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A nurse is teaching a parent how to administer antibiotics at home to a toddler with acute otitis media. Which statement by the parent indicates that teaching has been successful? 1. "I'll give the antibiotics for the full 10-day course of treatment." 2. "I'll give the antibiotics until my child's ear pain is gone." 3. "Whenever my child is cranky or pulls on an ear, I'll give a dose of antibiotics." 4. "If the ear pain is gone, there's no need to see the physician for another examination of the ears."
1. "I'll give the antibiotics for the full 10-day course of treatment." RATIONALE: The mother demonstrates understanding of antibiotic therapy by stating she'll give the full 10-day course of treatment. Antibiotics must be given for the full course of therapy, even if the child feels well. Otherwise, the infection won't be eradicated. Antibiotics should be taken at ordered intervals to maintain blood levels and not as needed for pain. A reexamination at the end of the course of antibiotics is necessary to confirm that the infection is resolved.
During a well-baby visit, a 2-month-old infant receives diphtheria, tetanus toxoids, and acellular pertussis (DTaP) vaccine, inactivated poliovirus vaccine, hepatitis B vaccine, pneumococcal vaccine, and Haemophilus influenzae b (Hib) vaccine. The parents ask why the baby must have the Hib vaccine. How should the nurse respond? 1. "This vaccine prevents infection by various strains of the influenza virus." 2. "This vaccine protects against serious bacterial infections, such as meningitis and bacterial pneumonia." 3. "This vaccine prevents infection by the hepatitis B virus." 4. "This vaccine prevents chickenpox."
2. "This vaccine protects against serious bacterial infections, such as meningitis and bacterial pneumonia." RATIONALE: The Hib vaccine provides protection against serious childhood infections caused by H. influenzae type B virus, such as meningitis and bacterial pneumonia. The Hib vaccine doesn't prevent infection by the influenza virus, hepatitis B virus, or the varicella virus (chickenpox). The influenza virus vaccine provides immunity to various strains of the influenza virus. The Heptavax vaccine prevents infection by the hepatitis B virus. The varicella vaccine prevents the chickenpox.
Which sign is an early indicator of heart failure in an infant with a congenital heart defect? 1. Tachypnea 2. Tachycardia 3. Poor weight gain 4. Pulmonary edema
2. Tachycardia RATIONALE: The earliest sign of heart failure in infants is tachycardia (sleeping heart rate greater than 160 beats/minute) as a direct result of sympathetic stimulation. Tachypnea (respiratory rate greater than 60 breaths/minute in infants) occurs later in response to decreased lung compliance. Poor weight gain is a result of the increased energy demands to the heart and breathing efforts, not an early sign of heart failure itself. Pulmonary edema occurs as the left ventricle fails and blood volume and pressure increase in the left atrium, pulmonary veins, and lungs; it isn't an early sign of heart failure.
A child, age 2, with a history of recurrent ear infections is brought to the clinic with a fever and irritability. To elicit the most pertinent information about the child's ear problems, the nurse should ask the parent: 1. "Does your child's ear hurt?" 2. "Does your child have any hearing problems?" 3. "Does your child tug at either ear?" 4. "Does anyone in your family have hearing problems?"
3. "Does your child tug at either ear?" RATIONALE: Although all of the options are appropriate questions to ask when assessing a young child's ear problems, questions about the child's behavior, such as "Does your child tug at either ear?" are most useful because a young child usually can't describe symptoms accurately.
An infant, age 8 months, has a tentative diagnosis of congenital heart disease. During physical assessment, the nurse measures a heart rate of 170 beats/minute and a respiratory rate of 70 breaths/minute. How should the nurse position the infant? 1. Lying on the back 2. Lying on the abdomen 3. Sitting in an infant seat 4. Sitting in high Fowler's position
3. Sitting in an infant seat RATIONALE: Because the infant's assessment findings suggest that respiratory distress is developing, the nurse should position the infant with the head elevated at a 45-degree angle to promote maximum chest expansion; an infant seat maintains this position. Placing an infant flat on the back or abdomen or in high Fowler's position could increase respiratory distress by preventing maximal chest expansion.
A nurse is caring for a young child with tetralogy of Fallot (TOF). The child is upset and crying. The nurse observes that he's dyspneic and cyanotic. Which position would help relieve the child's dyspnea and cyanosis? 1. Sitting in bed with the head of the bed at a 45-degree angle 2. Squatting 3. Lying flat in bed 4. Lying on his right side
A toddler has a temperature above 101° F (38.3° C). The physician orders acetaminophen (Tylenol), 120 mg suppository, to be administered rectally every 4 to 6 hours. The nurse should question an order to administer the medication rectally if the child has a diagnosis of: 1. sepsis. 2. leukocytosis. 3. anemia. 4. thrombocytopenia. 4. thrombocytopenia. RATIONALE: A child with thrombocytopenia or neutropenia shouldn't receive rectal medication because of the increased risk of infection and bleeding that may result from tissue trauma. No contraindications exist for administering rectal medication to a child with sepsis, leukocytosis, or anemia. A nurse is caring for a young child with tetralogy of Fallot (TOF). The child is upset and crying. The nurse observes that he's dyspneic and cyanotic. Which position would help relieve the child's dyspnea and cyanosis? 1. Sitting in bed with the head of the bed at a 45-degree angle 2. Squatting 3. Lying flat in bed 4. Lying 2. Squatting RATIONALE: Placing the child in a squatting position sequesters a large amount of blood to the legs, reducing venous return. Sitting with the head of the bed at a 45-degree angle, lying flat, and lying on the right side don't reduce venous return; therefore, they won't relieve the child's dyspnea and cyanosis. A child with TOF may also assume a knee-chest position to reduce venous return to the heart.
After a child has a cardiopulmonary arrest, which drug would the nurse expect to administer? 1. Dopamine (Inocor) 2. Epinephrine 3. Sodium bicarbonate 4. Atropine
RATIONALE: After successful resuscitation, dopamine would be given as an infusion to increase cardiac output and maintain blood pressure. Epinephrine, sodium bicarbonate, and atropine are first-round drugs that are used during a cardiopulmonary arrest.
A nurse is assessing a child who recently received an antibiotic for an ear infection. The mother states that her child seems to have a harder time hearing than before and that the child told her that he hears ringing in his ears. The nurse suspects the child is taking an antibiotic from which class? 1. Cephalosporins 2. Penicillins 3. Aminoglycosides 4. Carbapenems
aminoglycosides
A 6-year-old child is being discharged from the emergency department after being diagnosed with varicella (chickenpox). The nurse knows the parents need more medication teaching when they state they will give the child which over-the-counter medication? 1. Ibuprofen (Motrin) 2. Aspirin 3. Acetaminophen (Tylenol) 4. Naproxen (Aleve)
asprin
