Nursing Elites

1. A child who weighs 25 kg is receiving IV ampicillin 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 dose for each administration, multiply the child's weight (25 kg) by the dose (300 mg/kg/24 hours) and divide by the number of doses per day (6, as doses are every 4 hours). This gives us (25 kg * 300 mg/kg / 24 hours) / 6 doses = 1875 mg. Therefore, the nurse should administer 1875 mg for each dose. Choice B, 625 mg, is incorrect as it does not consider the correct calculation based on the weight and prescribed dose. Choice C, 2000 mg, is incorrect as it is not derived from the correct dosage calculation. Choice D, 1500 mg, is incorrect as it does not reflect the accurate dosage calculation based on the weight of the child and the prescribed dose.

2. A parent of a 2-month-old infant, who was treated for pyloric stenosis, is receiving discharge instructions from a healthcare provider. Which statement by the parent indicates a need for further teaching?

• A. We will burp our baby more frequently during feedings
• B. We should feed our baby in an upright position
• C. We will lay our baby on their stomach after feeding
• D. We will start feeding our baby with small, frequent feedings

Correct answer: C

Rationale: Placing infants on their stomach after feeding increases the risk of sudden infant death syndrome (SIDS). It is important to educate parents to always place infants on their back to sleep to reduce this risk.

3. The caregiver is caring for a 10-year-old child with a history of frequent ear infections. The parents are concerned about their child’s hearing and speech development. What is the caregiver’s best response?

• A. Let’s schedule a hearing test and refer to a speech therapist if needed
• B. Most children outgrow ear infections and speech delays
• C. There is no need to worry unless the infections persist into adolescence
• D. Your child’s hearing and speech should be normal by now

Correct answer: A

Rationale: The appropriate response for the caregiver is to address the parents' concerns by suggesting scheduling a hearing test and potentially referring the child to a speech therapist if necessary. This proactive approach can help evaluate and support the child's hearing and speech development effectively. Choice B is incorrect as assuming that most children outgrow ear infections and speech delays may overlook potential issues that need intervention. Choice C is wrong because waiting until adolescence to address concerns may lead to missed opportunities for early intervention. Choice D is incorrect as it dismisses the parents' valid concerns without offering a solution or further evaluation.

4. During a follow-up clinical visit, a mother tells the nurse that her 5-month-old son, who had surgical correction for tetralogy of Fallot, has rapid breathing, often takes a long time to eat, and requires frequent rest periods. The infant is not crying while being held, and his growth is in the expected range. Which intervention should the nurse implement?

• A. Stimulate the infant to cry to produce cyanosis
• B. Auscultate the heart and lungs while the infant is held
• C. Evaluate the infant for failure to thrive
• D. Obtain a 12-lead electrocardiogram

Correct answer: B

Rationale: Auscultating the heart and lungs while the infant is held can provide important diagnostic information in assessing the cardiac and respiratory status of the infant who had surgical correction for tetralogy of Fallot. This intervention can help the nurse identify any abnormal heart or lung sounds, which may indicate complications or issues that need further evaluation or intervention.

5. When planning care for a child diagnosed with rheumatic fever, what is the primary goal of nursing care?

• A. Reduce fever.
• B. Maintain fluid and electrolyte balance.
• C. Prevent cardiac damage.
• D. Maintain joint mobility and function.

Correct answer: C

Rationale: The primary goal of nursing care for a child diagnosed with rheumatic fever is to prevent cardiac damage. Rheumatic fever can lead to complications affecting the heart, making it crucial to monitor and prevent cardiac involvement to avoid long-term consequences. While addressing fever and joint pain are important aspects of care, preventing cardiac damage takes precedence in managing rheumatic fever. Therefore, choices A, B, and D are not the primary goals of nursing care in this case.

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