for a child who weighs 22 pounds. The available suspension is labeled Amoxicillin Suspension 250mg/5ml. The recommended maximum dose is 50mg/kg/24hr. How many mL should the nurse administer in a single dose based on the child’s weight?

• A. 10mL
• B. 15mL
• C. 7.5mL
• D. 5mL

Correct answer: A

Rationale: To calculate the dose for the child weighing 22 pounds, first convert the weight to kg: 22 lbs ÷ 2.2 = 10 kg. The maximum dose based on weight would be 10 kg × 50 mg/kg/24hr = 500 mg/24hr. Since the medication is prescribed every 8 hours, the dose for each administration would be 500 mg ÷ 3 doses = 166.67 mg. As the available suspension is 250mg/5ml, the nurse should administer 166.67 mg ÷ 250 mg/mL = 0.67 mL per dose. However, since it's not practical to administer a fraction of a milliliter, the nurse should round up to the nearest appropriate dose, which is 10mL.

2. An infant with tetralogy of Fallot becomes acutely cyanotic and hyperneic. Which action should the nurse implement first?

• A. Place the infant in a knee-chest position.
• B. Administer morphine sulfate.
• C. Start intravenous fluids.
• D. Provide 100% oxygen by face mask.

Correct answer: A

Rationale: In a tetralogy of Fallot situation, placing the infant in a knee-chest position is the initial priority to help increase systemic vascular resistance, which reduces the right-to-left shunt and improves oxygenation. This position can assist in optimizing oxygen levels before considering other interventions. Administering morphine sulfate (choice B) is not the first-line treatment for tetralogy of Fallot crisis. Starting intravenous fluids (choice C) may be necessary but is not the priority in this situation. Providing 100% oxygen by face mask (choice D) may not fully address the underlying issue of decreased systemic vascular resistance that leads to cyanosis in tetralogy of Fallot.

3. When assessing a child with HIV, which system should the nurse assess first?

• A. Assess the respiratory system.
• B. Assess the gastrointestinal system.
• C. Assess the cardiovascular system.
• D. Assess the neurological system.

Correct answer: A

Rationale: When assessing a child with HIV, it is essential to prioritize assessing the respiratory system first. Children with HIV are more susceptible to respiratory infections and complications, such as pneumonia, due to their weakened immune system. Identifying any respiratory issues early on can help in prompt intervention and management, thus improving outcomes for the child.

4. After a client delivered vaginally 2 days ago, what information should you share with her if she wants to resume using her diaphragm for birth control?

• A. The diaphragm is the most effective form of contraception.
• B. The diaphragm must be refitted after childbirth.
• C. Vaseline lubricant should be used when inserting the diaphragm.
• D. The diaphragm should be inserted 2 to 4 hours before intercourse.

Correct answer: B

Rationale: After childbirth, the diaphragm must be refitted to ensure a proper fit and effectiveness. Changes in the body post-delivery can affect the fit of the diaphragm, making it necessary to get refitted. Choice A is incorrect because while the diaphragm can be effective, it is not the most effective form of contraception. Choice C is incorrect because oil-based lubricants like Vaseline can damage latex diaphragms. Choice D is incorrect because the diaphragm should be inserted no more than 2 hours before intercourse, not 2 to 4 hours.

5. A new mother calls the nurse stating that she wants to start feeding her 6-month-old child something besides breast milk, but is concerned that the infant is too young to start eating solid foods. How should the nurse respond?

• A. Advise the mother to wait at least another month before starting any solid foods.
• B. Instruct the mother to offer a few spoons of 2 or 3 pureed fruits at each meal.
• C. Reassure the mother that the infant is old enough to eat iron-fortified cereal.
• D. Encourage the mother to schedule a developmental assessment of the infant.

Correct answer: C

Rationale: At 6 months, infants are generally ready to start eating iron-fortified cereals as their iron stores begin to deplete. Introducing iron-fortified cereals at this age helps meet the infant's nutritional needs, particularly for iron, which becomes deficient as the infant's iron reserves diminish. It is a safe and appropriate first food to introduce to infants around 6 months of age, along with continued breastfeeding or formula feeding. Choice A is incorrect because waiting another month is not necessary if the infant is 6 months old. Choice B is incorrect as introducing pureed fruits as the first food may not provide the necessary iron that the infant needs at this stage. Choice D is also incorrect as scheduling a developmental assessment is not indicated solely based on the desire to start solid foods; it is more appropriate to reassure the mother about starting iron-fortified cereal.

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