A fifteen-year-old has been injured during football practice and has been taken to the hospital via ambulance. Providers have been unable to speak to parents despite several attempts to contact them. The youth needs emergency surgery, and understands the risks and benefits of the surgery. Which action is most appropriate at this time?

Have the youth give assent, and proceed with surgery.

Attempt to contact another relative.

Give pain medications until consent can be obtained.

Wait for parents to obtain consent.

Answer and Explanation

The Correct Answer is A

Choice A reason: This is the most appropriate action because it respects the youth's autonomy and maturity, and allows for timely and necessary intervention. Assent is the agreement of a minor to participate in a medical decision, and it is usually sufficient in emergency situations when parental consent is not available.

Choice B reason: This is not the most appropriate action because it may delay the surgery and put the youth at risk of further complications. Another relative may not have the legal authority to consent for the youth, and may not be reachable in time.

Choice C reason: This is not the most appropriate action because it does not address the underlying problem of the injury. Pain medications may provide temporary relief, but they may also mask the symptoms and interfere with the surgery.

Choice D reason: This is not the most appropriate action because it may jeopardize the youth's health and safety. Waiting for parents to obtain consent may result in irreversible damage or even death. The youth's best interest should be the priority in this case.

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Correct Answer is A

Explanation

Choice A reason: This is correct because the ordered dose of Amoxicillin is within the safe range for a 3-year-old weighing 14 kg. The daily dose of Amoxicillin is 175 mg x 3 = 525 mg. The safe dose range for a 14 kg child is 20-40 mg/kg/day, which is 280-560 mg/day. Therefore, the ordered dose is safe.

Choice B reason: This is incorrect because the ordered dose of Amoxicillin is not above the safe range for a 3-year-old weighing 14 kg. It is not necessary to reduce the dose or report it to the prescriber.

A. Administer Synagis® immediately and encourage fluids by mouth. B. Administer antiviral medication, limit fluids and give antitussives. C. Encourage fluids by mouth, IV antibiotics, and oxygen mist therapy. D. Provide oxygen mist therapy, administer IV fluids, and hand washing.

Correct Answer is D

Explanation

Choice A reason: This is not the correct answer because Synagis® is a monoclonal antibody that is given as a prophylaxis to prevent severe RSV infection in high-risk infants. It is not effective as a treatment for RSV bronchiolitis.

Choice B reason: This is not the correct answer because antiviral medication is not routinely recommended for RSV bronchiolitis, as it has not been shown to improve outcomes. Limiting fluids and giving antitussives may also be harmful, as they can cause dehydration and suppress the cough reflex.

Choice C reason: This is not the correct answer because IV antibiotics are not indicated for RSV bronchiolitis, which is a viral infection. Antibiotics may increase the risk of antibiotic resistance and adverse effects.

Choice D reason: This is the correct answer because oxygen mist therapy can help humidify the air and relieve the respiratory distress. IV fluids can prevent dehydration and maintain electrolyte balance. Hand washing can prevent the spread of RSV infection to other patients and staff.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a 3-year-old weighing 14 kg who has been ordered Amoxicillin 175 mg PO q 8 hrs for a recurrent ear infection. The safe dose is 20-40 mg/kg/day. Is this a safe dose?

Correct Answer is A

Explanation

Correct Answer is D

Explanation

While caring for a 4-year-old, the nurse uses which tool to assess pain?

Which intervention for treating croup at home should be taught to parents?

The nurse is providing discharge teaching to the parents of a 4-year-old with newly diagnosed asthma. An important tool to assess how well the asthma is controlled is:

Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis?

Staff members working with school-aged children believe it is important for each child to understand and agree to medical treatment, especially when treatment is part of research protocols. The term for this process is:

Which factor is most likely to contribute to respiratory compromise in a child?

The parent of a toddler calls the nurse, asking about croup. What is a distinguishing manifestation of croup?

The mother of a 3-year-old who has been diagnosed with an ear infection states, "I can't understand why you won't give my child antibiotics. Can't you see that she is sick?" Which of the following responses by the nurse is appropriate at this time?