Exhibits

Based on the FLACC score and the client's developmental level, mark which nurse actions would be appropriate, and which would not be appropriate. Each row must have one option selected.

Ask the healthcare provider to prescribe a nonsteroidal antiinflammatory drug.

Have one of the parents hold the baby.

Perform guided imagery.

Consult a child life specialist.

Encourage the baby's mother to breastfeed the baby.

Wait 1 hour, reassess, and give medication if the FLACC score remains elevated.

Request a prescription for an opioid.

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"B"},"G":{"answers":"A"}}

Ask the healthcare provider to prescribe a nonsteroidal anti-inflammatory drug (NSAID)
NSAIDs such as ibuprofen are commonly used for postoperative pain relief in infants. They provide anti-inflammatory effects and pain control without the risk of respiratory depression seen with opioids. Given the infant’s surgical status, an NSAID can be an effective pain management option when prescribed appropriately.
Have one of the parents hold the baby: Parental presence and skin-to-skin contact are effective non-pharmacologic pain management strategies for infants. Holding and gentle rocking can provide comfort, reduce stress, and help lower the infant’s FLACC score by promoting relaxation.
Perform guided imagery: Guided imagery requires cognitive maturity, which a 4-month-old infant lacks. This technique is more appropriate for older children who can understand and visualize calming scenes. For infants, tactile and auditory comfort measures (such as holding and swaddling) are more effective.
Consult a child life specialist: A child life specialist can assist in non-pharmacologic pain management strategies, such as age-appropriate distraction techniques, comfort positioning, and soothing interventions. While the infant may not engage in interactive play, the specialist can help guide parents in comforting their baby.
Encourage the baby's mother to breastfeed the baby: The infant is NPO (nothing by mouth) postoperatively, meaning breastfeeding is contraindicated at this time. Providing oral intake against medical orders could lead to complications, especially after fundoplication surgery, which affects gastric emptying.
Wait 1 hour, reassess, and give medication if the FLACC score remains elevated: Delaying pain relief for an infant experiencing postoperative pain is not appropriate. Infants cannot verbalize pain, and an elevated FLACC score indicates discomfort. Instead of waiting, the nurse should take immediate action by implementing comfort measures and/or requesting appropriate pain medication.
Request a prescription for an opioid: If the infant's pain is moderate to severe, an opioid (such as morphine) may be needed for adequate pain relief. Opioids are used cautiously in infants due to the risk of respiratory depression, but they are appropriate for postoperative pain control when NSAIDs alone are insufficient.

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Correct Answer is ["450"]

Explanation

Calculate the concentration of the solution:

Concentration = Total grams of magnesium sulfate / Total volume (mL)

= 20 grams / 500 mL

= 0.04 grams/mL

Calculate the volume needed for the prescribed dose:

Volume (mL) = Desired dose (grams) / Concentration (grams/mL)

= 6 grams / 0.04 grams/mL

= 150 mL

Calculate the infusion rate in mL/hour:

Infusion rate (mL/hour) = Volume (mL) / Time (minutes) x 60 minutes/hour

= 150 mL / 20 minutes x 60 minutes/hour

= 450 mL/hour

The nurse should set the infusion pump to deliver 450 mL/hour.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

Mastitis: Mastitis is an infection of breast tissue that occurs when milk stasis leads to bacterial overgrowth, usually caused by Staphylococcus aureus. The client's firm, red, warm area on the breast, fever (101.2°F), chills, body aches, and fatigue all strongly indicate mastitis rather than other breast conditions.
Engorgement: Engorgement occurs when the breasts overfill with milk, leading to swelling and tenderness. However, engorgement typically affects both breasts, does not cause fever or flu-like symptoms, and resolves with regular breastfeeding or pumping.
Blocked milk duct: A clogged duct occurs when milk flow is obstructed, leading to a tender lump in the breast. While a blocked duct can progress to mastitis, it does not cause fever or systemic symptoms unless infection develops. The presence of fever and flu-like symptoms in this client suggests mastitis, not just a blocked duct.
Inflammatory breast cancer: This rare but aggressive form of breast cancer causes redness, swelling, and skin thickening, but it is not associated with fever or acute symptoms like mastitis. It does not develop suddenly but rather progresses over time, making mastitis the more likely diagnosis in this case.
Abscess: If mastitis is not treated promptly, it can lead to a breast abscess, a localized collection of pus requiring drainage. Signs of progression to an abscess include fluctuant swelling, worsening pain, and persistent fever despite antibiotic treatment.
Breastfeeding intolerance: Mastitis can cause temporary discomfort during breastfeeding, but it does not lead to true breastfeeding intolerance. In fact, continued breastfeeding helps resolve mastitis by improving milk drainage.
Nipple thrush: Nipple thrush (Candida infection) causes burning pain and white patches in the infant’s mouth but is not a complication of mastitis, which is bacterial, not fungal.
Postpartum haemorrhage: Postpartum hemorrhage is caused by uterine atony, retained placenta, or coagulation disorders, not mastitis. Mastitis is localized to the breast and does not affect uterine bleeding.

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Exhibits Based on the FLACC score and the client's developmental level, mark which nurse actions would be appropriate, and which would not be appropriate. Each row must have one option selected.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The healthcare provider prescribes magnesium sulfate 6 grams IV to be infused over 20 minutes for client with preterm labor. The IV bag contains "Magnesium sulfate 20 grams in dextrose 5% in water 500 mL." How many mL/hour should the nurse set the infusion pump? (Enter numerical value only.)

Correct Answer is ["450"]

Explanation

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

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Exhibits Based on the FLACC score and the client's developmental level, mark which nurse actions would be appropriate, and which would not be appropriate. Each row must have one option selected.

Exhibits

Based on the FLACC score and the client's developmental level, mark which nurse actions would be appropriate, and which would not be appropriate. Each row must have one option selected.