Nursing Elites

1. The healthcare provider is preparing to administer phytonadione to a newborn. Which statement made by the parents indicates understanding why the healthcare provider is administering this medication?

• A. Prevent hemorrhagic disorders.
• B. Help an immature liver.
• C. Improve insufficient dietary intake.
• D. Stimulate the immune system.

Correct answer: A

Rationale: The correct answer is A: 'Prevent hemorrhagic disorders.' Phytonadione (vitamin K) is administered to newborns to prevent hemorrhagic disease by promoting blood clotting. Newborns are born with low levels of vitamin K, which is essential for blood clotting, hence the administration to prevent hemorrhagic disorders. Choice B is incorrect because phytonadione is not given to help an immature liver but to supply vitamin K. Choice C is incorrect as phytonadione is not administered to improve dietary intake but to provide essential vitamin K. Choice D is incorrect as phytonadione does not stimulate the immune system but helps with blood clotting.

2. The client is 30 weeks pregnant and experiencing preterm labor. Which medication should the nurse anticipate administering to promote fetal lung maturity?

• A. Betamethasone (Celestone).
• B. Magnesium sulfate.
• C. Terbutaline (Brethine).
• D. Ampicillin.

Correct answer: A

Rationale: Betamethasone (Celestone) is the medication of choice to promote fetal lung maturity in cases of preterm labor. It helps accelerate surfactant production in the fetal lungs, reducing the risk of respiratory distress syndrome. Administering betamethasone to the mother can improve the baby's lung function and overall outcome if preterm birth occurs. Magnesium sulfate is commonly used to prevent seizures in preeclampsia or eclampsia. Terbutaline is a tocolytic agent used to suppress preterm labor contractions. Ampicillin is an antibiotic used for various bacterial infections but does not promote fetal lung maturity.

3. The healthcare provider prescribes Amoxicillin 500mg PO every 8hrs for a child who weighs 22 pounds. The available suspension is labeled Amoxicillin Suspension 250mg/5ml. The recommended maximum dose is 50mg/kg/24hr. How many mL should the nurse administer in a single dose based on the child’s weight?

• A. 10mL
• B. 15mL
• C. 7.5mL
• D. 5mL

Correct answer: A

Rationale: To calculate the dose for the child weighing 22 pounds, first convert the weight to kg: 22 lbs ÷ 2.2 = 10 kg. The maximum dose based on weight would be 10 kg × 50 mg/kg/24hr = 500 mg/24hr. Since the medication is prescribed every 8 hours, the dose for each administration would be 500 mg ÷ 3 doses = 166.67 mg. As the available suspension is 250mg/5ml, the nurse should administer 166.67 mg ÷ 250 mg/mL = 0.67 mL per dose. However, since it's not practical to administer a fraction of a milliliter, the nurse should round up to the nearest appropriate dose, which is 10mL.

4. A child with leukemia is admitted for chemotherapy, and the nursing diagnosis 'altered nutrition, less than body requirements related to anorexia, nausea, and vomiting' is identified. Which intervention should the nurse include in this child’s plan of care?

• A. Allow the child to eat any food desired and tolerated.
• B. Provide small, frequent meals that are high in protein and calories.
• C. Offer the child preferred foods and avoid foods that are not well-tolerated.
• D. Consult with a dietitian to provide appropriate nutritional support.

Correct answer: B

Rationale: In children with leukemia undergoing chemotherapy, anorexia, nausea, and vomiting are common issues leading to altered nutrition. Providing small, frequent meals that are high in protein and calories is essential to address these symptoms and meet the child's nutritional needs effectively. This approach helps in managing the side effects of treatment and supporting the child's nutritional requirements during this challenging time.

5. A 10-year-old is admitted to the orthopedic unit with a diagnosis of slipped femoral capital epiphysis (SFCE). What focus should the nurse include in this child’s plan of care?

• A. Ambulation with a walking cast.
• B. Pin and incision care after surgery.
• C. Use of injections for pain control.
• D. Administration of growth hormone.

Correct answer: B

Rationale: In the case of slipped femoral capital epiphysis, surgical intervention is often required. Post-surgery care is crucial to prevent complications such as infection and ensure proper healing. This care includes monitoring and managing pin and incision sites for signs of infection, promoting wound healing, and preventing postoperative complications. The focus on pin and incision care is essential for the child's recovery and overall well-being.

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