The nurse is caring for a child who has undergone cardiac catheterization. During the recovery, the nurse notices that the dressing is saturated with bright red blood. The nurse's first action is to:

Apply direct pressure 1 inch above the puncture site

Notify the Cardiac Cath Lab that the child will be returning

Place a call to the Interventional Radiologist

Apply a bulky pressure dressing over the present dressing

Answer and Explanation

The Correct Answer is A

A. Bright red blood indicates active arterial bleeding, most likely from the femoral artery used during the cardiac catheterization. The first priority is to stop the bleeding. Direct pressure should be applied just above the puncture site to help control the bleeding and prevent further blood loss.
B. While notifying the Cath Lab may be necessary later, intervention to stop the bleeding must come first to ensure patient safety.
C. Contacting the Interventional Radiologist may eventually be required, but it is not the first action. Immediate pressure to control bleeding is more urgent.
D. Applying a bulky dressing alone without direct pressure is inadequate in managing arterial bleeding and may delay life-saving intervention.

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Correct Answer is D

Explanation

Step 1: Use the Holliday-Segar formula for maintenance fluids:

For the first 10 kg: 100 mL/kg/day

For the next 10 kg: 50 mL/kg/day

For any additional kg over 20 kg: 20 mL/kg/day

Step 2: Calculate for 36 kg

First 10 kg → 10 × 100 = 1,000 mL

Next 10 kg → 10 × 50 = 500 mL

Remaining 16 kg → 16 × 20 = 320 mL

Total = 1000 + 500 + 320 = 1,820 mL/day

Step 3: Convert to hourly rate

1820 mL/day ÷ 24 hr = 75.8 mL/hr

= 76 mL/hr (rounded off to the nearest whole number.

A. Sign of detachment and rejection. B. Sign of maternal deprivation. C. Suggestive of autism associated with Down syndrome D. Result of the physical characteristics of Down syndrome.

Correct Answer is D

Explanation

A. Detachment and rejection are psychosocial interpretations that require deeper behavioral assessment and are not appropriate assumptions based on physical presentation alone.
B. Maternal deprivation refers to a lack of emotional bonding or nurturing, which is not evidenced here and is not the cause of the floppiness described.
C. While autism can co-occur with Down syndrome, the description given is more characteristic of hypotonia, not autism-specific behavior.
D. Infants with Down syndrome commonly have generalized hypotonia (low muscle tone), which causes them to feel “floppy” or like a rag doll when held. This is a well-known physical trait of the condition and not a sign of emotional or developmental issues at this stage.

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The nurse is caring for a child who has undergone cardiac catheterization. During the recovery, the nurse notices that the dressing is saturated with bright red blood. The nurse's first action is to:

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Naxlex Comprehensive Predictor Exams

Cierra, a 10-year-old female weighing 36kg, is now NPO for surgery in the morning and needs _____ of maintenance fluids.

Correct Answer is D

Explanation

Correct Answer is D

Explanation

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