A child is receiving maintenance intravenous (IV) fluids at the rate of 1000 mL for the first 10 kg of body weight, plus 50 mL/kg per day for each kilogram between 10 and 20. How many milliliters per hour should the nurse program the infusion pump for a child who weighs 19.5 kg?

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Question 1 of 9

A child is receiving maintenance intravenous (IV) fluids at the rate of 1000 mL for the first 10 kg of body weight, plus 50 mL/kg per day for each kilogram between 10 and 20. How many milliliters per hour should the nurse program the infusion pump for a child who weighs 19.5 kg?

Correct Answer: B

Rationale: To calculate the IV fluids for a 19.5 kg child: 1. For the first 10 kg: 1000 mL 2. For the weight between 10-20 kg: (19.5 kg - 10 kg) * 50 mL/kg = 475 mL Total IV fluids = 1000 mL + 475 mL = 1475 mL To convert to mL per hour: 1475 mL / 24 hours = ~61 mL/hr Therefore, the correct answer is B (61 mL/hr). Incorrect Choices: A (24 mL/hr): Incorrect, as it doesn't consider the additional fluids for the weight between 10-20 kg. C (73 mL/hr) and D (58 mL/hr): Incorrect, as these values are not obtained from the correct calculation based on the given formula.

Question 2 of 9

Following an emergency Cesarean delivery, the nurse encourages the new mother to breastfeed her newborn. The client asks why she should breastfeed now. Which information should the nurse provide?

Correct Answer: A

Rationale: The correct answer is A because breastfeeding helps stimulate the uterus to contract, which reduces the risk of postpartum hemorrhage in the mother. When the baby suckles at the breast, it triggers the release of oxytocin, a hormone that causes the uterus to contract. This contraction helps the uterus to return to its pre-pregnancy size and shape, promoting faster healing and reducing bleeding. Choice B is incorrect because lactation initiation is a separate process that involves hormonal changes and milk production, which may not occur immediately after delivery. Choice C is incorrect as bonding can occur through various interactions beyond breastfeeding. Choice D is incorrect as neonatal hypoglycemia is primarily prevented by ensuring the baby receives adequate nutrition, which can also be achieved through other feeding methods besides breastfeeding.

Question 3 of 9

A nurse has been working as a staff nurse in the surgical inabteirbn.scoivme/t ecsat re unit for 2 years and is interested in certification. Which credential would be most applicable for her to seek?

Correct Answer: C

Rationale: The correct answer is C: CCRN. The nurse works in a surgical unit, making CCRN (Critical Care Registered Nurse) the most applicable credential as it focuses on critical care nursing, which is relevant to the nurse's current practice. ACNPC (Acute Care Nurse Practitioner Certification) and PCCN (Progressive Care Certified Nurse) are not suitable as they are more focused on advanced practice or progressive care respectively, not directly related to surgical units. CCNS (Clinical Nurse Specialist Certification) is not the best choice as it is more geared towards advanced practice roles in specific clinical specialties, not general staff nursing.

Question 4 of 9

The nurse is a member of a committee to design a critical care unit in a new building. Which design trend would best be implemented to facilitate famil y-centered care?

Correct Answer: A

Rationale: Correct Answer: A Rationale: 1. Family-centered care promotes involvement of family members in patient care. 2. A sleeper sofa in the patient's room allows family members to stay overnight, enhancing support for the patient. 3. Storage for personal belongings ensures families can have essentials close by, increasing comfort and convenience. 4. These design elements facilitate family presence, communication, and participation in care, aligning with family-centered care principles. Summary of Incorrect Choices: B. Having a diagnostic suite nearby is convenient but not directly related to family-centered care principles. C. A waiting room with amenities is beneficial but does not directly involve families in patient care. D. Access to a garden for meditation is helpful for relaxation but does not emphasize family involvement in care.

Question 5 of 9

A patient’s ventilator settings are adjusted to treat hypoxemia. The fraction of inspired oxygen is increased from.60 to.70, and the positive end-expiratory pressure is increased from 10 to 15 cm H O. Shortly after these adjustments, the nurse notes that the patient’s blood pressure drops from 120/76 mm Hg to 90/60 mm Hg. What is the m ost likely cause of this decrease in blood pressure?

Correct Answer: B

Rationale: The correct answer is B: Hypovolemia. When the ventilator settings are adjusted to treat hypoxemia by increasing FiO2 and PEEP, it can lead to increased oxygenation but also potentially decrease venous return to the heart, causing a decrease in blood pressure. This decrease in blood pressure is most likely due to hypovolemia, as the increased PEEP can increase intrathoracic pressure, reducing venous return and preload, leading to a decrease in cardiac output and subsequent decrease in blood pressure. This choice is the most likely cause as the other options (A: Decrease in cardiac output, C: Increase in venous return, D: Oxygen toxicity) do not directly correlate with the changes in ventilator settings described in the question.

Question 6 of 9

The patient has just returned from having an arteriovenous fistula placed. The patient asks, “When will they be able to use this and take this other catheter out?” The nurse should reply,

Correct Answer: C

Rationale: The correct answer is C: “The fistula will be usable in about 4 to 6 weeks.” The rationale for this is that an arteriovenous fistula typically requires 4 to 6 weeks to mature and be ready for use. During this time, the fistula develops the necessary blood flow for efficient dialysis. Choice A is incorrect because immediate use of the fistula is not recommended as it needs time to mature. Choice B is incorrect as it underestimates the time needed for the fistula to heal and mature. Choice D is incorrect as the usability of the fistula is not dependent on the manufacturer but rather on the patient's individual healing process.

Question 7 of 9

The nurse is preparing to provide postmortem care for a patient who has just died. Which action should the nurse take first?

Correct Answer: A

Rationale: Rationale: A: Closing the patient's eyes and placing a pillow under the head is the first step in postmortem care to maintain dignity and prevent airway occlusion. B: Washing the body and changing clothes can be done later and is not the priority. C: Removing medical equipment can wait until after ensuring the patient's comfort. D: Confirming the death certificate is important but not the immediate first step in postmortem care.

Question 8 of 9

The nurse returns from the cardiac catheterization laboratory with a patient following insertion of a pulmonary artery catheter and assists in transferring th e patient from the stretcher to the bed. Prior to obtaining a cardiac output, which action is m ost important for the nurse to complete?

Correct Answer: B

Rationale: The correct answer is B: Zero reference the transducer system at the phlebostatic axis. This is the most important action before obtaining a cardiac output because zero referencing ensures accurate pressure readings. The phlebostatic axis is the level of the atria when the patient is supine, and zeroing at this point minimizes errors in pressure measurements. Choice A is incorrect because documenting a pulmonary artery catheter occlusion pressure is not the priority at this stage. Choice C is incorrect as inflating the balloon with air should be done after zero referencing. Choice D is incorrect as injecting normal saline into the port is not necessary before zero referencing.

Question 9 of 9

Which statement is consistent with societal views of dying in the United States?

Correct Answer: D

Rationale: Rationale: The correct answer is D because the purpose of the healthcare system in the United States is primarily focused on disease prevention and symptom management. This aligns with societal views as healthcare is geared towards improving health outcomes and quality of life. Incorrect choices: A: Dying is not viewed as a failure of the system or providers, rather as a natural part of life. B: Most Americans prefer to die at home or in hospice care rather than in a hospital. C: Illnesses are not always curable, and death can result from various complex conditions beyond treatment.

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