Question 1

The nurse is planning to administer an intramuscular injection to a 13-year-old child. What is the maximum volume of medication that can be injected into the ventrogluteal site?&#10;A) 0.5 to 1 milliliter&#10;B) 1 to 1.5 milliliters&#10;C) 1.5 to 2 milliliters&#10;D) 2 to 2.5 milliliters

Accepted Answer

The maximum volume of medication for an intramuscular injection to an older child (6 to 14 years) is 1.5 to 2.0 milliliters. 0.5 to 1.4 milliliters are acceptable volumes to inject, but they are not the maximum. 2 to 2.5 milliliters exceeds the amount that can be safely injected into one site for a 13-year-old child.

Question 2

A nurse is preparing to start a continuous IV infusion on a child. The nurse selects a Buretrol (volume-control) attachment as part of the IV tubing set-up. The main purpose for selecting a Buretrol attachment is to:

A) avoid fluid overload.
B) aid in measuring intake.
C) administer antibiotics.
D) ensure adequate intravenous fluid intake.

avoid fluid overload.

Accepted Answer

A volume-control device such as a Buretrol or an infusion pump allows the nurse to set a specific volume of fluid to be given in a specific period of time (usually 1 hour) and decreases the risk of inadvertently administering a large amount of fluid. Although the use of a volume-control device allows for accurate measurement of intake, the primary purpose for using this equipment is to prevent fluid overload. Medications such as antibiotics can be administered with a volume-control device; however, this is not the primary purpose.

Question 3

A nurse has just initiated an intravenous piggyback of gentamicin (Garamycin). What is the best time for a trough serum level to be measured?&#10;A) Just before the next dose&#10;B) When the infusion is finished&#10;C) One hour after the medication is administered&#10;D) Depends on the specific medication

Accepted Answer

The medication trough is the level at which the serum concentration is lowest. Trough levels are usually obtained just before the next medication dose. The serum concentration would be increasing as the infusion finishes. This is not the concentration trough. The peak concentration, or the concentration after the medication has been distributed, varies according to the specific medication. Trough is always the lowest just before the next medication dose.

Question 4

A family has just learned their child has cystic fibrosis. They told the nurse this wont change anything, our child is not that sick. The nurse recognizes that the family is in which stage of the grieving process?

A) Anger and resentment
B) Sorrow and depression
C) Shock and disbelief
D) Acceptance and adjustment

Accepted Answer

According to Kbler-Ross, denial is the initial stage of the grieving process when an individual reacts with shock and disbelief to the diagnosis of a chronic illness. Feelings of anger, resentment, sadness, and depression are part of the grieving process, after the initial response of shock and disbelief. Acceptance is the final stage of the grieving process.

Question 5

A nurse is planning care for a dying child. Which priority intervention is planned to address the primary concern parents have for the dying child?&#10;A) Pain&#10;B) Safety&#10;C) Food intake&#10;D) Fluid intake

Accepted Answer

The primary concern of all parents of dying children is the possibility of their child feeling pain. Although safety, eating, and hydration are important, they are not the priority concern.

Question 6

A parent of an infant states that she will room-in while her child is hospitalized. The nurse supports her decision knowing that the major fears of infants during illness and hospitalization are:&#10;A) bodily injury and pain.&#10;B) separation from caregivers and fear of strangers.&#10;C) loss of control and altered body image.&#10;D) the unknown and being left alone.

Accepted Answer

The major fear of infants during illness and hospitalization are separation from caregivers and fear of strangers. Bodily injury and pain are fears of preschool and school-age children. Loss of
 control is a fear of children from the preschool period through adolescence. Altered body image applies to adolescents. Fear of the unknown and being left alone are applicable to preschoolers.

Question 7

A nurse has just completed a teaching session for parents about childrens understanding of death. Parents of a 5-year-old child understood the teaching if they indicate which corresponds to their childs understanding of death?

A) Loss of a caretaker
B) Reversible and temporary
C) Permanent
D) Inevitable

Accepted Answer

Children in early childhood (2 to 7 years old) view death as reversible and temporary. Toddlers view death as loss of a caretaker. The school-age child and adolescent understand death is permanent. The adolescent understands death not only as permanent, but also inevitable.

Question 8

A nurse plans to include family in the aspects of care for a dying 12-month-old child. The nurse bases this plan on the understanding that death for an infant is understood as:&#10;A) temporary.&#10;B) permanent.&#10;C) loss of caretaker.&#10;D) punishment.

Accepted Answer

Infants and toddlers view death as loss of a caretaker. The preschool-age child views death as temporary. The school-age child and adolescent understand the permanence of death. The preschool-age child facing impending death may view his or her condition as punishment for behaviors or thoughts.

Question 9

Parents express recurrent feelings of grief, loss, and fear related to their childs chronic condition. The nurse understands that this is:&#10;A) anticipatory grieving.&#10;B) chronic sorrow.&#10;C) bereavement.&#10;D) illness trajectory.

Accepted Answer

The stated recurrent feelings define chronic sorrow, which is considered a normal process involving grief that may never be resolved. Anticipatory grieving is the process of mourning, coping, interacting, planning, and psychosocial reorganization that is begun as a response to the impending loss of a loved one. Bereavement is defined as the objective condition or state of loss. Illness trajectory is defined as the impact of the disease or condition on all family members, physiological unfolding of the disease, and work organization done by the family to cope.

Question 10

Place the stages of grieving in order starting with the initial stage and ending with the final stage.&#10;a. Anger&#10;b. Depression&#10;c. Denial&#10;d. Acceptance&#10;e. Bargaining

Accepted Answer

The answer of Place the stages of grieving in order...

Deck 2: Medication Administration, Intravenous Therapy, and Child With a Chronic Health Problem