A nurse is preparing to administer Ringer’s lactate via continuous IV infusion at a rate of 120 mL/hr. The manual IV tubing’s drop factor is 60 gtt/mL. How many gtt/min should the nurse set the manual IV infusion to deliver?

(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

The correct answer is Choice A

Choice A rationale: Serum iron levels in children typically range from 50 to 120 mcg/dL. A value of 38 mcg/dL is significantly below the lower limit, indicating possible iron deficiency. Iron is essential for hemoglobin synthesis, oxygen transport, and cognitive development. Deficiency can lead to microcytic anemia, fatigue, and developmental delays. Early detection is critical, especially in pediatric populations where growth and neurodevelopment are rapid. This abnormal value warrants prompt provider notification for further evaluation and intervention.

Choice B rationale: Normal red blood cell (RBC) count in children ranges from approximately 4.1 to 5.5 million/mm³. A value of 4.9 million/mm³ falls comfortably within this range and does not suggest anemia or polycythemia. RBC count reflects bone marrow function and oxygen-carrying capacity. In the absence of symptoms or abnormal hemoglobin levels, this value is considered physiologically appropriate and does not require provider notification. It supports adequate erythropoiesis and oxygenation in the pediatric patient.

Choice C rationale: White blood cell (WBC) count in children typically ranges from 5,000 to 10,000 cells/mm³. A value of 10,000 cells/mm³ is at the upper limit of normal and may reflect mild physiological variation, such as recent activity or minor stress. It does not indicate infection, inflammation, or hematologic disorder unless accompanied by clinical symptoms or abnormal differential counts. Therefore, this value is not considered pathologic and does not require immediate reporting to the provider.

Choice D rationale: Blood lead levels below 5 mcg/dL are considered acceptable by CDC standards, although no level is truly safe. A value of 2 mcg/dL is within the expected range and does not indicate acute toxicity or environmental exposure requiring intervention. Lead affects neurological development, but levels under 5 mcg/dL are generally monitored without urgent action. Continued surveillance and environmental precautions are advised, but this value does not necessitate immediate provider notification.

Choice A rationale

The priority action for a nurse when caring for a patient exhibiting symptoms of a myocardial infarction is to initiate oxygen therapy. Oxygen therapy is crucial because it increases the amount of oxygen in the blood, which can help reduce the heart’s workload and relieve pain. This intervention is aimed at reducing myocardial oxygen demand and improving oxygen supply to the ischemic myocardium.

Choice B rationale

Obtaining a blood sample is important as it can help diagnose a myocardial infarction. Blood tests can measure levels of certain proteins, such as troponins, in the bloodstream that can indicate heart muscle damage. However, this is not the immediate priority when compared to initiating oxygen therapy.

Choice C rationale

Attaching the leads for a 12-lead ECG is an important step in the assessment of a patient with suspected myocardial infarction. An ECG can show whether the heart muscle has been damaged and where the damage has occurred. However, this should be done after initiating oxygen therapy.

Choice D rationale

Inserting an IV catheter is a necessary step in the management of a myocardial infarction. It allows for the administration of medications and fluids as needed. However, it is not the first priority. The first priority is to stabilize the patient, which includes initiating oxygen therapy.