The nurse plans to administer a vitamin B12 injection to a school aged child. Which intervention should the nurse implement?

Allow the child to choose among age appropriate injection sites.

Apply topical anesthesia ten minutes prior to injection.

Ask the child to stand to access the ventrogluteal site.

Select an abdominal subcutaneous site to enhance absorption.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Allowing a child to choose an injection site may lead to an inappropriate or unsafe location. The ventrogluteal and vastus lateralis muscles are the preferred sites for intramuscular injections in children, selected based on the child's age, muscle development, and the volume of medication. Allowing a child to select an unsafe site could risk nerve or vascular injury.

Choice B rationale

Topical anesthetics, such as lidocaine/prilocaine cream, are effective in reducing the perception of pain associated with injections. They work by blocking sodium channels in neuronal membranes, preventing the propagation of pain signals to the central nervous system. Applying the cream ten minutes before the procedure allows for adequate time for the anesthetic effect to take place.

Choice C rationale

The ventrogluteal site is the preferred site for intramuscular injections in children over seven months old. The nurse should ask the child to lie on their side with the upper knee bent to a 45-degree angle. This position ensures relaxation of the gluteal muscles and allows for accurate landmarking of the greater trochanter, anterior superior iliac spine, and iliac crest, minimizing the risk of sciatic nerve injury.

Choice D rationale

Subcutaneous sites are not typically used for vitamin B12 injections. Subcutaneous injections are given into the fatty tissue below the dermis and are best for small volumes of non-irritating, water-soluble medications, such as insulin. Vitamin B12 is typically administered via the intramuscular route to ensure proper absorption into the muscle tissue.

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Correct Answer is C

Explanation

Choice A rationale

An LDH level of 525 U/L is elevated (normal range is 140-280 U/L), which can indicate cell damage, particularly in the liver. However, this finding alone does not necessitate an immediate cesarean section. Delivery is the definitive cure for preeclampsia, but it is not automatically triggered by a single elevated lab value without other signs of maternal or fetal compromise. A cesarean section is a major surgical procedure.

Choice B rationale

An uric acid level of 5.8 mg/dL is within or near the normal range for women (2.4-6.0 mg/dL), and therefore, no medication is needed to lower it. Elevated uric acid is a common finding in preeclampsia due to decreased renal clearance, but this specific level is not considered pathologically high enough to require therapeutic intervention. The focus is on the overall clinical picture, not a single normal lab value.

Choice C rationale

An elevated lactate dehydrogenase (LDH) level, along with other signs and symptoms, is a marker of cell damage and hemolysis, often associated with HELLP syndrome. This syndrome is a severe form of preeclampsia involving Hemolysis, Elevated Liver enzymes, and Low Platelets. Monitoring for signs of liver dysfunction, such as right upper quadrant pain or jaundice, is essential to detect this serious complication.

Choice D rationale

Restricting fluid intake is not an appropriate intervention to decrease uric acid levels in preeclampsia. In fact, severe fluid restriction can be harmful and may worsen maternal hypovolemia, which is already a concern in preeclampsia due to capillary leakage. Uric acid is typically managed by addressing the underlying preeclampsia and promoting diuresis, not restricting fluids.

A. Mix infant formula with breast milk. B. Introduce baby food for one meal daily. C. Offer a follow-up transitional formula. D. Supplement with an iron-rich formula.

Correct Answer is D

Explanation

Choice A rationale

Mixing infant formula with breast milk is not recommended because the mother is trying to increase her breast milk supply, and introducing formula can decrease the infant's demand for breast milk, which in turn reduces the mother's milk production. This approach also risks overfeeding the infant and does not address the underlying issue of insufficient supply.

Choice B rationale

Introducing baby food at 5 months is generally not recommended as a primary solution for insufficient breast milk. The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months. Early introduction of solids can displace breast milk intake, leading to reduced milk production and potentially interfering with the infant's nutritional needs and digestive development.

Choice C rationale

Follow-up or transitional formulas are typically designed for infants older than 1 year. The infant in this scenario is 5 months old and requires a formula specifically tailored to meet the nutritional needs of infants under 1 year of age. Providing an inappropriate formula can lead to nutritional imbalances and potential digestive issues for the infant.

Choice D rationale

A 5-month-old infant's primary source of nutrition should still be breast milk or formula. If the mother is having difficulty pumping enough milk, supplementing with an iron-rich formula is the most appropriate recommendation. This ensures the infant receives adequate nutrition, including essential iron, which is critical for growth and development at this age. This approach also helps prevent nutritional deficiencies while allowing the mother to continue breastfeeding.

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The nurse plans to administer a vitamin B12 injection to a school aged child. Which intervention should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with preeclampsia is admitted to the hospital. The client's laboratory results indicate a lactate dehydrogenase (LDH) level of 525 U/L and uric acid of 5.8 mg/dL. Which intervention should the nurse anticipate?

Correct Answer is C

Explanation

A breastfeeding mother returns to work when her infant is 5 months old. She is having difficulty pumping enough milk to meet her infant's dietary requirements. Which suggestion should the nurse provide to this mother?

Correct Answer is D

Explanation

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