A nurse is preparing to insert a peripheral intravenous line on an infant. Which of the following actions should the nurse plan to take?
Use gauze to cover the IV insertion site.
Monitor the IV site every 8 hours.
Insert the catheter into the foot.
Obtain a 24-gauge catheter.
The Correct Answer is D
Choice A reason: Using gauze to cover an infant’s IV site obscures visualization, delaying detection of infiltration or infection. Transparent dressings are preferred, as infants’ small veins are prone to complications. Gauze increases risk by hiding signs like swelling, critical for early intervention in pediatric IV management.
Choice B reason: Monitoring an IV site every 8 hours is inadequate for infants, who need hourly checks due to small vein fragility and high infiltration risk. Frequent assessment detects complications like phlebitis or extravasation early, ensuring vascular integrity and preventing tissue damage in pediatric patients.
Choice C reason: Inserting an IV in the foot is less preferred, as scalp or hand veins are more accessible and stable in infants. Foot IVs risk dislodgement from movement and may impair circulation, increasing complications like tissue damage, making this a suboptimal choice for IV placement.
Choice D reason: A 24-gauge catheter is ideal for infants, as their small veins require smaller needles to minimize trauma and infiltration. This size ensures adequate fluid or medication delivery while reducing vascular damage, aligning with pediatric IV guidelines for safe and effective venous access.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D"]
Explanation
Choice A reason: Explaining the implications of a Do Not Resuscitate (DNR) status ensures the client understands that no CPR or intubation will occur if their condition deteriorates. This supports informed consent and autonomy, clarifying the scope of DNR to prevent misunderstandings. It respects the client’s decision-making capacity, ensuring their wishes align with end-of-life care preferences.
Choice B reason: Placing a “Do Not Resuscitate” sign outside the room breaches confidentiality under HIPAA, risking unauthorized disclosure of sensitive information. DNR status is communicated via medical records or wristbands. This action is inappropriate, as it does not contribute to implementing the client’s wishes and violates privacy standards, making it an incorrect response.
Choice C reason: Obtaining family consent is unnecessary for a competent client’s DNR request, as autonomy rests with the client. If decisionally capable, their wishes override family input. The nurse’s role is to support the client’s decision, not seek family approval, unless the client is incapacitated, which is not indicated, making this action inappropriate.
Choice D reason: Documenting the DNR request in the medical record ensures the care team follows the client’s wishes, preventing unwanted interventions. Accurate documentation communicates code status, supports legal and ethical standards, and ensures continuity of care. This is critical for aligning treatment with the client’s end-of-life preferences, making it a necessary action.
Correct Answer is A
Explanation
Choice A reason: Decreased serotonin levels are linked to depression, as serotonin regulates mood in the brain’s limbic system. Antidepressants like SSRIs increase serotonin, alleviating low mood and anhedonia, making this client a prime candidate for therapy to address neurochemical imbalances in depression.
Choice B reason: Decreased cortisol is not directly tied to depression requiring antidepressants. Cortisol dysregulation may occur in stress disorders, but antidepressants target serotonin or norepinephrine, not adrenal function, making this client less suitable for antidepressant therapy based on this imbalance.
Choice C reason: Elevated dopamine is linked to schizophrenia or mania, not depression. Antidepressants target serotonin or norepinephrine, not dopamine. This client may need antipsychotics or mood stabilizers, not antidepressants, as dopamine excess does not indicate depressive pathology requiring such therapy.
Choice D reason: Elevated thyroid levels suggest hyperthyroidism, mimicking anxiety, not depression. Antidepressants are not indicated, as treatment targets thyroid function. Depression may coexist, but thyroid correction is prioritized, making this client unsuitable for primary antidepressant therapy based on this finding.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.
