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. During a well-child visit, a 10-year-old child is found to be above the 95th percentile for weight and reports watching more than two hours of television daily. An appropriate nursing diagnosis for this child is:

• A. Imbalanced Nutrition: More than body requirements
• B. Altered Growth and Development
• C. Ineffective Coping
• D. Altered Family Processes

Correct answer: A

Rationale: The correct nursing diagnosis for a 10-year-old child who is above the 95th percentile for weight and watches more than two hours of television daily would be 'Imbalanced Nutrition: More than body requirements.' This diagnosis reflects the excessive intake of nutrients compared to the child's energy expenditure, which can contribute to weight gain. 'Altered Growth and Development' (choice B) is not the most appropriate diagnosis in this scenario, as the primary concern is related to nutrition and sedentary behavior rather than developmental issues. 'Ineffective Coping' (choice C) and 'Altered Family Processes' (choice D) are also not relevant to the child's weight status and television habits. Monitoring and addressing the child's dietary habits and sedentary behavior are essential to promote a healthier lifestyle and prevent further weight-related issues.

3. What is the MOST appropriate method for assessing a small child's level of responsiveness?

• A. Palpate for a radial pulse.
• B. Shout at the child to see if they respond.
• C. Ask the parent about the child's level of responsiveness.
• D. Tap the child and shout, 'Are you okay?'

Correct answer: D

Rationale: When assessing a small child's level of responsiveness, the most appropriate method is to tap the child and shout, 'Are you okay?' This approach is more likely to elicit a response from the child, providing a direct assessment of their level of consciousness and responsiveness. Palpating for a radial pulse (Choice A) is not the most direct method for assessing responsiveness in a child. Shouting at the child (Choice B) may startle them and not provide an accurate assessment. Asking the parent (Choice C) does not directly evaluate the child's responsiveness.

4. A postpartum client is experiencing heavy lochia and a boggy uterus. What should be the nurse's initial action?

• A. Administer a uterotonic medication
• B. Encourage the client to void
• C. Perform fundal massage
• D. Increase the client's fluid intake

Correct answer: C

Rationale: The correct initial action for a postpartum client experiencing heavy lochia and a boggy uterus is to perform fundal massage. Fundal massage helps to firm the uterus and reduce bleeding by promoting uterine contractions, which can assist in preventing postpartum hemorrhage. Administering uterotonic medication may be necessary in some cases but should not be the initial action. Encouraging the client to void and increasing fluid intake can be important interventions but are not the priority in this situation where immediate uterine firmness is needed to control bleeding.

5. Following the initial steps of resuscitation, a newborn remains apneic and cyanotic. What should you do next?

• A. begin ventilations with a bag-mask device.
• B. gently flick the soles of their feet for up to 60 seconds.
• C. immediately suction their mouth and nose.
• D. start CPR if the heart rate is less than 80 beats/min.

Correct answer: A

Rationale: If a newborn remains apneic and cyanotic after the initial resuscitation steps, the next appropriate action is to begin ventilations with a bag-mask device. This helps provide oxygen to the newborn and can be crucial in supporting their respiratory efforts. Option B of flicking the soles of their feet is not recommended in this scenario as the priority is addressing the respiratory distress. Option C of suctioning their mouth and nose is not the immediate next step if the newborn is not spontaneously breathing. Option D of starting CPR based only on the heart rate is not the first-line intervention for an apneic and cyanotic newborn.

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