Nursing Elites

1. The healthcare provider plans to administer 10 mcg/kg of digoxin elixir as a loading dose to a child who weighs 55 pounds. Digoxin is available as an elixir of 50 mcg/ml. How many milliliters of the digoxin elixir should the healthcare provider administer to this child?

• A. 5 ml
• B. 10 ml
• C. 15 ml
• D. 20 ml

Correct answer: A

Rationale: To calculate the dose, first, convert the child's weight to kilograms by dividing 55 pounds by 2.2, which equals approximately 25 kg. Then, multiply the weight by the dose (10 mcg/kg) to get the total dose needed, which is 250 mcg. Next, divide the total dose by the concentration of the elixir (50 mcg/ml) to determine the volume needed, which is 5 ml. Therefore, the correct dose is 5 ml based on the child's weight and the concentration of the elixir.

2. The child is 3 years old and is 2 hours postop from a cardiac catheterization via the right femoral artery. Which assessment finding indicates arterial obstruction?

• A. Blood pressure is decreasing, and the pulse is rapid and irregular.
• B. The right foot feels cool to the touch and appears pale and blanched.
• C. The pulse distal to the femoral artery is weaker in the left foot than the right foot.
• D. The pressure dressing at the right femoral area is damp and oozing blood.

Correct answer: B

Rationale: A cool, pale, and blanched foot is indicative of arterial obstruction, leading to poor blood flow. This finding requires immediate intervention to prevent further complications such as tissue damage or necrosis. Monitoring for signs of arterial compromise, such as color changes, temperature, and capillary refill, is crucial in detecting and managing vascular complications post-cardiac catheterization. Choices A, C, and D do not directly indicate arterial obstruction. While a decreasing blood pressure and rapid, irregular pulse may suggest compromise, these findings are more nonspecific. A weaker pulse distal to the femoral artery indicates reduced perfusion but not necessarily arterial obstruction. Finally, a damp, oozing pressure dressing suggests a dressing issue rather than arterial obstruction.

3. The mother of a 9-month-old girl provides the practical nurse with information about her daughter's diet. Which statement by the mother may indicate why the infant has been diagnosed with iron-deficiency anemia?

• A. She almost never drinks sugary water.
• B. She has been on whole milk for 7 months.
• C. She likes to chew on bread as a snack.
• D. She doesn't like to eat peaches or pears.

Correct answer: B

Rationale: The correct answer is B. Infants should not be given cow's milk before 1 year of age as it can interfere with iron absorption and lead to anemia. Choice A is incorrect as avoiding sugary water is actually a good practice. Choice C is unrelated to iron-deficiency anemia. Choice D, not liking peaches or pears, is also not directly related to iron-deficiency anemia.

4. A 10-year-old child with hemophilia is admitted to the hospital with joint pain and swelling. What should the healthcare provider do first?

• A. Apply ice to the affected joint
• B. Administer pain medication
• C. Elevate the affected limb
• D. Administer factor VIII as prescribed

Correct answer: D

Rationale: Administering factor VIII as prescribed is the priority intervention for a child with hemophilia experiencing joint pain and swelling. Hemophilia is a genetic disorder that impairs the blood's ability to clot properly, leading to prolonged bleeding. Factor VIII replacement therapy is essential as it helps restore the missing clotting factor in patients with hemophilia, thereby aiding in clot formation and preventing further bleeding. Applying ice, administering pain medication, or elevating the limb may be supportive measures but addressing the underlying cause by providing factor VIII therapy takes precedence in managing hemophilia-related joint pain and swelling.

5. 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.

Similar Questions