Free NCLEX PN RN Questions of the Day 50th Edition

Free NCLEX PN RN Questions of the Day 50th Edition (Child Health)

1. A child is receiving edetate calcium disodium for the treatment of lead poisoning. Which of the following laboratory studies would be most important to monitor during treatment?

A. Potassium level
B. White blood cell (WBC) count
C. Red blood cell (RBC) count
D. Blood urea nitrogen (BUN) level

Answer: D. Blood urea nitrogen (BUN) level

Rationale: An adverse effect of edetate calcium disodium is nephrotoxicity. Urine flow and BUN level are assessed before the start of therapy. Options 1, 2, and 3 are not related to adverse effects of the medication.

Test-Taking Strategy: Knowledge regarding the adverse effects of this medication is required to answer this question. Recalling that the medication is nephrotoxic will direct you to option D. Review this medication and its adverse effects 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
References: McKinney, E., James, S., Murray, S., & Ashwill, J. (2005). Maternal-child nursing (2nd ed.). St. Louis: Elsevier, p. 873.
Wong, D., & Hockenberry, M. (2003). Nursing care of infants and children (7th ed.). St. Louis: Mosby, p. 680.

2. A licensed practical nurse (LPN) employed in the emergency room prepares to assist in treating a child with acetaminophen (Tylenol) overdose. The LPN checks the medication supply room anticipating that which of the following medications will be prescribed?

A. Vitamin K
B. Protamine sulfate
C. Edetate calcium disodium
D. Acetylcysteine (Mucomyst)

Answer: D. Acetylcysteine (Mucomyst)

Rationale: Acetylcysteine is the antidote for acetaminophen overdose. It is administered orally with juice or cola or via a nasogastric tube. Vitamin K is the antidote for warfarin sodium (Coumadin). Protamine sulfate is the antidote for heparin. Edetate calcium disodium is used in the treatment of lead poisoning.

Test-Taking Strategy: Knowledge regarding the antidote for acetaminophen overdose is required to answer this question. Remember, acetylcysteine is the antidote for acetaminophen overdose. Review this information if you had difficulty with this question.

Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Planning
Content Area: Child Health
References: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W. B. Saunders, p. 9.
Price, D., & Gwin, J. (2005). Thompson’s pediatric nursing (9th ed.). Philadelphia: W.B. Saunders, p. 207.

3. A child is brought to the emergency room by the mother who reports that she found the child sitting on the floor next to an open bottle of aspirin. The mother reports that the bottle contained five aspirin and that the bottle was empty when she found the child. The nurse determines that the child may have received a toxic dose of the medication if the child consumed more than:

A. 50 mg/kg of child’s body weight
B. 100 mg/kg of child’s body weight
C. 150 mg/kg of child’s body weight
D. 200 mg/kg of child’s body weight

Answer: D. 200 mg/kg of child’s body weight

Rationale: The ingestion of salicylates is a common cause of poisoning in children. A toxic dose is a single dose exceeding 200 to 280 mg/kg. Peak gastric absorption occurs within 2 hours of ingestion.

Test-Taking Strategy: Use the process of elimination and focus on the key words toxic dose. Because you need to select an option, and if you were not sure, it is best in this type of a question to select the highest value. Review salicylate toxicity 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
References: Leifer, G. (2003). Introduction to maternity & pediatric nursing (4th ed.). Philadelphia: W.B. Saunders, p. 680.
McKinney, E., James, S., Murray, S., & Ashwill, J. (2005). Maternal-child nursing (2nd ed.). St. Louis: Elsevier, p. 872.

4. A nursing student is assigned to care for a child that has been experiencing vomiting and diarrhea. The physician documents a diagnosis of gastroenteritis and isotonic dehydration. The nursing instructor asks the student to describe isotonic dehydration. The student correctly responds by stating that it occurs when:

A. “Water and electrolytes are lost in approximately the same proportion as they exist in the body.”
B. “The loss of electrolytes is greater than the loss of water.”
C. “The loss of water is greater than the loss of electrolytes.”
D. “Serum sodium level rises above 150 mEq/L.”

Answer: A. “Water and electrolytes are lost in approximately the same proportion as they exist in the body.”

Rationale: Isotonic dehydration occurs when water and electrolytes are lost in approximately the same proportion as they exist in the body. In this type of dehydration, the serum sodium levels remain normal (135 to 145 mEq/L). Option 2 describes hypotonic dehydration, and in this type of dehydration the serum sodium level is less than 130 mEq/L. Options 3 and 4 describe hypertonic dehydration.

Test-Taking Strategy: Knowledge regarding the various types of dehydration is required to answer this question. However, thinking about the terms hypotonic and hypertonic and relating these terms to losses or excesses may assist you to eliminate options 2, 3, and D. Review these types of dehydration 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: Price, D., & Gwin, J. (2005). Thompson’s pediatric nursing (9th ed.). Philadelphia: W.B. Saunders, p. 157.

Source : NCLEX example quiz and answer

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