Med Math
How many milliliters are in 1/2 ounce?
A. 10 ml
B. 60 ml
C. 15 mL
D. 30 mL
C. 15 mL
What is the normal range for platelets?
150,000-450,000 per microliter of blood
What is the term for an infection of the lining of the heart?
Bacterial Endocarditis
A toddler with hemophilia is being discharged from the hospital. Which teaching should the nurse include in the discharge instructions to the mother?
Apply padding on the sharp corners of the furniture.
The appearance of which hallmark clinical manifestation occurs in measles?
1. Conjunctivitis
2. Koplik spots
3. Fever
4. Cough
2. Koplik spots
The doctor ordered 1.5 tsp of Tylenol to be given every 4 hours as needed for fever. Using a syringe, how many mL will you instruct the mother to give to her son?
A. 4.5 ml
B. 15 ml
C. 7.5 ml
D. 10 ml
C. 7.5 ml
Laboratory studies are performed for a child suspected to have iron deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia?
1.Elevated hemoglobin level
2.Decreased reticulocyte count
3.Elevated red blood cell count
4.Red blood cells that are microcytic and hypochromic
Ans. 4
In iron deficiency anemia, iron stores are depleted, resulting in a decreased supply of iron for the manufacture of hemoglobin in red blood cells. The results of a complete blood cell count in children with iron deficiency anemia show decreased hemoglobin levels and microcytic and hypochromic red blood cells. The red blood cell count is decreased. The reticulocyte count is usually normal or slightly elevated.
An infant with CHF is receiving digoxin to enhance myocardial function. What should the nurse assess prior to administering the medication?
1. Yellow sclera.
2. Apical pulse rate.
3. Cough.
4. Liver function test.
The apical pulse rate is ordered because digoxin decreases the HR, and if the HR is <60 digoxin should not be administered.
The nurse is conducting staff in-service training on von Willebrand's disease. Which should the nurse include as characteristics of von Willebrand's disease? Select all that apply.
1.Easy bruising occurs.
2.Gum bleeding occurs.
3. It is a hereditary bleeding disorder.
4.Treatment and care are similar to that for hemophilia.
5. It is characterized by extremely high creatinine levels.
6.The disorder causes platelets to adhere to damaged endothelium.
Ans. 1, 2, 3, 4, 6
von Willebrand's disease is a hereditary bleeding disorder characterized by a deficiency of or a defect in a protein termed von Willebrand factor. The disorder causes platelets to adhere to damaged endothelium. It is characterized by an increased tendency to bleed from mucous membranes. Assessment findings include epistaxis, gum bleeding, easy bruising, and excessive menstrual bleeding. An elevated creatinine level is not associated with this disorder.
A nurse monitors a patient receiving TPN for complications of the therapy and should assess the patient for which manifestation of hyperglycemia?
A. Fever, weak pulse, and thirst
B. Nausea, vomiting, and oliguria
C. Sweating, chills, and abdominal pain
D. Weakness, thirst, and increased urine output
D. Weakness, thirst, increased urine output
A child is to receive vancomycin (Vancocin) 20 mg/kg IV one hour before a scheduled procedure. The child weight 77 pounds. How many mg of the medication should the nurse prepare to administer?
700 mg
A patient is severely dehydrated. Which lab value should the nurse be closely monitoring?
A. Hemoglobin/hematocrit
B. Electrolytes
C. WBC
D. Blood cultures
B. Electrolytes
A child diagnosed with tetralogy of fallot becomes upset, crying and thrashing around when a blood specimen is obtained. The child's color becomes blue and respiratory rate increases to 44 bpm. Which of the following actions would the nurse do first?
a) obtain an order for sedation for the child
b) assess for an irregular heart rate and rhythm
c) explain to the child that it will only hurt for a short time
d) place the child in knee-to-chest position
D.
the child is experiencing a "tet spell" or hypoxic episode. Therefore the nurse should place the child in a knee-to-chest position. Flexing the legs reduces venous flow of blood from lower extremities and reduces the volume of blood being shunted through the interventricular septal defect and the overriding aorta in the child with tetralogy of fallot. As a result, the blood then entering the systemic circulation has higher oxygen content, and dyspnea is reduced. Flexing the legs also increases vascular resistance and pressure in the left ventricle. An infant often assumes a knee-to-chest position to relieve dyspnea. If this position is ineffective, then the child may need sedative. Once the child is in this position, the nurse may assess for an irregular heart rate and rhythm. Explaining tho the child that it will only hurt for a short time does nothing to alleviate hypoxia.
When does a patient receive their hepatitis B vaccines?
Within 24hrs of birth, 1 month, and 6 months
A client has Buck's extension traction applied to the right leg. The nurse plans which of the following interventions to prevent complications from the device?
a) provide pin care once a shift
b) massage the skin of the right leg with lotion every 8 hours
c) inspect the skin on the right leg at least once every 8 hours
d) release the weights on the right leg for range of motion exercises daily
c) inspect the skin on the right leg at least once every 8 hours
Buck's extension traction is a type of skin traction. The nurse inspects the skin of the limb in traction at least once every 8 hours for irritation or inflammation. Massaging the skin with lotion is not indicated. The nurse never releases the weights of traction unless specifically ordered by the physician. There are no pins to care for with skin traction.
You are instructing a mother of a 3-month-old infant to give Tylenol. She shows you the label of the acetaminophen elixir she has purchased from the drugstore. It states: 0-6 months 125 mg per dose; 6-12 months 250 mg per dose. The concentration is 50 mg/1 ml. How many tsp will you instruct her to give?
A. 1/4 tsp
B. 1/2 tsp
C. 3/4 tsp
D. 1 tsp
B. 1/2 tsp
Which would the nurse explain to parents about the inheritance of cystic fibrosis?
1. CF is an autosomal-dominant trait passed on from the child's mother.
2. CF is an autosomal-dominant trait passed on from the child's father.
3. The child of parents who are both carriers of the gene for CF has a 50% chance of acquiring CF.
4. The child of a mother who has CF and a father who is a carrier of the gene for CF has a 50% chance of acquiring CF.
ANS 4
4. If the child is born to a parent with CF and the other parent is a carrier, the child has a 50% chance of acquiring the disease and a 50% chance of being a carrier of the disease. TEST-TAKING HINT: Answers 1 and 2 can be eliminated with knowledge of the genetic inheritance of CF. CF is inherited as an autosomal-recessive trait.
Which of the following is true regarding the Dx of Cystic Fibrosis?
A. sweat chloride concentration is 60mmol/ or greater
B. CFTR mutation analysis may be helpful when considering Dx of CF.
C. There may or may not be a family Hx of CF in a sibling.
D. All the above
D. All of the above
The nurse is reviewing a health care provider's prescriptions for a child with sickle cell anemia who was admitted to the hospital for the treatment of vaso-occlusive crisis. Which prescriptions documented in the child's record should the nurse question? Select all that apply.
1.Restrict fluid intake.
2.Position for comfort.
3.Avoid strain on painful joints.
4.Apply nasal oxygen at 2 L/minute.
5.Provide a high-calorie, high-protein diet.
6.Give meperidine (Demerol), 25 mg intravenously, every 4 hours for pain
Ans. 1, 6
Sickle cell anemia is one of a group of diseases termed hemoglobinopathies, in which hemoglobin A is partly or completely replaced by abnormal sickle hemoglobin S. It is caused by the inheritance of a gene for a structurally abnormal portion of the hemoglobin chain. Hemoglobin S is sensitive to changes in the oxygen content of the red blood cell; insufficient oxygen causes the cells to assume a sickle shape, and the cells become rigid and clumped together, obstructing capillary blood flow. Oral and intravenous fluids are an important part of treatment. Meperidine (Demerol) is not recommended for a child with sickle cell disease because of the risk for normeperidine-induced seizures. Normeperidine, a metabolite of meperidine, is a central nervous system stimulant that produces anxiety, tremors, myoclonus, and generalized seizures when it accumulates with repetitive dosing. The nurse would question the prescription for restricted fluids and meperidine for pain control. Positioning for comfort, avoiding strain on painful joints, oxygen, and a high-calorie and high-protein diet are also important parts of the treatment plan.
An 18 y.o. student is admitted with dark urine, fever, and flank pain and is diagnosed with acute glomerulonephritis. Which would most likely be in this student's health history?
A. Renal calculi
B. Renal trauma
C. Recent sore throat
D. Family history of acute glomerulonephritis
C. Recent sore throat
The physician orders Wellcovorin 1mg IM. The drug comes in powdered form in a vial containing 50mg. The directions for reconstitution are: Add 5mL of diluent for a final concentration of 10mg/1mL. After reconstituting, how many mL should you draw up?
0.1ml
Three-year-old Carlo has been admitted to the pediatric unit with a tentative diagnosis of nephrotic syndrome.
The diagnosis of Idiopathic Nephrotic Syndrome has been confirmed. Which unexpected finding would the nurse report?
a) proteinuria
b) distended abdomen
c) blood in the urine
d) elevated serum lipid levels
c) blood in the urine
hematuria is rare in nephrotic syndrome but it is profuse in acute glomerulonephritis
The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, "Why do my child's fingertips look like that?" The nurse bases a response on the understanding that clubbing occurs as a result of:
a. untreated congestive heart failure.
b. a left-to-right shunting of blood.
c. decreased cardiac output.
d. chronic hypoxia.
D. Clubbing of the fingers develops in response to chronic hypoxia.
When does the anterior fontanel close? and when is it ok for it to bulge?
It closes between 12-18 months and during vigorous crying it is normal for it to bulge.