Nursing Elites

1. Atta, who weighs 20kg, has been prescribed amoxicillin 500 mg b.i.d. The drug information indicates a daily dose of amoxicillin at 50 mg/kg/day in two divided doses. What is the safest dose in milligrams for this child?

• A. 1000 mg
• B. 750 mg
• C. 500 mg
• D. 250 mg

Correct answer: A

Rationale: To calculate the safest dose of amoxicillin for Atta, we multiply the weight (20kg) by the daily dose (50 mg/kg/day) which equals 1000 mg/day. Since the dose is to be given in two divided doses, the safest dose for each administration would be 500 mg. Therefore, the correct answer is 1000 mg, as it aligns with the prescribed dose for this child based on weight and dosing guidelines. Choice B, 750 mg, is incorrect as it does not match the calculated daily dose. Choice C, 500 mg, is incorrect as it represents the safest dose for each administration, not the total daily dose. Choice D, 250 mg, is incorrect as it is below the calculated daily dose required for the child.

2. You and your partner are performing CPR on a 2-year-old female in cardiac arrest. During your resuscitation attempt, you should:

• A. hyperventilate her due to severe hypoxia.
• B. attach the AED pads after 5 minutes of high-quality CPR.
• C. perform compressions and ventilations at a ratio of 30:2.
• D. allow the chest to fully recoil between compressions.

Correct answer: D

Rationale: Allowing the chest to fully recoil between compressions is crucial during CPR to ensure proper blood flow. This action allows the heart to refill with blood, enhancing the effectiveness of compressions and circulation. Hyperventilating the patient can lead to decreased cardiac output and is not recommended. Attaching AED pads should be done as soon as possible in a pediatric cardiac arrest situation, ideally within 2 minutes. The correct compression-to-ventilation ratio for pediatric CPR is 30:2, focusing on high-quality compressions to provide adequate perfusion to vital organs.

3. Which of the following is an abnormal finding when assessing the abdomen of a newborn?

• A. The umbilical cord has two arteries and one vein.
• B. The presence of green vomit.
• C. The liver is palpable 1 to 2 cm below the costal margin.
• D. The abdomen is soft and nondistended.

Correct answer: B

Rationale: The correct answer is B. The presence of green vomit in a newborn is an abnormal finding and indicates a possible intestinal obstruction. This finding requires immediate attention and further investigation. Choices A, C, and D are normal findings in a newborn's abdomen assessment. A newborn typically has an umbilical cord with two arteries and one vein, a liver that may be palpable 1 to 2 cm below the costal margin due to its normal size in a neonate, and a soft, nondistended abdomen as expected in healthy newborns.

4. Which of the following statements regarding SIDS is correct?

• A. SIDS can occur in premature infants.
• B. It is most commonly a result of child abuse.
• C. Death usually occurs during sleep.
• D. SIDS can be prevented by placing the baby on its back to sleep.

Correct answer: C

Rationale: The correct statement regarding SIDS is that death usually occurs during sleep. Sudden Infant Death Syndrome (SIDS) is the unexpected death of a seemingly healthy infant, typically occurring during sleep. The exact cause of SIDS is not fully understood. While placing the baby on its back to sleep is a recommended preventive measure to reduce the risk of SIDS, it cannot guarantee prevention. Choice A is incorrect as SIDS is not limited to premature infants. Choice B is incorrect as SIDS is not primarily caused by child abuse.

5. Fred is a 12-year-old boy diagnosed with pneumococcal pneumonia. Which of the following would Nurse Nica expect to assess?

• A. Mild cough
• B. Slight fever
• C. Chest pain
• D. Bulging fontanel

Correct answer: C

Rationale: Chest pain is a common symptom seen in patients with pneumococcal pneumonia. It can result from inflammation of the pleura or irritation of the diaphragm due to the infection. While cough and fever are also common symptoms, chest pain is particularly significant in pneumonia cases as it can be a distressing symptom for the patient and may indicate complications or severity of the infection. Bulging fontanel, on the other hand, is more indicative of conditions affecting infants and is not typically associated with pneumococcal pneumonia in a 12-year-old boy.

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