The nurse is caring for a 2 month old child with a fever of 101.76. The child also appears toxic with poor color. Which of the following actions would the nurse expect to implement as a priority?

Replace fluids orally

Administer antibiotics as prescribed

Obtain a specimen for complete blood co

Obtain urinalysis

Answer and Explanation

The Correct Answer is B

A. While fluid replacement is important, in a toxic-appearing child, oral fluids may not be safe or adequate due to potential dehydration and risk of worsening condition.

B. Administering antibiotics is the priority action because the child shows signs of potential serious infection, and timely antibiotic treatment is crucial in young infants who may quickly deteriorate.

C. Obtaining a specimen for a complete blood count is necessary for diagnosing infection but is not as urgent as administering antibiotics.

D. While obtaining a urinalysis may help identify a urinary tract infection, it is not the immediate priority compared to starting antibiotic therapy.

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Correct Answer is D

Explanation

A. Cashews contain some iron but are not the highest source compared to red meat.

B. Oranges are high in vitamin C but low in iron; they can help with iron absorption when consumed with iron-rich foods.

C. Yogurt provides calcium and protein but is not a significant source of iron.

D. Red meat is an excellent source of heme iron, which is more easily absorbed by the body than non-heme iron found in plant foods.

A. "I will elevate the affected part.” B. "I will have my child rest.” C. "I will apply heat.” D. "I will compress the site.”

Correct Answer is C

Explanation

A. Elevating the affected part is correct and helps reduce swelling and bleeding.

B. Resting the affected area is appropriate and will help minimize movement and further bleeding.

C. Applying heat is not recommended for bleeding episodes as it can increase blood flow and exacerbate bleeding; ice is generally recommended.

D. Compressing the site is appropriate as it helps control bleeding and provides pressure to the affected area.

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The nurse is caring for a 2 month old child with a fever of 101.76. The child also appears toxic with poor color. Which of the following actions would the nurse expect to implement as a priority?

Nursing Test Bank

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