The nurse is preparing to administer botulinum toxin to a child with spastic cerebral palsy. How will the nurse administer this medication?

Oral suspension.

Intravenous infusion.

Subcutaneous injection.

Intramuscular injection.

Answer and Explanation

The Correct Answer is D

Choice A reason: Oral suspension is not an appropriate method for administering botulinum toxin. This medication is not effective when taken orally and needs to be administered directly into the muscle to address spasticity.

Choice B reason: Intravenous infusion is also not the appropriate method for administering botulinum toxin. The medication is intended to act locally at the site of injection to reduce muscle spasticity, and intravenous administration would not achieve the desired localized effect.

Choice C reason: Subcutaneous injection is not the correct method for administering botulinum toxin. This medication needs to be injected directly into the muscle to have a therapeutic effect on muscle spasticity.

Choice D reason: Intramuscular injection is the correct method for administering botulinum toxin. The medication works by blocking the release of acetylcholine at the neuromuscular junction, thereby reducing muscle spasticity. Administering it directly into the muscle ensures that the medication reaches its target and provides the desired therapeutic effect.

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Correct Answer is ["B","C","E"]

Explanation

Choice A reason: Obtaining an arterial blood gas is not typically a routine intervention immediately following a caesarean section. Arterial blood gas measurements are usually performed if there is a specific indication or concern about the baby's respiratory status or acid-base balance. Routine care focuses on stabilizing and assessing the baby rather than performing invasive procedures unless clinically indicated.

Choice B reason: Ensuring thermoregulation is a crucial intervention for newborns, especially those delivered by caesarean section. Maintaining an appropriate body temperature is essential to prevent hypothermia, which can lead to complications such as metabolic disturbances and respiratory issues. The nurse should use measures like pre-warmed blankets and radiant warmers to keep the baby warm and stable.

Choice C reason: Administering oxygen as needed is an important intervention to ensure the baby's oxygenation and respiratory stability. Newborns delivered by caesarean section may have transient respiratory difficulties due to the lack of the natural squeeze through the birth canal, which helps clear the lungs of fluid. Monitoring the baby's respiratory status and providing supplemental oxygen if necessary is vital for their well-being.

Choice D reason: Inserting an orogastric tube is not a standard routine intervention immediately after a caesarean section unless there is a specific indication, such as if the baby has difficulty feeding, significant respiratory distress, or gastrointestinal issues. Routine care focuses on more immediate stabilization measures unless clinical signs suggest the need for an orogastric tube.

Choice E reason: Keeping the head in a sniffing position is important for maintaining an open airway and ensuring effective ventilation. The sniffing position aligns the airway and promotes optimal breathing. This position is particularly useful for newborns who may have respiratory difficulties or require resuscitation efforts, ensuring that their airway remains patent and clear.

A. A 5-year-old child admitted with asthma exacerbation who used a rescue inhaler 16 hours ago. B. A 3-year-old toddler who swallowed several sunflower seeds and continues to cough with an oxygen saturation of 91%. C. A 15-year-old adolescent who had a laparoscopic appendectomy 10 hours ago, rates their pain a 3/10, and is preparing for discharge this morning. D. An 18-month-old admitted for dehydration 2 days ago who has had six wet diapers in the last 24 hours and ate 70% of their meals.

Correct Answer is B

Explanation

Choice A reason: While a child with asthma exacerbation needs monitoring, they used their rescue inhaler 16 hours ago and are currently stable. This patient is not the highest priority.

Choice B reason: A 3-year-old who continues to cough with an oxygen saturation of 91% is at risk of respiratory distress or obstruction due to the swallowed sunflower seeds. The low oxygen saturation indicates impaired gas exchange and requires immediate attention.

Choice C reason: A 15-year-old recovering from a laparoscopic appendectomy who is stable and preparing for discharge can wait to be seen after more urgent cases.

Choice D reason: An 18-month-old admitted for dehydration who is producing a normal number of wet diapers and eating well indicates improved hydration status and can be seen after addressing the more critical situation.

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The nurse is preparing to administer botulinum toxin to a child with spastic cerebral palsy. How will the nurse administer this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["B","C","E"]

Explanation

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Correct Answer is B

Explanation

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