The nurse is providing phone advice to the father of a 7-year-old child who has lice. The nurse recommends:

Applying oil to the scalp for the next ten days.

Throwing away all stuffed animals.

Thorough cleaning of brushes, hats, and linens and staying home until there are no more nits.

Applying a pediculicide and thoroughly combing the nits out of the hair.

Answer and Explanation

The Correct Answer is D

Choice A reason: This is not a correct recommendation, as oil may not be effective in killing lice or nits. Oil may also make the hair greasy and difficult to comb.

Choice B reason: This is not a necessary recommendation, as throwing away all stuffed animals may be wasteful and upsetting for the child. Stuffed animals can be treated by sealing them in plastic bags for two weeks or by putting them in a dryer on high heat for 20 minutes¹.

Choice C reason: This is a good recommendation, as thorough cleaning of brushes, hats, and linens can help prevent the spread of lice to other people or items. However, staying home until there are no more nits is not required, as nits are not contagious and do not pose a health risk².

Choice D reason: This is the best recommendation, as applying a pediculicide and thoroughly combing the nits out of the hair can effectively treat lice infestation. Pediculicides are medicated shampoos or lotions that kill lice and some nits. Combing the nits out of the hair can remove any remaining eggs and prevent reinfestation¹².

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Correct Answer is B

Explanation

Choice A reason: Cardiac arrhythmia is an abnormal heart rhythm that can affect the heart's ability to pump blood. However, it is not a direct consequence of a ventricular septal defect (VSD), which is a hole in the wall between the lower chambers of the heart¹.

Choice B reason: Decreased cardiac output is the amount of blood pumped by the heart per minute. It can be reduced by a VSD, as the blood can flow back from the left ventricle to the right ventricle through the hole, instead of being pumped to the body. This can cause the infant to have cool extremities, thready pulses, and low urine output, as the tissues are not receiving enough oxygen and nutrients².

Choice C reason: Increased stroke volume is the amount of blood pumped by the heart per beat. It can be increased by a VSD, as the left ventricle has to work harder to compensate for the blood loss through the hole. However, this does not explain the infant's symptoms, as the stroke volume may not be enough to maintain a normal cardiac output².

Choice D reason: Cyanosis is a bluish discoloration of the skin and mucous membranes due to low oxygen levels in the blood. It can be caused by a VSD, as the oxygen-rich blood from the left ventricle can mix with the oxygen-poor blood from the right ventricle through the hole, and then be pumped to the body. However, this is more likely to occur in large VSDs or in infants with other heart defects that cause right-to-left shunting of blood³.

A. IV fluids at 2x maintenance, oxygen, medication to support cardiac function B. Oxygen, medication to support cardiac function, IV fluid bolus of 20 ml/kg C. Oxygen, IV fluid bolus of 20 ml/kg, medications to support cardiac function D. Oxygen, IV fluid bolus of 10 ml/kg, medication to support cardiac function

Correct Answer is C

Explanation

Choice A reason: This is not the correct order, as IV fluids at 2x maintenance are not enough to restore the blood volume and perfusion in hypovolemic shock. The child needs a rapid IV fluid bolus of 20 ml/kg to replace the fluid losses and improve the hemodynamic status¹.

Choice B reason: This is not the correct order, as medication to support cardiac function should be given after the IV fluid bolus, not before. The fluid bolus is the first priority to increase the preload and cardiac output in hypovolemic shock. Medications such as inotropes or vasopressors may be needed if the fluid bolus is not effective or causes adverse effects¹².

Choice C reason: This is the correct order, as oxygen, IV fluid bolus of 20 ml/kg, and medications to support cardiac function are the appropriate interventions for hypovolemic shock. Oxygen is given to improve the oxygen delivery and tissue perfusion. IV fluid bolus of 20 ml/kg is given to restore the blood volume and improve the hemodynamic status. Medications such as inotropes or vasopressors are given to support the cardiac function and maintain the blood pressure¹².

Choice D reason: This is not the correct order, as IV fluid bolus of 10 ml/kg is not enough to restore the blood volume and perfusion in hypovolemic shock. The child needs a rapid IV fluid bolus of 20 ml/kg to replace the fluid losses and improve the hemodynamic status¹.

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The nurse is providing phone advice to the father of a 7-year-old child who has lice. The nurse recommends:

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Naxlex Comprehensive Predictor Exams

A six-month-old infant is hospitalized for repair of a ventricular septal defect. As you are doing his physical exam, you note that the infant's extremities are cool, he has thready pulses, and his urine output is diminished. These clinical findings are suggestive of which of the following?

Correct Answer is B

Explanation

An 18-month-old is admitted to the Emergency Department in hypovolemic shock. What would be the correct order of nursing interventions (assuming MD orders were written)?

Correct Answer is C

Explanation

Which should the nurse consider when preparing a school-age child and the family for heart surgery?

Nurses must be alert for increased fluid requirements when a child has:

Therapeutic management of the child with acute diarrhea and dehydration usually begins with what intervention?

The treatment of choice in a child with intussusception who is not showing signs of sepsis or shock is hydrostatic reduction of telescoped bowel with an air or saline enema.

A 14-year-old girl has returned to the nursing unit after undergoing an appendectomy. To help relieve pain and facilitate drainage, the nurse should place her in what position?

A mother who intended to breastfeed has given birth to an infant with a cleft palate. Which nursing interventions should be included in the plan of care?

A four-month-old infant is hospitalized for repair of a ventricular septal defect. The infant's admitting diagnosis is moderate congestive heart failure. If the infant's CHF worsens, the nurse may implement which of the following interventions, assuming an order was written?

A child in compensated shock will show which symptoms?