Exhibits
For each potential provider prescription, click to specify if the prescription is expected or unexpected for the adolescent. There must be at least 1 selection in every row. There does not need to be a selection in every column.
Insert a peripheral IV catheter.
Place the adolescent on a cooling blanket.
Administer IV acyclovir.
Place on seizure precautions.
Keep adolescent flat in bed for 24 hr post lumbar puncture.
Administer IV cefotaxime.
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"}}
Rationale:
- Insert a peripheral IV catheter: A peripheral IV catheter is essential for administering fluids and medications, which is critical for this adolescent, especially with the concern for bacterial meningitis.
- Place the adolescent on a cooling blanket: The adolescent has a high fever (39°C), which needs to be managed promptly to prevent further complications. A cooling blanket helps reduce the fever and manage the patient’s temperature.
- Administer IV acyclovir: Acyclovir is an antiviral medication typically used to treat viral infections such as herpes simplex virus or varicella-zoster virus, not bacterial meningitis. Given the CSF findings and suspected bacterial meningitis, acyclovir is not appropriate. Antibiotics like cefotaxime are indicated instead.
- Place on seizure precautions: Given the adolescent's symptoms (e.g., headache, photophobia, lethargy), the risk of seizures is elevated, especially if meningitis is suspected. Seizure precautions are important to prevent injury during a potential seizure.
- Keep adolescent flat in bed for 24 hr post lumbar puncture: After a lumbar puncture, keeping the adolescent flat in bed for 24 hours helps prevent post-lumbar puncture headaches and minimizes the risk of cerebrospinal fluid leaks or complications.
- Administer IV cefotaxime: IV cefotaxime is an appropriate antibiotic for treating bacterial meningitis. Given the abnormal CSF results (low glucose, high protein, elevated WBC), the adolescent is at high risk for bacterial meningitis, and IV cefotaxime is expected to be part of the treatment plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Promoting nutrition: While nutrition is important, preventing infections is more urgent in a preschooler with leukemia. Leukemia and its treatments, such as chemotherapy, can significantly weaken the immune system, making the child more susceptible to infections.
B. Preventing infections: Preventing infections is critical for children with leukemia because their immune systems are compromised, either by the disease itself or by treatments like chemotherapy. Educating the guardians on how to prevent infections (e.g., hand hygiene, avoiding crowds, keeping the environment clean) is crucial to avoid serious complications.
C. Supporting psychological wellness: While psychological support is important, the priority for a preschooler with leukemia is to focus on preventing infections and ensuring their physical well-being, as infections can lead to severe consequences.
D. Managing mucosal ulcerations: Mucosal ulcerations can be a concern for children undergoing cancer treatment, but preventing infections is a more immediate and potentially life-saving priority. Once infections are controlled, mucosal ulcerations can also be addressed.
Correct Answer is C
Explanation
A. “I can leave my child alone in the bathtub for up to 15 minutes after they learn to swim." Leaving a toddler alone in the bathtub is not safe, even if they know how to swim. Drowning occurs very quickly, and toddlers should always be supervised when in or near water.
B. "Open windows are safe as long as the screens fit snugly." Even if the screens fit snugly, open windows still pose a risk of falls for toddlers. It is important to keep windows securely closed or use window guards to prevent accidents.
C. "The water heater should be set to 120 degrees Fahrenheit or less." Setting the water heater to 120°F or lower is an appropriate and safe recommendation to prevent burns. Water temperatures higher than 120°F can cause serious burns, especially in young children.
D. “I will tell my toddler to never touch a firearm." Simply telling a toddler to avoid firearms may not be enough. Firearms should be securely stored in a locked, childproof safe, away from the child's reach, regardless of what the child is told.
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