A nurse is caring for a group of toddlers receiving digoxin therapy. For which of the following toddlers should the nurse revise the plan of care?

A toddler who has an apical pulse of 100/min

A toddler who has a potassium level of 4.0 mEq/L (3.4 to 4.7 mEq/L)

A toddler who has vomited 2 times in the last hour

A toddler who has a digoxin level of 1.2 ng/mL (0.8 to 2 ng/mL)

Answer and Explanation

The Correct Answer is C

A. An apical pulse of 100/min is within the normal range for a toddler. Digoxin should be administered cautiously if the heart rate is too low (below 90-100/min for young children), but 100/min is not a concern.

B. A potassium level of 4.0 mEq/L is within the normal range for toddlers (3.4-4.7 mEq/L), so there is no indication to revise the plan of care.

C. Vomiting is a sign of digoxin toxicity, and it requires immediate attention. The nurse should reassess the digoxin dose and check for other signs of toxicity, such as nausea, bradycardia, and arrhythmias.

D. A digoxin level of 1.2 ng/mL is within the therapeutic range for a toddler (0.8-2 ng/mL), so there is no need to revise the plan of care based on this finding.

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Correct Answer is A

Explanation

A. Facial twitching could indicate a neurological problem, such as a seizure, which requires immediate attention in a child with sickle cell anemia, who is at increased risk for neurological complications.

B. Kyphosis is a chronic issue and not an acute concern in sickle cell anemia.

C. Constipation is common in children with sickle cell anemia, but it is not as urgent as facial twitching.

D. Enuresis (bedwetting) is a common issue for children with sickle cell anemia but is not as immediately concerning as facial twitching, which may suggest a more urgent issue.

A. Encourage flexion and extension of the neck. B. Tighten the screws on the halo device one-quarter turn every 48 hr. C. Assess the pin sites for infection once every other day. D. Reposition the client using a turning sheet.

Correct Answer is D

Explanation

A. Flexion and extension of the neck should be avoided to prevent further injury.

B. The screws on the halo device should not be tightened routinely unless directed by the provider.

C. Pin site assessment should be done daily, not every other day, to check for infection.

D. Repositioning the client using a turning sheet is important to prevent movement of the halo device and to prevent injury to the cervical spine.

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A nurse is caring for a group of toddlers receiving digoxin therapy. For which of the following toddlers should the nurse revise the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a child who has sickle cell anemia. Which of the following findings is the priority for the nurse to report to the provider?

Correct Answer is A

Explanation

A nurse is caring for a client who is postoperative following placement of a halo vest to manage a cervical vertebral fracture. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

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