a male toddler is brought to the emergency center approximately three hours after swallowing tablets from his grandmothers bottle of digoxin lanoxin w
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Nursing Elites

HESI RN

Pediatric HESI

1. What intervention should the nurse implement first for a male toddler brought to the emergency center approximately three hours after swallowing tablets from his grandmother's bottle of digoxin (Lanoxin)?

Correct answer: A

Rationale: Administering activated charcoal is the priority intervention as it binds with digoxin, preventing further absorption in the gastrointestinal tract. This helps reduce the amount of digoxin available for systemic circulation and minimizes its toxic effects. Gastric lavage is no longer recommended due to potential complications and lack of evidence of efficacy. Obtaining an electrocardiogram may help assess the effects of digoxin toxicity, but it is not the initial priority. IV digoxin immune fab (Digibind) is used in severe cases of digoxin toxicity but is not the first-line intervention.

2. A child with Graves' disease who is taking propranolol (Inderal) is seen in the clinic. The nurse should monitor the child for which therapeutic response?

Correct answer: B

Rationale: The correct answer is B: 'Decreased heart rate.' Propranolol is a beta-blocker commonly used to manage symptoms of hyperthyroidism, including tachycardia. Monitoring for a decreased heart rate is important as it indicates the drug's therapeutic response in controlling the elevated heart rate associated with Graves' disease. Choices A, C, and D are incorrect because weight gain, reduced headaches, and diminished fatigue are not typical therapeutic responses to propranolol in the context of managing Graves' disease.

3. According to Erikson's theory, what behavioral pattern should be displayed by a child who has not developed a sense of competence?

Correct answer: D

Rationale: Erikson's theory of psychosocial development outlines that the failure to establish a sense of competence during the industry vs. inferiority stage results in feelings of inferiority. This stage occurs during middle childhood where children strive to master skills and tasks. If they are unable to meet challenges successfully, they may start feeling inferior to their peers and may lack confidence in their abilities. Choices A, B, and C are incorrect as guilt, shame, and alienation are not the specific behavioral patterns associated with the lack of developing a sense of competence according to Erikson's theory.

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

Correct answer: C

Rationale: In a situation where an infant with tetralogy of Fallot is acutely cyanotic and hyperpneic, the priority action should be to place the infant in a knee-chest position. This position helps increase systemic vascular resistance, improving pulmonary blood flow and subsequently ameliorating the cyanosis and hyperpnea. It is a non-invasive and effective intervention that can be promptly implemented by the nurse to address the immediate respiratory distress. Administering morphine sulfate (Choice A) is not the priority in this case as it may cause further respiratory depression. Starting IV fluids (Choice B) may not address the immediate cyanosis and hyperpnea. Providing 100% oxygen by face mask (Choice D) can help with oxygenation but may not be as effective as placing the infant in a knee-chest position to improve blood flow dynamics.

5. Which drink choice on a hot day indicates that a teenager with sickle cell anemia understands dietary considerations related to the disease?

Correct answer: D

Rationale: Lemonade is the correct choice for a teenager with sickle cell anemia as it provides hydration without caffeine, which is important for individuals with this condition. Caffeine can lead to dehydration, vasoconstriction, and potentially worsen symptoms in sickle cell anemia patients. Milkshake (choice A) may contain dairy, which can be high in fat and may not be the best choice for someone with sickle cell anemia. Iced tea (choice B) and diet cola (choice C) both contain caffeine, which should be avoided by individuals with sickle cell anemia due to its dehydrating effects.

Similar Questions

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A mother brings her school-aged daughter to the pediatric clinic for evaluation of her anti-epileptic medication regimen. What information should the nurse provide to the mother?
A child receives a prescription for amantadine 42 mg PO BID. Amantadine is available as a 50 mg/5 mL syrup. Using a supplied calibrated measuring device, how many mL should be administered per dose? (Round to the nearest tenth.)
When should a mother introduce solid foods to her 4-month-old baby girl? The mother states, 'My mother says I should put rice cereal in the baby's bottle now.' The nurse should instruct the mother to introduce solid foods when her child exhibits which behavior?
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