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 a digoxin level of 1.2 ng/mL (0.8 to 2 ng/mL)

A toddler who has vomited 2 times in the last hour

Answer and Explanation

The Correct Answer is D

A.   A normal apical pulse for a toddler is around 90-140 beats per minute. This toddler's heart rate is within normal range.
B.   This toddler's potassium level is within the normal range.
C.   This toddler's digoxin level is within the therapeutic range.
D.   Vomiting can be a sign of digoxin toxicity. Digoxin has a narrow therapeutic index, meaning that even small increases in the drug level can lead to toxicity.

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Correct Answer is A

Explanation

A. Logrolling is a specific turning technique used to maintain spinal alignment post-operatively. It requires two nurses to prevent injury to the spine.

B. While elevating the head of the bed is important to prevent respiratory complications, a 30° angle is too high for a patient with spinal instrumentation. A lower angle is typically recommended to maintain spinal alignment.
C. Early ambulation is encouraged after surgery, but 12 hours is too soon. The adolescent will likely be on bed rest for several days to allow the fusion to stabilize.
D. Clear liquids are often introduced earlier than 4 hours post-surgery, once bowel sounds return and there is no evidence of nausea or vomiting.

A. Increased dependency B. Less emotionally labile C. Resistant to routines D. Frequent negative responses

Correct Answer is D

Explanation

A. Toddlers are typically moving towards independence, not increased dependency. This is a stage of exploration and asserting their autonomy.
B. Toddlers are known for their intense emotions and rapid mood swings. This is a normal part of their development.
C. While toddlers can be unpredictable, they often thrive on routines. However, they also enjoy exploring new things, which can sometimes lead to resistance to established routines.
D. The "terrible twos" is a common phrase for a reason. Toddlers often assert their independence through negative responses, such as saying "no" or throwing tantrums.

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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

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Correct Answer is D

Explanation

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