Using the West nomogram scale, the nurse needs to calculate the safe dosage of a medication for a child. The child is 50 inches tall and weighs 76 lb. The normal dosage of the medication for an adult is 300 mg. Which of the following is the correct way to use the West nomogram scale?
Use the “shortcut” scale because this child is average. This will show the nurse the percentage of the adult dosage appropriate for this child. Use this percentage to calculate the dosage.
Locate the child’s height and weight on the nomogram. Use a straight edge to align these numbers with the scale indicating percentage of adult dosage and multiply the adult dosage by this number.
Locate the child’s height and weight on the scale, multiply those two numbers, and divide the adult dosage by the resulting number.
Use the scale to locate the child’s height and weight. Use a straight edge to align these numbers with the scale indicating the surface area, divide that by the average adult body surface area, and multiply the resulting number by the adult dose.
The Correct Answer is D
Choice A reason: The “shortcut” scale is not a standard method for the West nomogram, which calculates body surface area (BSA) for precise dosing. Using BSA ensures accuracy for a 76-lb, 50-inch child, making this simplified approach incorrect for calculating a safe pediatric medication dosage in clinical practice.
Choice B reason: Aligning height and weight to a percentage of adult dosage is not how the West nomogram works; it calculates BSA. The correct method uses BSA relative to adult BSA, making this incorrect, as it skips the critical step of surface area calculation for accurate pediatric dosing.
Choice C reason: Multiplying height and weight and dividing the adult dosage is not a nomogram method. The West nomogram uses BSA to adjust doses, comparing child and adult surface areas, making this mathematically incorrect and inappropriate for calculating a safe pediatric medication dose for the child.
Choice D reason: The West nomogram calculates a child’s BSA using height (50 inches) and weight (76 lb), then divides by the average adult BSA (1.7 m²) to find the proportion of the adult dose (300 mg). This method ensures accurate pediatric dosing, making it the correct choice for safe administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Children’s liver and pancreatic enzyme levels are not greater than adults’ but are sufficient for age-specific needs. Complex carbohydrate digestion is limited in children due to immature enzymes, making this inaccurate and incorrect compared to the carbohydrate metabolism difference in pediatric gastroenterology.
Choice B reason: Food passes through a child’s gastrointestinal tract faster, not slower, due to shorter intestines and higher motility. Limited complex carbohydrate digestion is the key difference, making this incorrect, as it misrepresents the speed of pediatric gastrointestinal transit compared to adults.
Choice C reason: The child’s gastrointestinal system is not fully mature at birth; it develops over years, particularly in enzyme function. Inability to digest complex carbohydrates reflects this immaturity, making this incorrect compared to the accurate statement about carbohydrate metabolism limitations in children.
Choice D reason: Children have limited ability to break down complex carbohydrates due to immature digestive enzymes, like amylase, compared to adults. This aligns with pediatric gastroenterology evidence, making it the most correct statement about the child’s gastrointestinal system development and function in digestion.
Correct Answer is C
Explanation
Choice A reason: Bone marrow transplant is reserved for high-risk or relapsed ALL, not routine across treatment phases. Complete remission is the goal periodically assessed, making this incorrect, as it’s not a standard periodic occurrence in the child’s treatment for acute lymphoblastic leukemia.
Choice B reason: Relapse is a complication, not an expected periodic outcome in ALL treatment phases. Complete remission is regularly evaluated, making this incorrect, as it represents a failure rather than the anticipated progress in the child’s ongoing leukemia treatment protocol.
Choice C reason: Complete remission, marked by no detectable leukemia cells, is the goal periodically assessed during ALL treatment phases. This aligns with pediatric oncology protocols, making it the correct outcome most likely seen as the child progresses through treatment for acute lymphoblastic leukemia.
Choice D reason: Methotrexate injections into cerebrospinal fluid are specific to central nervous system prophylaxis, not periodic across all phases. Complete remission is routinely monitored, making this incorrect, as it’s not a universal periodic event in the child’s ALL treatment process.
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