Exhibits
For each potential provider prescription, click to specify if the prescription is expected or unexpected for the adolescent. There must be at least 1 selection in every row. There does not need to be a selection in every column.
Insert a peripheral IV catheter.
Place the adolescent on a cooling blanket.
Administer IV acyclovir.
Place on seizure precautions.
Keep adolescent flat in bed for 24 hr post lumbar puncture.
Administer IV cefotaxime.
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"}}
Rationale:
- Insert a peripheral IV catheter: A peripheral IV catheter is essential for administering fluids and medications, which is critical for this adolescent, especially with the concern for bacterial meningitis.
- Place the adolescent on a cooling blanket: The adolescent has a high fever (39°C), which needs to be managed promptly to prevent further complications. A cooling blanket helps reduce the fever and manage the patient’s temperature.
- Administer IV acyclovir: Acyclovir is an antiviral medication typically used to treat viral infections such as herpes simplex virus or varicella-zoster virus, not bacterial meningitis. Given the CSF findings and suspected bacterial meningitis, acyclovir is not appropriate. Antibiotics like cefotaxime are indicated instead.
- Place on seizure precautions: Given the adolescent's symptoms (e.g., headache, photophobia, lethargy), the risk of seizures is elevated, especially if meningitis is suspected. Seizure precautions are important to prevent injury during a potential seizure.
- Keep adolescent flat in bed for 24 hr post lumbar puncture: After a lumbar puncture, keeping the adolescent flat in bed for 24 hours helps prevent post-lumbar puncture headaches and minimizes the risk of cerebrospinal fluid leaks or complications.
- Administer IV cefotaxime: IV cefotaxime is an appropriate antibiotic for treating bacterial meningitis. Given the abnormal CSF results (low glucose, high protein, elevated WBC), the adolescent is at high risk for bacterial meningitis, and IV cefotaxime is expected to be part of the treatment plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Promoting nutrition: While nutrition is important, preventing infections is more urgent in a preschooler with leukemia. Leukemia and its treatments, such as chemotherapy, can significantly weaken the immune system, making the child more susceptible to infections.
B. Preventing infections: Preventing infections is critical for children with leukemia because their immune systems are compromised, either by the disease itself or by treatments like chemotherapy. Educating the guardians on how to prevent infections (e.g., hand hygiene, avoiding crowds, keeping the environment clean) is crucial to avoid serious complications.
C. Supporting psychological wellness: While psychological support is important, the priority for a preschooler with leukemia is to focus on preventing infections and ensuring their physical well-being, as infections can lead to severe consequences.
D. Managing mucosal ulcerations: Mucosal ulcerations can be a concern for children undergoing cancer treatment, but preventing infections is a more immediate and potentially life-saving priority. Once infections are controlled, mucosal ulcerations can also be addressed.
Correct Answer is C
Explanation
A. “I’m guessing your other parent did not do anything to stop this from happening.”
This statement makes assumptions about the other parent's actions and could lead to further conflict or discomfort for the adolescent. It’s important to avoid making judgments and focus on providing support.
B. “Your parent was wrong to hit you for coming home late.” This statement may come across as judgmental or accusatory, which could hinder communication and trust with the adolescent. It's important to validate their feelings first and address the situation appropriately.
C. “It is not your fault that this happened to you.” This response is empathetic and supportive. It reassures the adolescent, which is an important step in helping them feel safe and understood. It also provides an opportunity for further discussion about their safety.
D. “I won’t tell anyone else about this unless you say it’s okay.” While privacy is important, this could be misleading. In cases of abuse, the nurse is required to report the situation to protect the adolescent, even if they don't consent.
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