Question

A nurse is caring for an 18-month-old toddler in the emergency department. The nurse reviews the toddler's medical record and assessment findings. Which of the following provider prescriptions should the nurse anticipate?

Answer 1

Correct Answers:

oral rehydration solution.

Rationale :

🧃Dehydration is a common concern in toddlers presenting to the emergency department, often due to gastroenteritis or fever.

🧪Oral rehydration solution (ORS) is the first-line treatment for mild to moderate dehydration because it restores fluid and electrolyte balance effectively and safely.

🍼Using ORS avoids the invasiveness and risks associated with intravenous therapy unless the child is severely dehydrated or unable to tolerate oral fluids.

💊Other options like acetaminophen or antibiotics may treat symptoms or secondary infections but do not directly address the fluid loss, which is the immediate concern.

📌Core Message

Oral rehydration solution is the appropriate intervention for a toddler with suspected dehydration, helping to restore fluid and electrolyte balance without invasive measures.

Answer 2

Correct Answers:

intramuscular penicillin.

Rationale :

💉The symptoms and context suggest a bacterial infection such as streptococcal pharyngitis, for which IM penicillin is a standard treatment.

🦠IM penicillin provides a sustained release of the antibiotic and is preferred when compliance with oral medication is a concern or if the child is unable to swallow.

📊It is especially useful in eradicating Group A Streptococcus, which can prevent complications like rheumatic fever.

💊Other options like IVIG or acyclovir are specific to viral or immune-related conditions, not common bacterial infections.

📌Core Message

Intramuscular penicillin is effective for treating bacterial infections like streptococcal pharyngitis in toddlers and ensures compliance when oral intake is problematic.

Answer 3

Correct Answers:

Continue to monitor the client.

Rationale :

🧮A 3-year-old child weighing 33 lb (15 kg) should have a minimum urine output of about 0.5–1 mL/kg/hr, which translates to 60–120 mL in 8 hours.

📈The child has produced 160 mL in 8 hours, which exceeds the minimum expected output, indicating adequate kidney function.

🩺In this case, no immediate intervention is needed other than continued routine monitoring of hydration and urinary output.

⚠️Initiating interventions like bladder scans or notifying the provider would be unnecessary and could lead to over-treatment.

📌Core Message

Monitoring is sufficient because the child’s urine output is within normal range for weight and age, indicating proper kidney function.

Answer 4

Correct Answers:

Rice.

Rationale :

🌾Children with celiac disease cannot digest gluten, which is found in wheat, rye, and barley.

🍚Rice is a gluten-free grain that is safe and well-tolerated by children with celiac disease.

🚫Consuming gluten triggers an autoimmune response that damages the small intestine in celiac disease, leading to malabsorption and poor growth.

🧺Education should focus on identifying and incorporating safe, gluten-free alternatives like rice, corn, and quinoa.

📌Core Message

Rice is gluten-free and safe for children with celiac disease, who must avoid gluten-containing grains like wheat, barley, and rye.

Answer 5

Correct Answers:

Provide a latex-free environment

Rationale :

🛑Children with spina bifida, especially those with myelomeningocele, have a high risk of developing latex allergies due to early and repeated exposure to latex-containing medical equipment.

⚠️A latex-free environment minimizes the risk of allergic reactions, which can be severe and potentially life-threatening.

🧴This includes avoiding latex gloves, catheters, and other supplies and substituting with non-latex alternatives.

🚼Other options like positioning or visitor limitation are important, but latex avoidance is a critical safety priority in these patients.

📌Core Message

Infants with spina bifida are at high risk for latex allergy, and maintaining a latex-free environment is a priority in care planning.

Answer 6

Correct Answers:

meningitis.

Rationale :

🧠Symptoms such as lethargy, irritability, high-pitched cry, and poor feeding in a 4-month-old strongly suggest meningitis, a medical emergency.

💉Immediate intervention includes initiating IV antibiotics after obtaining blood and CSF cultures.

📊Key parameters to monitor include neurological status, fontanel tension, temperature, and seizure activity, as they reflect central nervous system involvement.

🚨Prompt diagnosis and treatment reduce the risk of long-term complications such as hearing loss or developmental delays.

📌Core Message

Meningitis should be suspected in infants with systemic and neurological symptoms, and immediate antibiotic therapy and monitoring of neurologic function are essential.

Answer 7

Correct Answers:

hydrocephalus.

Rationale :

🧠Hydrocephalus involves accumulation of CSF, leading to increased intracranial pressure and an abnormally large head circumference.

📏Symptoms in a 4-month-old include bulging fontanel, rapid head growth, vomiting, and poor feeding.

📉Monitoring should focus on head circumference, fontanel tension, and signs of increased ICP such as irritability and vomiting.

🩺Prompt identification leads to early intervention, often with a ventriculoperitoneal (VP) shunt, to prevent neurological damage.

📌Core Message

Hydrocephalus presents with head enlargement and signs of increased ICP, requiring close monitoring and possible surgical intervention.

Answer 8

Correct Answers:

The insertion site of the central line catheter is erythematous with a scant amount of purulent drainage.

Rationale :

🚨This finding suggests a central line-associated bloodstream infection (CLABSI), which is a serious and potentially life-threatening complication.

🧫Infection at the site of a central line can rapidly become systemic in children, especially in those who are immunocompromised or critically ill.

👩‍⚕️The nurse should report this to the provider immediately so that cultures can be obtained and antibiotic therapy initiated.

📍Other findings like mild fever or behavioral changes are common and expected in pediatrics, but purulent drainage at a central line is an urgent concern.

📌Core Message

Purulent drainage from a central line insertion site requires immediate attention due to the risk of bloodstream infection.

Answer 9

Correct Answers:

Leukemia.

Rationale :

🧬A high WBC count, low hemoglobin, and low hematocrit in the presence of systemic signs like fever and hypoxia are indicative of leukemia.

🧪In leukemia, the bone marrow is infiltrated with immature WBCs (blasts), which displace normal blood cells, leading to anemia and immune dysfunction.

🌡️Fever and tachycardia reflect systemic inflammation, and low oxygen saturation may result from anemia or pulmonary infiltration.

🩸Prompt further diagnostic work-up such as bone marrow biopsy is needed to confirm the diagnosis and initiate treatment.

📌Core Message

Leukemia presents with abnormal blood counts, fever, and fatigue due to bone marrow suppression and requires urgent investigation.

Answer 10

Correct Answers:

An 11-year-old school-age child.

Rationale :

💉The meningococcal conjugate vaccine (MCV4) is routinely recommended at 11–12 years of age, with a booster at 16 years.

🧫This vaccine protects against Neisseria meningitidis, a cause of life-threatening meningitis and sepsis in adolescents and young adults.

📅Vaccination at this age provides protection during the peak years of susceptibility, especially in settings like schools or dormitories.

👶Infants and toddlers are not routinely given MCV4 unless they are at high risk due to medical conditions or outbreaks.

📌Core Message

The MCV4 vaccine is indicated at 11–12 years to protect against meningococcal disease, especially in adolescents entering group environments.

1 :
A nurse is caring for an 18-month-old toddler in the emergency department. The nurse reviews the toddler's medical record and assessment findings. Which of the following provider prescriptions should the nurse anticipate?

2 :
A nurse is caring for an 18-month-old toddler in the emergency department. The nurse reviews the toddler's medical record and assessment findings. Which of the following provider prescriptions should the nurse anticipate?

3 :
A nurse is caring for a 3-year-old child who has had 160 mL of urine output over the past 8 hr period. The child weighs 33 lb. Which of the following actions should the nurse take?

4 :
A nurse is providing teaching to a parent of a child who has celiac disease. The nurse should include which of the following food choices for this child?

5 :
A nurse is planning care for an infant who has spina bifida and is to undergo surgical closure of the myelomeningocele sac. Which of the following interventions should the nurse include in the plan of care?

8 :
A nurse on a pediatric unit is preparing to admit a preschooler after receiving a transfer report from a nurse in the emergency department. Which of the following findings should the nurse report to the provider immediately?

10 :
A nurse is administering vaccines at a county health immunization clinic. Which of the following clients should the nurse plan to administer the meningococcal conjugate (MCV4) vaccine?

1 : A nurse is caring for an 18-month-old toddler in the emergency department. The nurse reviews the toddler's medical record and assessment findings. Which of the following provider prescriptions should the nurse anticipate?

2 : A nurse is caring for an 18-month-old toddler in the emergency department. The nurse reviews the toddler's medical record and assessment findings. Which of the following provider prescriptions should the nurse anticipate?

3 : A nurse is caring for a 3-year-old child who has had 160 mL of urine output over the past 8 hr period. The child weighs 33 lb. Which of the following actions should the nurse take?

4 : A nurse is providing teaching to a parent of a child who has celiac disease. The nurse should include which of the following food choices for this child?

5 : A nurse is planning care for an infant who has spina bifida and is to undergo surgical closure of the myelomeningocele sac. Which of the following interventions should the nurse include in the plan of care?

8 : A nurse on a pediatric unit is preparing to admit a preschooler after receiving a transfer report from a nurse in the emergency department. Which of the following findings should the nurse report to the provider immediately?

10 : A nurse is administering vaccines at a county health immunization clinic. Which of the following clients should the nurse plan to administer the meningococcal conjugate (MCV4) vaccine?

1 :
A nurse is caring for an 18-month-old toddler in the emergency department. The nurse reviews the toddler's medical record and assessment findings. Which of the following provider prescriptions should the nurse anticipate?

2 :
A nurse is caring for an 18-month-old toddler in the emergency department. The nurse reviews the toddler's medical record and assessment findings. Which of the following provider prescriptions should the nurse anticipate?

3 :
A nurse is caring for a 3-year-old child who has had 160 mL of urine output over the past 8 hr period. The child weighs 33 lb. Which of the following actions should the nurse take?

4 :
A nurse is providing teaching to a parent of a child who has celiac disease. The nurse should include which of the following food choices for this child?

5 :
A nurse is planning care for an infant who has spina bifida and is to undergo surgical closure of the myelomeningocele sac. Which of the following interventions should the nurse include in the plan of care?

8 :
A nurse on a pediatric unit is preparing to admit a preschooler after receiving a transfer report from a nurse in the emergency department. Which of the following findings should the nurse report to the provider immediately?

10 :
A nurse is administering vaccines at a county health immunization clinic. Which of the following clients should the nurse plan to administer the meningococcal conjugate (MCV4) vaccine?