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. A nurse is providing dietary teaching to the parent of a school-age child with cystic fibrosis. Which of the following statements should the nurse make?

• A. You should offer your child high-protein meals and snacks throughout the day
• B. Your child should decrease dietary fats to less than 10% of their caloric intake
• C. Your child will need to take a 1-gram sodium chloride tablet daily throughout their lifetime
• D. You should calculate your child's carbohydrate needs based on their daily activities

Correct answer: A

Rationale: The parent should provide a well-balanced diet that is high in protein and calories for a child with cystic fibrosis. This diet helps meet the child's increased energy requirements. Offering high-protein meals and snacks throughout the day is essential to ensure adequate nutrition and energy intake for children with cystic fibrosis. Choices B, C, and D are incorrect because children with cystic fibrosis actually need a higher fat intake for proper absorption of fat-soluble vitamins, sodium chloride supplementation is not a general recommendation for all children with cystic fibrosis, and carbohydrate needs are usually based on maintaining adequate weight and growth rather than daily activities.

3. Prior to hydrotherapy treatment for wound debridement following a burn injury, which of the following actions should be taken?

• A. Apply topical antimicrobial ointment to the child's wound
• B. Place a mesh gauze dressing over the child's wound
• C. Administer an analgesic to the child
• D. Initiate prophylactic antibiotic therapy for the child

Correct answer: C

Rationale: Corrected Rationale: Prior to hydrotherapy for wound debridement, it is crucial to administer an analgesic to the preschooler. The procedure is known to be extremely painful, and providing analgesia or sedation is essential to manage the discomfort and pain experienced by the child during the treatment. Choice A is incorrect because applying topical antimicrobial ointment is not a pre-procedural requirement but rather a post-procedure wound care step. Choice B is incorrect as placing a mesh gauze dressing does not address the pain management aspect. Choice D is also incorrect as prophylactic antibiotic therapy is not the primary intervention needed before hydrotherapy for wound debridement.

4. During a vaso-occlusive crisis in sickle cell anemia, what action is crucial for a nurse to take?

• A. Administer meperidine for pain.
• B. Apply cold compresses to the child's joints.
• C. Limit the child's fluid intake.
• D. Maintain bed rest for the child.

Correct answer: D

Rationale: During a vaso-occlusive crisis in sickle cell anemia, maintaining bed rest is crucial to reduce oxygen consumption and alleviate pain. Movement can worsen the crisis by increasing sickling of red blood cells, leading to further tissue damage and pain. Bed rest helps to improve blood flow, reduce pain, and promote healing. Administering meperidine for pain (Choice A) is not recommended due to the risk of normeperidine accumulation and potential neurotoxicity. Applying cold compresses (Choice B) may cause vasoconstriction, worsening the vaso-occlusive crisis. Limiting fluid intake (Choice C) is not appropriate as adequate hydration is essential to prevent dehydration and maintain blood flow.

5. Which clinical manifestation should a nurse monitor for when assessing a pediatric client diagnosed with a basilar skull fracture?

• A. Periorbital ecchymosis
• B. Subdural hematoma
• C. Protruding bone
• D. Epidural hematoma

Correct answer: A

Rationale: Periorbital ecchymosis, also known as raccoon eyes, is a classic sign of a basilar skull fracture. It presents as bruising around the eyes due to blood collecting in the tissues. Monitoring for periorbital ecchymosis is crucial in assessing a pediatric client with a basilar skull fracture because it can indicate the presence of this serious injury.

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