1 A child diagnosed with asthma begins corticosteroid treatments. The nurse
explains to the parents that the purpose of corticosteroid treatment is to
... [Show More] produce
which therapeutic effect?
Incorrect: Dilation of the bronchial airways is common in treating asthma.
Albuterol is a common medication.
Incorrect: Bronchospasms are usually reduced by B-2 agonists and
bronchodilators.
Incorrect: Infections are treated by antibiotics but not indicated in the treatment of
asthma unless lung congestion is noted.
Correct: Corticosteroid usage is common for decreasing inflammation of the
bronchial airways.Dilation of bronchial airways
Decrease bronchospasms
Prevention of infection
Anti-inflammatory effect
2 Which is the recommended treatment for moderate to severe lead poisoning?
Incorrect: IV fluids are typically not used in the treatment of lead poisoning. IV
fluids area conservative treatment regimen and are not indicated for treatment of
lead poisoning; a more radical therapy is needed to remove the lead from the body.
Incorrect: Treatment with antiemetic is not effective in the treatment of lead
toxicity because the heavy metal is absorbed into the body. Lead ingestion usually
occurs more than one time.
Correct: The heavy metal antagonist, edetate calcium disodium, is frequently
the drug of choice for the removal of the lead toxin from the body. Chelating
agents inactivate the toxicity of the lead and cause excretion through the
urine. Others drugs may treat the symptoms of toxicity rather than remove
the lead from the body. Untreated lead toxicity can lead to a wide array of
neurobehavioral problems include: attention deficit-hyperactivity disorder,
reduced cognitive performance, irritability or lethargy, aggressiveness, and
hearing impairment. The most serious and irreversible side effect of lead
poisoning is encephalopathy, which is associated with lead levels > 100 mg/
dL.
Incorrect: Antibiotics have no effect on the removal of the toxin.
IV fluids
Antiemetics
Heavy metal antagonist
Antibiotics3 Which treatment is a nursing priority when providing care for an infant
diagnosed with bacterial meningitis?
Incorrect: Cardiorespiratory monitoring is standard for care of the child with
bacterial meningitis as a means of establishing the baseline parameters for vital
signs. The infant with meningitis may have a low baseline heart rate, tachypnea or
fever. This however, is not the priority nursing intervention.
Incorrect: The initiation of IV fluids for hydration and nutrition is a primary
concern for the care of the infant with bacterial meningitis. However, the most
important intervention is starting antibiotic therapy.
Incorrect: Meningococcal meningitis is the only type of meningitis spread through
air-born droplets and therefore, respiratory precautions need to be initiated as soon
as possible. Respiratory isolation is important for the control of transmission of the
disease after the child receives the first doses of antibiotics.
Correct: The first nursing priority is the implementation of antibiotic therapy,
which prohibits the microbial damage to the neurologic system through the
cerebral spinal fluid. Bacterial meningitis has a high rate of infant morbidity
(illness) or mortality (death). Immediate treatment with antibiotics can
prevent: death, deafness, reduced cognitive ability, attention
deficithyperactive disorder, seizures and various other complications.
Initiate cardiorespiratory monitoring.
Initiate intravenous fluids.
Observe respiratory isolation.
Administer antibiotic therapy.
4 The dosage of a pediatric medication is 120mg/kg/day to be give t.i.d. The
patient weighs 12 pounds. What is the correct dose for the nurse to administer?
Incorrect: The dose of 120 mg is half the indicated dose. The erred dosage
represents a failure to divide the total daily dose by the number of individual
dosages required per day. The failure to use the weight in the calculation is
evident.Incorrect: The dosage of 480 mg is an excessive dose for the child. The calculation
error is likely a failure to convert pounds to kilograms.
Correct: The patient weighs twelve pounds. This weight converts to kilograms
by dividing 12 by 2.2 (1 kg. = 2.2 lb.). In this example, the child's weight
converts to 5.4 kg. The daily dose of 120 mg is given t.i.d: each individual dose
is 40 mg/kg. Then multiply the weight in kilograms by the individual dose
(40mg). The individual dose is 218 mg.
Incorrect: The dose of 650 mg is too large of a dose. The weight of the child when
converting from pounds to kilograms is 5.45 kg. The dose is ordered to be given
t.i.d.. Therefore, the daily dose of 120 mg/kg/day is divided by 3 to yield an
individual dose of 40 mg/kg/dose. The error is this dosage was likely a failure to
divide the total daily dose by the number of doses required per day.
120 mg 480
mg 218 mg
651 mg
5 In a child diagnosed with Tetralogy of Fallot, which of the following is a
compensatory mechanism to decrease venous return to the heart?
Correct: Squatting is a compensatory mechanism that decreases venous
return (deoxygenated blood) to the heart. The clinical sign is commonly seen
in young children with Tetralogy of Fallot (a type of cyanotic heart disease).
The signs associated with cyanotic heart disease include hypoxia, poor growth,
low tolerance for physical exertion, cardiomegaly, murmur and acute,
intermittent blue spells that occur after crying or feeding (tet spells).
Incorrect: Clubbing is found in children with chronic respiratory disease and
cyanotic heart disease. However, this finding is rare in young children.
Incorrect: Shortness of breath, retractions and increased respiratory effort occur
with lung dysfunction. Generally, the child with impaired oxygenation due to a
cardiac lesion does not exhibit signs of respiratory distress.Incorrect: Polycythemia is common in children with hypoxia due to respiratory or
cardiac dysfunction. This compensatory mechanism increases the oxygen-.
carrying capacity in the body. The effect is not related to the venous return of
unoxygenated blood to the heart.
Squatting
Clubbing
Shortness of breath
Polycythemia
6 A 1-year-old receives routine health maintenance care at the pediatric clinic. The
child receives an MMR immunization. The mother asks the nurse, "When will my
child get the next dose of MMR vaccine?" Which is the correct response by the
nurse?
Incorrect: The DPT vaccine is routinely given in six months.
Incorrect: An additional dose of MMR vaccine is needed in the middle school
years to maintain full immunity from the diseases.
Incorrect: The first dose of Hepatitis B vaccine (HBV) is given in the hospital
prior to discharge home. A follow-up HBV is given in 1-2 months and followed up
in 6-12 months following the second does. The schedule does not coordinate with
the routine immunization schedule for MMR.
Correct: A second MMR, often called a booster, will be needed when the child
enters middle school at age eleven or twelve years of age.
In six months with the next DPT
No further vaccination needed
With the Hepatitis B series
After the child is 10 years of age7 Which is a major difference in the clinical manifestation of adolescents with
anorexia nervosa compared to bulimia?
Incorrect: Binge eating is a common manifestation of both disorders.
Incorrect: Purging can be associated with both disorders.
Correct: The major difference between adolescents with anorexia nervosa and
adolescents with bulimia is body image distortion. Clients with anorexia see
themselves as being overweight no matter how underweight they become.
Clients with bulimia see their weight realistically but have psychological
problems that manifest in an eating disorder.
Incorrect: Decreased self-esteem is often a catalyst of both disorders.
Binge eating
Purging
Body image distortion
Decreased self esteem
8 Which is the most common factor associated with non-organic failure to thrive?
Incorrect: A cool, drafty sleeping area is not a comfortable environment for sleep,
but is unrelated as a cause of failure to thrive.
Correct: The most significant factor associated with non-organic failure to
thrive is typically a disturbance in the mother/child relationship. A situation
involving dysfunctional family relationships is often complex; characterized
by marital discord, economic pressures, and parental immaturity with a low
stress tolerance.
Incorrect: Lack of interest in the surroundings is a symptom of failure to thrive but
not an etiologic factor.
Incorrect: The financial hardship related to the expense of infant formula is not
usually a primary cause of non-organic failure to thrive. The Women's Infant and
Children program (WIC) provides infant formula at a low or no cost witheligibility. Therefore, the disorder is not likely to be related to obtaining adequate
nutrition but instead related to the ability of the infant to consume, digest, and
utilize the nutritive source.
A cool, drafty area for sleeping
Disturbance of mother/child relationship
Lack of interest in the surroundings
Financial hardship causing poor nutritional care
9 An adolescent recovering from substance abuse is diagnosed with hepatitis B.
Which nursing instruction should be included when planning the client's care?
Incorrect: During periods of acute hepatitis, the client needs plenty of rest.
Correct: The mode of the transmission in hepatitis B is via the parenteral
route through blood products, intravenous injection and maternal-fetal trans
placental transmission. It is extremely important for the nurse to educate the
family about the relationship between intravenous exposure and the
transmission of the disease.
Incorrect: Fluid intake is not limited in the treatment of hepatitis B.
Incorrect: Eating a diet high in fat is contraindicated because of the liver
involvement.
Increase exercise.
Avoid sharing needles.
Limit fluid intake.
Eat a diet high in fat.
10 Changes in the growth and development of the preschooler are characterized by:Incorrect: Continued rapid physical growth is not common for this developmental
level.
Incorrect: Major changes in weight, height and head circumference have usually
already taken place prior to this developmental level.
Correct: Physical growth slows in the preschool years. Preschoolers enjoy
social contacts. Preschoolers are gaining control of their muscles and
participate in vigorous activities with other children.
Incorrect: Improvement in motor ability is rapid at this developmental level as the
children are gaining control of their muscles.
Preschoolers' gait resembles that of an adult.
Rapid physical growth and a persistent curiosity.
Major changes in weight, height and head circumference.
A slowing of physical growth and expansion of social contacts.
A slow improvement in motor ability. [Show Less]