Nursing Elites

1. The healthcare provider is providing postoperative care to a 4-year-old child who underwent tonsillectomy. The provider notices that the child is frequently swallowing. What should the provider do first?

• A. Check the child’s throat for signs of bleeding
• B. Offer the child ice chips to soothe the throat
• C. Elevate the head of the child’s bed
• D. Administer prescribed pain medication

Correct answer: A

Rationale: Frequent swallowing after tonsillectomy may indicate bleeding, which requires immediate assessment and intervention. Checking the child’s throat for signs of bleeding is the priority to ensure timely identification and management of any potential bleeding complications.

2. 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.)

• A. 4.2 mL
• B. 5 mL
• C. 3.6 mL
• D. 4 mL

Correct answer: A

Rationale: To calculate the mL per dose, divide the prescribed dose (42 mg) by the concentration of the syrup (50 mg/5 mL) and then convert the result to mL. 42 mg / 50 mg = 0.84. To find the amount in mL, multiply 0.84 by 5 mL, which equals 4.2 mL. Therefore, 4.2 mL should be administered per dose.

3. A male adolescent who is newly diagnosed with a seizure disorder receives a prescription for an anticonvulsant. Which statement indicates the client is at risk for non-compliance with life-long medication management?

• A. I hope I will be able to drive while taking these pills.
• B. My friends will think I am a freak if I take these pills.
• C. I don't want my parents monitoring my medications.
• D. I will take the pills at home so others will not see me.

Correct answer: B

Rationale: The statement 'My friends will think I am a freak if I take these pills' indicates concerns about peer perception, which can lead to non-compliance in adolescents. Peer pressure and fear of social stigma can significantly impact medication adherence in this age group. Option B is the most concerning response as it reflects the client's worry about how others perceive him for taking medication, potentially leading to non-compliance due to social pressures. Choices A, C, and D do not directly address societal perception or peer pressure, making them less likely to impact the client's medication adherence negatively.

4. The healthcare provider is preparing to administer a scheduled dose of digoxin to a 4-year-old child with heart failure. The healthcare provider notes that the child’s heart rate is 70 beats per minute. What should the healthcare provider do next?

• A. Administer the medication as prescribed
• B. Hold the medication and notify the healthcare provider
• C. Recheck the heart rate in 30 minutes
• D. Administer half of the prescribed dose

Correct answer: B

Rationale: In pediatric patients, digoxin administration is guided by the heart rate. If the child's heart rate is below the established threshold, which is typically 90-100 beats per minute in a 4-year-old, the medication should be withheld, and the healthcare provider should be notified for further evaluation and instructions. Choice A is incorrect because administering the medication when the heart rate is low can lead to adverse effects. Rechecking the heart rate in 30 minutes (Choice C) may delay necessary intervention if the heart rate remains low. Administering half of the prescribed dose (Choice D) is not recommended without healthcare provider guidance.

5. A 6-year-old child is diagnosed with rheumatic fever and demonstrates associated chorea (sudden aimless movements of the arms and legs). Which information should the nurse provide to the parents?

• A. Permanent lifestyle changes need to be made to promote safety in the home
• B. The chorea or movements are temporary and will eventually disappear
• C. Muscle tension is decreased with fine motor project skills, so these activities should be encouraged
• D. Consistent discipline is needed to help the child control the movements

Correct answer: C

Rationale: Chorea associated with rheumatic fever is usually temporary and will subside over time.

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