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Which of the following is a primary consideration in fluid and electrolye imbalance in pediatric patients?
A.
A young child has a smaller body surface in relation to weight, resulting in greater fluid loss than in adults
B.
Metabolic rate is three times slower than the adult, which increases water requirements greatly
C.
Pediatric patients have mature hemeostatic-regulating mechanisms
D.
The younger the child, the greater the risk of fluid and electrolyte imbalance, fluid overload, and congestive heart failure.
Correct Answer
D. The younger the child, the greater the risk of fluid and electrolyte imbalance, fluid overload, and congestive heart failure.
Explanation The answer is correct because it states that the younger the child, the greater the risk of fluid and electrolyte imbalance, fluid overload, and congestive heart failure. This is a primary consideration in fluid and electrolyte imbalance in pediatric patients because their immature physiological systems make them more susceptible to these imbalances and complications.
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2.
When venipuncture is to be performed on a child, the parent or guardian should be?
A.
Provided with an explanation of what the procedure entails
B.
Required to be present during the procedure
C.
Asked to restrain the child during the procedure
D.
Emotional in front of the patient
Correct Answer
A. Provided with an explanation of what the procedure entails
Explanation When performing venipuncture on a child, it is important to provide the parent or guardian with an explanation of what the procedure entails. This helps to ensure that they understand the process and can provide informed consent for their child. It also helps to alleviate any anxiety or concerns they may have about the procedure. By providing this explanation, healthcare professionals can establish trust and communication with the parent or guardian, creating a more positive and supportive environment for both the child and their caregiver.
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3.
What type of intravenous cannula is most frequently used for pediatric vascular access?
A.
Cutdown catheter
B.
ONC
C.
PICC
D.
Winged infusion set
Correct Answer
B. ONC
Explanation ONC stands for Over-the-Needle Catheter, which is the most frequently used type of intravenous cannula for pediatric vascular access. It is a flexible plastic catheter that is inserted into a vein over a needle, and the needle is then withdrawn, leaving the catheter in place. ONC catheters are commonly used in pediatric patients due to their ease of insertion, flexibility, and ability to minimize the risk of complications. They are also available in various sizes to accommodate different age groups and vein sizes in pediatric patients.
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4.
What IV catheter gauge is commonly used for all pediatric patient age groupings?
A.
24
B.
20
C.
18
D.
16
Correct Answer
A. 24
Explanation The IV catheter gauge commonly used for all pediatric patient age groupings is 24. This gauge size is smaller in diameter compared to the other options (20, 18, and 16), making it suitable for pediatric patients who have smaller veins. Using a smaller gauge helps minimize discomfort and trauma during the insertion of the catheter.
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5.
When using a volume control set to provide infusion therapy for an infant, it should:
A.
Be filled to its capacity
B.
Have incremental hourly filling
C.
Contain no more than one third of the infant's daily fluid replacement at any given time
D.
Contain the infant's daily fluid requirement
Correct Answer
C. Contain no more than one third of the infant's daily fluid replacement at any given time
Explanation When using a volume control set to provide infusion therapy for an infant, it is important to ensure that the volume does not exceed one third of the infant's daily fluid replacement at any given time. This is because infants have smaller fluid requirements compared to adults, and overfilling the volume control set can lead to fluid overload and potential complications. By limiting the volume to one third of the daily fluid replacement, the risk of fluid overload is minimized, allowing for safer and more effective infusion therapy for the infant.
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6.
Where is the ideal place to perform venipuncture on a child?
A.
In the playroom where distraction is great
B.
In a treatment room
C.
At the child's bedside
D.
At the nurses's station while the parent or guardian holds the child
Correct Answer
B. In a treatment room
Explanation Performing venipuncture on a child in a treatment room is the ideal place because it provides a controlled environment that is specifically designed for medical procedures. The treatment room is equipped with necessary tools and equipment, ensuring that the procedure can be performed safely and efficiently. Additionally, the treatment room offers privacy, which can help the child feel more comfortable and reduce anxiety. Performing the procedure in a treatment room also allows healthcare professionals to have easy access to any necessary medical assistance or resources if needed.
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7.
Which one of the following statements applies to the use of scalp veins for venipuncture?
A.
Scalp veins are considered the first choice for establishing vascular access in infants
B.
This site can be used up to 30 months of age
C.
Using this site can cause physchological stress for the child's parent or guardian
D.
Minimal securement is required because dislodgement is unlikely
Correct Answer
C. Using this site can cause pHyschological stress for the child's parent or guardian
Explanation The use of scalp veins for venipuncture can cause psychological stress for the child's parent or guardian.
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8.
To ensure the accurate infusion flow rate in a pediatric patient, the flow rate should be adjusted when the child is?
A.
Ambulating
B.
Crying
C.
Playing
D.
Resting
Correct Answer
D. Resting
Explanation To ensure accurate infusion flow rate in a pediatric patient, it is best to adjust the flow rate when the child is resting. This is because when the child is resting, their body is in a more stable state, with minimal movement or activity. This allows for a more accurate measurement of the infusion flow rate and ensures that the medication or fluid is being delivered at the appropriate rate. When the child is ambulating, crying, or playing, their movement and activity levels can affect the flow rate and potentially lead to under or over-infusion. Therefore, adjusting the flow rate when the child is resting helps to maintain the accuracy and effectiveness of the infusion.
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9.
The intake and output of a pediatric IV therapy patient should be computed and recorded for accurate monitoring every?
A.
Half hour
B.
Hour
C.
2 hours
D.
4 hours
Correct Answer
B. Hour
Explanation The intake and output of a pediatric IV therapy patient should be computed and recorded for accurate monitoring every hour. This frequency allows healthcare providers to closely monitor the patient's fluid balance and assess any potential issues or changes in their condition. By recording the intake and output every hour, healthcare professionals can make timely adjustments to the IV therapy as needed and ensure the patient's hydration levels are maintained properly.
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10.
When evaluating the general condition of an infant receiving intravenous therapy, the absence of tears when crying is a sign of?
A.
Fluid volume deficit
B.
Fluid volume excess
C.
Hypernatremia
D.
Infiltration
Correct Answer
A. Fluid volume deficit
Explanation The absence of tears when crying in an infant receiving intravenous therapy is a sign of fluid volume deficit. Tears are composed mainly of water and electrolytes, so the lack of tears suggests a decrease in fluid volume in the body. This can be caused by factors such as inadequate fluid intake, excessive fluid loss (e.g., through sweating or diarrhea), or impaired fluid balance.
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11.
Which of the following variables affect how often infusion flow rates must be monitored for pediatric patients?
A.
Age of child, clinical status, and mode of delivery
B.
Age of child, composition of fluid, and skin turgor
C.
Clinical status, composition of fluid, and experience of nurse
D.
Clinical status, mode of delivery, and renal function
Correct Answer
A. Age of child, clinical status, and mode of delivery
Explanation The variables that affect how often infusion flow rates must be monitored for pediatric patients are the age of the child, clinical status, and mode of delivery. The age of the child is important because younger children may require more frequent monitoring due to their smaller size and potential for faster metabolism. The clinical status of the patient is crucial as patients with certain medical conditions or illnesses may require closer monitoring to ensure their safety and well-being. The mode of delivery refers to the method by which the fluid is administered, such as through an IV or a pump, and can impact the rate at which the fluid is delivered and therefore the need for monitoring.
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12.
What products are transfused during exchange blood transfusions?
A.
Platelets and cryoprecipitate
B.
Plasma and granulocytes
C.
Fresh red blood cells and plasma
D.
Cross matched whole blood and albumin
Correct Answer
C. Fresh red blood cells and plasma
Explanation During an exchange blood transfusion, fresh red blood cells and plasma are transfused. This type of transfusion involves removing a patient's blood and replacing it with donor blood, typically in small amounts at a time. Fresh red blood cells are used to replenish the patient's red blood cell count, while plasma is used to replace the patient's plasma volume. This helps to improve the patient's overall blood composition and can be used to treat conditions such as sickle cell disease or certain types of blood disorders.
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13.
The preservative sodium benzoate in the form of benzyl alcohol is recognized as being toxic to which group?
A.
Neonates and infants
B.
Infants and toddlers
C.
Toddlers and preschoolers
D.
Adolescents
Correct Answer
A. Neonates and infants
Explanation Sodium benzoate in the form of benzyl alcohol is recognized as being toxic to neonates and infants. Neonates are newborn babies, and infants are children under the age of one. This means that this preservative is harmful to very young children, particularly those in their first year of life. It is important to avoid exposing neonates and infants to products containing sodium benzoate to ensure their safety and well-being.
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14.
When can an umbilical catheter be used?
A.
Birth to 4 days
B.
Birth to 1 month
C.
1 month to 6 months
D.
1 month to 1 year
Correct Answer
A. Birth to 4 days
Explanation An umbilical catheter can be used from birth to 4 days. This is because immediately after birth, the umbilical cord is still attached to the baby's abdomen and provides a direct route to the bloodstream. An umbilical catheter can be inserted into the umbilical vein to administer medication or fluids, or to monitor blood pressure or blood gases. After 4 days, the umbilical cord stump typically falls off and the umbilical vein closes, making it no longer suitable for catheter use.
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15.
Which statement is applicable to the principles of pediatric drug administration?
A.
General pharmacokinetic parameters have no effect on therapy
B.
There is often a lack of information regarding interaction between a drug and the body processes of a child
C.
Dosage is usually calculated in milligrams per kilogram of weight
D.
Monitoring for an adverse drug reaction is unnecessary because such events are rare
Correct Answer
B. There is often a lack of information regarding interaction between a drug and the body processes of a child
Explanation Pediatric drug administration is often challenging due to a lack of information regarding how drugs interact with the body processes of a child. This lack of information makes it difficult to determine the appropriate dosage and potential side effects in pediatric patients. Therefore, healthcare providers must exercise caution and closely monitor the child's response to the medication.
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16.
Which of the following methods may an IV-certified LPN use to administer an IV push drug?
A.
Using a safety syringe and needle to inject directly into the vein or into the injection port of an intermittent infusion set
B.
Through injection port of an intermittent infusion set or using syringe and needle to directly enter an artery
C.
By accessing an implanted port with a Huber needle or through Y injection port of primary infusion administration set
D.
Using syringe and needle to directly enter vein or by accessing an implanted port with a Huber needle
Correct Answer
A. Using a safety syringe and needle to inject directly into the vein or into the injection port of an intermittent infusion set
Explanation An IV-certified LPN may administer an IV push drug by using a safety syringe and needle to inject directly into the vein or into the injection port of an intermittent infusion set. This method ensures that the drug is delivered directly into the bloodstream for rapid absorption and effect. It also allows for precise dosage administration and minimizes the risk of contamination or infection.
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17.
Selecting the largest vein suitable for direct injection of an IV drug will?
A.
Provide heparin-locked infusion set
B.
Provide immediate hemodilution of the drug
C.
Prevent therapeutic incompatibility
D.
Prevent brachial plexus injury
Correct Answer
B. Provide immediate hemodilution of the drug
Explanation Selecting the largest vein suitable for direct injection of an IV drug will provide immediate hemodilution of the drug. This is because the larger the vein, the faster the drug will be diluted and dispersed throughout the bloodstream. This can be advantageous in certain situations where a rapid onset of action is desired or when a highly concentrated drug needs to be diluted to prevent adverse effects. By selecting a large vein, the drug can be quickly and effectively distributed throughout the body, ensuring its desired therapeutic effects.
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18.
It is often necessary to flush the primary administration set or an intermittent infusion device with normal saline before IV push drug administration to prevent?
A.
Bioincompatibility
B.
Infiltration
C.
Mechanical phlebitis
D.
Thrombotic process
Correct Answer
A. Bioincompatibility
Explanation When administering an IV push drug, it is important to flush the primary administration set or intermittent infusion device with normal saline before to prevent bioincompatibility. Bioincompatibility refers to the potential reaction or incompatibility between the drug being administered and the materials used in the administration set or device. Flushing with normal saline helps to ensure that any residue or incompatible substances are cleared from the system, reducing the risk of adverse reactions or complications for the patient.
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19.
In using a syringe/needle for directly injecting a drug into a vein, the needle should be bevel:
A.
Down at 30 degree angle, reaching 1/2 inch into the vein
B.
Up at 10-30 degree angle, reaching 1/4 inch into the vein
C.
Down at 15 degree angle, reaching 1/8 inch into the vein
D.
Up at 15 degree angle, reaching 1/16 inch into the vein
Correct Answer
B. Up at 10-30 degree angle, reaching 1/4 inch into the vein
Explanation The correct answer is "up at 10-30 degree angle, reaching 1/4 inch into the vein." This is because when injecting a drug into a vein, the needle should be inserted at a shallow angle, between 10-30 degrees, to avoid damaging the vein or causing discomfort to the patient. Inserting the needle to a depth of 1/4 inch ensures that the medication is delivered directly into the vein for optimal absorption and effectiveness.
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20.
Infiltration of a drug being adminstered IV push could result in which of the following conditions?
A.
Chemical phlebitis
B.
Clotting cascade
C.
Mechanical phlebitis
D.
Potential tissue damage
Correct Answer
D. Potential tissue damage
Explanation Infiltration of a drug being administered IV push could result in potential tissue damage. When a drug infiltrates, it means that it has leaked from the vein into the surrounding tissue. This can cause irritation and damage to the tissue, leading to complications such as swelling, pain, and impaired function. It is important to monitor the IV site closely to detect infiltration early and take appropriate measures to prevent further damage.
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21.
What elements are essential for appropriate documentation of a drug given by IV push?
A.
Name of drug, dosage, rate of adminstration, name of prescribing physician, and date and time
B.
Name of drug, dosage, manufacturer, rate of administration, and date and time
C.
Name of drug, dosage, rate of administration, date and time and mode of delivery
D.
Name of drug, dosage, lot number, rate of administration, and date and time
Correct Answer
C. Name of drug, dosage, rate of administration, date and time and mode of delivery
Explanation The elements that are essential for appropriate documentation of a drug given by IV push are the name of the drug, dosage, rate of administration, date and time, and mode of delivery. This information is necessary to accurately record and track the administration of the drug, ensuring patient safety and proper medication management. The name of the drug and dosage are important for identifying the specific medication and the amount given. The rate of administration and mode of delivery provide details on how the drug was administered. Finally, the date and time are essential for documenting when the drug was given.
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22.
Volumes of fluids furnished with precalculated, prepackaged systems containing diluent and drug include which of the following?
A.
50, 75, and 100 ml
B.
50, 100, and 250 ml
C.
100, 250 and 1000 ml
D.
250, 500 and 1000 ml
Correct Answer
B. 50, 100, and 250 ml
Explanation The correct answer is 50, 100, and 250 ml. This answer is correct because it includes the volumes of fluids that are commonly used in precalculated, prepackaged systems containing diluent and drug. These volumes are often used in medical settings for accurate dosing and administration of medications.
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23.
Commercially available precalculated, prepackaged systems containing diluent and drug include which of the following systems?
A.
ADD-Vantage and Mini-Bag Plus
B.
Centermark and VERIFUSE
C.
VERIFUSE and ADD-Vantage
D.
Mini-Bag Plus and Centermark
Correct Answer
A. ADD-Vantage and Mini-Bag Plus
Explanation ADD-Vantage and Mini-Bag Plus are commercially available precalculated, prepackaged systems containing diluent and drug. These systems are used in healthcare settings to simplify the preparation and administration of medications. ADD-Vantage is a system that allows for the easy reconstitution of powdered medications by attaching a vial to a bag of diluent. Mini-Bag Plus is a system that combines a medication vial and diluent bag into one unit, eliminating the need for manual mixing. Both of these systems are designed to improve medication safety and efficiency in healthcare settings.
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24.
Which of the following principles applies to precalculated, prepackaged drug systems?
A.
Determine the integrity of diluent and drug containers after use
B.
Employ blood barrier techniques druing assembly
C.
Ensure that the drug is completely dissolved and is within the diluent container
D.
Disconnect drug vial from the diluent container during drug infusion
Correct Answer
C. Ensure that the drug is completely dissolved and is within the diluent container
Explanation The principle that applies to precalculated, prepackaged drug systems is to ensure that the drug is completely dissolved and is within the diluent container. This means that the drug should be fully mixed with the diluent solution and contained within the same container. This principle ensures that the drug is properly prepared and ready for administration without any risk of incomplete dissolution or contamination.
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25.
What is the most vital nursing consideration concerning the use of a precalculated, prepackaged system that contains diluent and drug?
Correct Answer follow manufacturer's instructions
Explanation The most vital nursing consideration concerning the use of a precalculated, prepackaged system that contains diluent and drug is to follow the manufacturer's instructions. This is important because the manufacturer's instructions provide specific guidelines on how to properly use the system, including the correct dosage, dilution ratios, and administration techniques. Following these instructions ensures the safe and effective use of the system, minimizing the risk of errors or complications.
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