Based on developmental norms for a 5-year-old child, a healthcare professional decides to withhold a scheduled dose of digoxin (Lanoxin) elixir and notify the healthcare provider. Below what apical pulse did the healthcare professional withhold the medication?

Correct Answer: C

Rationale: For a 5-year-old child, an apical pulse below 90 beats/min is an indicator to withhold digoxin. Digoxin is a medication that affects the heart, and in pediatric patients, monitoring the pulse rate is crucial due to the risk of bradycardia (slow heart rate) as a potential side effect. In this case, an apical pulse of 90 beats/min or lower indicates a heart rate that may be too slow for a child of this age, warranting the withholding of digoxin and prompt notification of the healthcare provider. Choices A, B, and D are not within the critical range specified for withholding digoxin in a 5-year-old child and would not necessitate withholding the medication.

Correct Answer: A

Rationale: In this scenario, focusing on teaching the mother proper care procedures is crucial. This empowers the mother to provide appropriate care for her daughter's broken arm, promoting optimal healing. Dealing with insurance coverage (Choice B) is important but not the immediate focus for the mother. Determining the success of treatment (Choice C) is typically done by healthcare professionals, not family members. Transmitting information to family members (Choice D) may be beneficial but ensuring the primary caregiver, in this case, the mother, is well-informed and capable of providing care takes precedence.

Correct Answer: C

Rationale: In this scenario, asking about the gestational age is crucial as it helps determine the stage of labor and potential complications. Knowing the number of weeks of gestation can guide the healthcare provider in assessing the progress of labor and making decisions about the care of both the mother and the baby. Choices A, B, and D are not as relevant in this urgent situation. While knowing if the bag of waters has broken is important for assessing the progress of labor, determining gestational age is more critical at this point. Asking about regular prenatal care or the number of other children does not provide immediate information necessary for managing the current situation.

Correct Answer: B

Rationale: The correct first action before administering tube feeding to an infant is to offer a pacifier. Providing a pacifier stimulates the sucking reflex, aiding in digestion and providing comfort to the infant. Irrigating the tube with water (Choice A) is not typically the initial step and could potentially introduce unnecessary fluid into the infant's system. Slowly instilling formula (Choice C) should only be done after ensuring the tube is appropriately placed. Placing the infant in the Trendelenburg position (Choice D) is not necessary for tube feeding and could pose risks such as aspiration.

Correct Answer: D

Rationale: In this scenario, option D is correct because it provides a balanced and reassuring approach to address the parent's fear of psychological trauma to the baby during catheterization. The nurse should explain to the parent that while the procedure may be uncomfortable for the infant, it is a necessary step to obtain a sterile urine specimen for accurate diagnosis and treatment. By acknowledging the discomfort but reassuring the parent that there should not be any damaging long-term effects, the nurse can help alleviate the parent's concerns. Option A is incorrect because suggesting a "clean catch" specimen as an alternative does not address the need for sterility in certain diagnostic situations, which is crucial for accurate results. Option B is incorrect because while parents have the right to refuse procedures, in this case, the nurse should educate them on the importance of the sterile specimen for the baby's health. Option C is also incorrect as it fails to provide adequate reassurance to the parent about the potential psychological impact on the baby. Educationally, this scenario highlights the importance of effective communication with parents in pediatric care. Nurses play a crucial role in educating and supporting parents through procedures, helping them understand the necessity of certain medical interventions for the well-being of their child. It also underscores the significance of balancing clinical requirements with parental concerns to provide holistic and patient-centered care.