A child with a heart defect has been prescribed a maintenance dose of Lanoxin elixir at 0.07 mg/kg/day, divided into two doses.
The child weighs 19 pounds.
What is the maximum dose of medication the nurse should administer in each dose? T 0.3 mg.
Answer and explanation
The correct answer is Choice B, Choice C, Choice D.
Choice A rationale
A large bruise on the forehead of a 2-year-old could occur from accidental falls, which are common at this developmental stage due to increased mobility and decreased coordination. It does not necessarily suggest abuse unless accompanied by other suspicious findings.
Choice B rationale
Circular abrasions around the wrists are highly indicative of physical abuse as they suggest binding injuries. Restraining a child is neither acceptable nor normal, and such findings must be reported for further investigation by child protective services.
Choice C rationale
A burn on the palm of a 10-year-old’s hand raises concerns for abuse as accidental burns usually occur on accessible areas like arms or legs, not the palm. This pattern could indicate intentional infliction, requiring mandatory reporting to authorities.
Choice D rationale
Splash burns on the front torso in a 6-year-old are suspicious if inconsistent with the child’s developmental abilities or history provided by caregivers. Intentional scald burns often follow specific patterns, like splash marks, and must be reported for investigation.

Choice A rationale

Postpartum depression is more likely in individuals with a history of depression due to predisposing factors such as neurochemical imbalances and psychosocial stressors. Pregnancy and childbirth exacerbate these vulnerabilities through hormonal fluctuations, sleep deprivation, and new parenting stress. Early identification of at-risk populations is critical to prevent severe outcomes and promote maternal mental health.

Choice B rationale

Psychotic behavior is not a common feature of postpartum depression. It is more characteristic of postpartum psychosis, a rare and severe condition that requires immediate intervention. Postpartum depression primarily manifests as feelings of sadness, anxiety, and difficulty bonding with the infant, rather than psychotic symptoms like delusions or hallucinations.

Choice C rationale

Harming the infant is not the most common manifestation of postpartum depression. While intrusive thoughts may occur, the condition primarily presents with emotional symptoms such as hopelessness, guilt, and fatigue. Focused therapy can address these feelings and help prevent rare but severe outcomes involving harm.

Choice D rationale

Postpartum depression typically develops within 1–4 weeks after delivery, with symptoms often emerging gradually. The claim that it begins within 48 hours is inaccurate and more representative of the "baby blues," a transient and less severe condition. Accurate diagnosis involves monitoring symptom progression over time. .

Choice A rationale

Removing a pacifier does not align with preventing SIDS. Studies suggest pacifier use during sleep reduces the risk of SIDS by maintaining airway patency and ensuring better sleep quality, though it should be used appropriately without attaching strings or clips that may pose risks.

Choice B rationale

Feeding every 2 hours does not directly prevent SIDS but supports adequate nutrition for growth and development. While proper feeding schedules are important, specific sleeping arrangements and environment management play a more significant role in reducing SIDS risk.

Choice C rationale

Placing the newborn on their back to sleep aligns with safe sleep recommendations to prevent SIDS. This position reduces the risk of airway obstruction and promotes proper breathing. The supine sleep position is widely endorsed by health organizations for its protective effect.

Choice D rationale

Draping a blanket over the newborn increases the risk of suffocation and overheating, both of which are associated with SIDS. It is essential to keep sleep environments free of loose items and ensure the baby is dressed appropriately for the room's temperature to reduce these risks.