ATI RN
Pediatric Nursing Cardiovascular Disorders Questions
Question 1 of 5
The healthcare provider prescribes an IV solution of regular insulin (Hummulin-R) 100 units in 250 ml of 0.45% saline to infuse at 12 units/hour. The nurse should program the infusion pump to deliver how many ml/hour?
Correct Answer: A
Rationale: In this scenario, the correct answer is A) 30 ml/hour. To understand why, let's break down the calculation. The IV solution contains 100 units of regular insulin in 250 ml of 0.45% saline. The prescribed infusion rate is 12 units/hour. To find out how many ml of the solution must be infused per hour, we can set up a proportion: 100 units = 250 ml 12 units = x ml Cross multiplying, we get: 100x = 250 * 12 x = 250 * 12 / 100 x = 30 ml/hour Therefore, the nurse should program the infusion pump to deliver 30 ml/hour. Now, let's analyze why the other options are incorrect: - Option B) 3 ml/hour: This is too low and does not match the calculation. - Option C) 40 ml/hour: This is too high and does not align with the calculation. - Option D) 15 ml/hour: This value is not derived from the correct calculation and is therefore incorrect. In an educational context, understanding how to calculate medication dosages and infusion rates is crucial for pediatric nurses to ensure safe and effective care for their young patients. This type of question tests the nurse's ability to perform dosage calculations accurately, which is a fundamental skill in pediatric pharmacology and nursing practice. Nurses must be proficient in dosage calculations to prevent medication errors and ensure optimal patient outcomes.
Question 2 of 5
The nurse calculates the body mass index (BMI) for an obese adult. Which additional assessment finding places the client at high risk for cardiac disease?
Correct Answer: A
Rationale: In pediatric nursing, understanding the relationship between obesity and cardiovascular risk factors is crucial. In this scenario, option A, "Large waist circumference with central fat," is the correct answer. Central obesity, often indicated by a large waist circumference, is a significant risk factor for cardiac disease. Excess visceral fat around the abdomen is associated with insulin resistance, inflammation, and dyslipidemia, all contributing to cardiovascular complications. Option B, "High serum insulin level," while indicative of metabolic dysfunction in obesity, is more directly related to diabetes risk rather than specifically cardiac disease in this context. Option C, "Hyperpigmentation on neck skin folds," is a sign of conditions like acanthosis nigricans, which is associated with insulin resistance and obesity-related metabolic issues rather than cardiac disease specifically. Option D, "Poor muscle tone," is not directly linked to cardiac disease risk in the context of obesity. While physical inactivity related to poor muscle tone can contribute to cardiovascular issues, central obesity is a more significant and direct risk factor in this scenario. Educationally, this question helps pediatric nursing students understand the importance of assessing obesity-related risk factors for cardiovascular disease in pediatric patients. Understanding these relationships is crucial for providing holistic care and early interventions to prevent long-term complications related to obesity in children.
Question 3 of 5
An adult client is admitted with diabetic ketoacidosis (DKA) and a urinary tract infection (UTI). Prescriptions for intravenous antibiotics and an insulin infusion are initiated. Which serum laboratory value warrants the most immediate intervention by the nurse?
Correct Answer: D
Rationale: In this scenario, the most immediate intervention by the nurse should be directed towards the serum potassium level of 2.5 mEq/L (Option D). This low potassium level, known as hypokalemia, poses the most immediate threat to the client's health due to the potential for serious cardiac complications such as arrhythmias and cardiac arrest. The other options are not as critical as hypokalemia in this situation: - Option A: A glucose level of 350 mg/dl is high but is a common finding in diabetic ketoacidosis and can be addressed through insulin therapy. - Option B: A white blood cell count of 15,000 mm3 indicates infection but is not as immediately life-threatening as severe hypokalemia. - Option C: A blood pH of 7.30 is slightly low but is a common finding in diabetic ketoacidosis and can be managed along with the insulin infusion. Educationally, this question highlights the importance of prioritizing interventions based on the client's condition and potential complications. Understanding the significance of electrolyte imbalances in critically ill patients is crucial for nurses caring for clients with complex health issues like diabetic ketoacidosis and infections.
Question 4 of 5
The nurse is preparing a client for discharge who was recently diagnosed with Addison's disease. Which instruction is most important for the nurse to include in the client's discharge teaching plan?
Correct Answer: D
Rationale: In the context of pediatric nursing and cardiovascular disorders, understanding the management of Addison's disease is crucial. The correct answer is D) Take prescribed cortisone accurately. This instruction is paramount because Addison's disease results from adrenal insufficiency, leading to decreased cortisol production. Cortisone replacement therapy is essential to manage the condition and prevent adrenal crisis. Option A) Use a walker when weakness occurs is incorrect as it does not address the primary treatment for Addison's disease. Option B) Avoid extreme environmental temperatures is important for some conditions but is not the priority in Addison's disease management. Option C) Increase daily intake of sodium in the diet is relevant for Addison's disease due to mineralocorticoid deficiency, but ensuring proper cortisone replacement is the primary focus. In an educational context, it is vital for pediatric nurses to prioritize teaching accurate medication administration to children with chronic conditions like Addison's disease. Emphasizing the significance of adherence to cortisone therapy can prevent life-threatening complications and empower patients and families to manage the condition effectively.
Question 5 of 5
A client who has a history of long-standing back pain treated with methadone (Dolophines), is admitted to the surgical unit following urological surgery. Which modifications in the plan of care should the nurse make for this client's pain management during the postoperative period?
Correct Answer: C
Rationale: The correct answer is C: Maintain the client's methadone and medicate surgical pain based on pain rating. This choice is appropriate because abrupt discontinuation of methadone can lead to withdrawal symptoms, and methadone should be continued to manage the client's chronic pain. Additionally, surgical pain should be managed based on the client's pain rating to ensure adequate pain control postoperatively. Option A is incorrect because increasing methadone in lieu of parenteral opioids may not be necessary if the client's chronic pain is well managed with their current dose of methadone. Option B is incorrect because using minimal parenteral opioids in addition to oral methadone may not provide adequate pain control for the client postoperatively, especially after urological surgery which can be painful. Option D is incorrect because holding methadone can lead to withdrawal symptoms and inadequate pain management for the client. It is important to maintain continuity of care and manage both chronic and acute pain appropriately. Educationally, this scenario highlights the importance of understanding the principles of pain management in clients with chronic opioid therapy undergoing surgery. It emphasizes the need for individualized pain management plans that consider both the chronic pain regimen and acute postoperative pain control.