Saunders Comprehensive Review for the NCLEX-PN Examination 2019 / 2020 32th Edition
Saunders Comprehensive Review for the NCLEX-PN Examination 2019 / 2020 32th Edition (Child Health)
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| Saunders Comprehensive Review for the NCLEX-PN Examination 2019 / 2020 32th Edition |
1. A 7-year-old child is diagnosed with viral conjunctivitis, and antibiotic eye drops are prescribed for the child. The mother asks the nurse when the child can return to school. The nurse makes which response to the mother?
A. “The child can return to school immediately.”
B. “The child should be kept home until the antibiotic eye drops have been administered for 24 hours.”
C. “The child should be kept home until the antibiotic eye drops have been administered for 1 week.”
D. “The child cannot return to school until seen by the physician in 1 week.”
Answer: A. “The child can return to school immediately.”
Rationale: Viral conjunctivitis is extremely contagious. The child should be kept home from school or day care until the child has received antibiotic eye drops for 24 hours. Options 1, 3, and 4 are incorrect instructions.
Test-Taking Strategy: Use the process of elimination. Recalling that viral conjunctivitis is highly contagious will assist in eliminating option A. Next eliminate options 3 and 4 because they are similar and because the time frames are lengthy. Also, recalling the action of antibiotics will assist in directing you to option B. Review infection control measures related to viral conjunctivitis if you had difficulty with this question.
Level of Cognitive Ability: Application
Client Needs: Safe, Effective Care Environment
Integrated Process: Nursing Process/Implementation
Content Area: Child Health
Reference: McKinney, E., James, S., Murray, S., & Ashwill, J. (2005). Maternal-child nursing (2nd ed.). St. Louis: Elsevier, p. 1588.
2. A 4-year-old child is diagnosed with otitis media, and the mother asks the nurse about the causes of this illness. The nurse responds knowing that which of the following is an unassociated risk factor related to otitis media?
A. Household smoking
B. Bottle-feeding
C. Exposure to illness in other children
D. A history of urinary tract infections
Answer: D. A history of urinary tract infections
Rationale: Factors that increase the risk of otitis media include exposure to illness in other children in day care centers, household smoking, bottle-feeding, and congenital conditions such as Down syndrome and cleft palate. The use of a pacifier beyond age 6 months has also been identified as a risk factor. Allergies are also thought to precipitate otitis media. Urinary tract infections are not associated with otitis media.
Test-Taking Strategy: Note the key word unassociated in the stem of the question. Careful reading of each of the options will direct you to option D. Review the causes of otitis media if you had difficulty with this question.
Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Teaching/Learning
Content Area: Child Health
Reference: Leifer, G. (2003). Introduction to maternity & pediatric nursing (4th ed.). Philadelphia: W.B. Saunders, p. 536.
3. Penicillin V potassium (Pen Vee K) 250 mg orally every 8 hours is prescribed for a child with a respiratory tract infection. The medication label reads: Penicillin, 125 mg per 5 mL. The nurse has determined that the dosage prescribed is safe for the child.
How many milliliters (mL) will the nurse administer to the child per dose?
Answer: 10
Rationale: Use the following formula for calculating the appropriate medication dose:
Desired 250 mg
_________ x Volume = _______ x 5 mL = 10 mL per dose
Available 125 mg
Test-Taking Strategy: Follow the formula for calculating the correct dose. Recheck your calculation with a calculator and make sure that the answer makes sense. If you had difficulty with this question, review medication calculation problems.
Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Fundamental Skills
Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, p. 80.
4. A physician has prescribed phenobarbital sodium (Luminal sodium) 25 mg orally twice daily for a child with febrile seizures. The child’s weight is 7.2 kg. The safe pediatric dosage is 1 to 6 mg/kg/day. The nurse determines that:
A. The dosage is too low
B. The dosage is too high
C. The dosage is within the safe range
D. There is not enough information to determine the safe dosage
Answer: B. The dosage is too high
Rationale: Calculate the dosage parameters, using the safe dose range identified in the question and the child’s weight in kilograms. Next, determine the total daily dose.
Dosage parameters: 1 mg/kg/day x 7.2 kg = 7.2 mg/day
6 mg/kg/day x 7.2 kg = 43.2 mg/day
Dosage frequency: 25 mg x 2 doses = 50 mg/day
The dosage is too high.
Test-Taking Strategy: Identify the key components of the question and what the question is asking. In this case, the question asks for the safe dosage range of the medication. Follow the formula steps. Calculate the dosage parameters using the safe dose range identified in the question and the child’s weight in kilograms. Remember to determine the total daily dosage before selecting an option. Review this formula if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Child Health
Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, pp. 235-236.
5. Diphenhydramine hydrochloride (Benadryl) 25 mg orally every 6 hours is prescribed for a child with an allergic reaction. The child weighs 25 kg. The safe pediatric dosage is 5 mg/kg/day. The nurse determines that:
A. The physician needs to prescribe a lower dosage
B. The dosage is too high
C. The dosage is safe
D. There is not enough information to determine the safe dosage
Answer: C. The dosage is safe
Rationale: Calculate the dosage parameters, using the safe dose range identified in the question and the child’s weight in kilograms. Next, determine the total daily dose.
Dosage parameters: 5 mg/kg x 25 kg = 125 mg/day
Dosage frequency: 25 mg x 4 doses = 100 mg/day
The dosage is safe.
Test-Taking Strategy: Identify the key components of the question and what the question is asking. In this case, the question asks for the safe dosage range of the medication. Follow the formula steps. Calculate the dosage parameters, using the safe dose range identified in the question and the child’s weight in kilograms. Remember to determine the total daily dosage before selecting an option. Review this formula if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Child Health
Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, pp. 235-236.
Source : NCLEX example quiz and answer
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