Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is preparing to initiate IV antibiotic therapy for a newly admitted 12- month-old infant.
Which of the following actions should the nurse plan to take?
A. Use a 24-gauge catheter to start the IV.
A 24-gauge catheter is the smallest-gauge catheter and is appropriate for administering IV fluids and medications to an infant.
B. Cover the insertion site with an opaque dressing.
Choice B is wrong because an opaque dressing would prevent the nurse from visualizing the insertion site.
C. Start the IV in the infant's foot.
Choice C is wrong because starting an IV in an infant’s foot can be painful and difficult to secure.
D. Change the IV site every 3 days.
Choice D is wrong because IV sites should be changed every 72-96 hours or according to facility policy.
This question is an excerpt from Nurse Dive's nursing test bank - ATI RN Nursing Care of Children 2019 Proctored Exam. Take the full exam now
Full Explanation
A 24-gauge catheter is the smallest-gauge catheter and is appropriate for administering IV fluids and medications to an infant.
Choice B is wrong because an opaque dressing would prevent the nurse from visualizing the insertion site.
Choice C is wrong because starting an IV in an infant’s foot can be painful and difficult to secure.
Choice D is wrong because IV sites should be changed every 72-96 hours or according to facility policy.
Similar Questions
A nurse in the emergency department is assessing a toddler who has hyperpyrexia, severe dyspnea, and is drooling.
Which of the following actions should the nurse take first?
A. Administer an antibiotic to the toddler.
Choice A is wrong because administering an antibiotic is not the priority intervention for a toddler with airway obstruction.
B. Obtain a blood culture from the toddler.
Choice B is wrong because obtaining a blood culture is not the priority intervention for a toddler with airway obstruction.
C. Insert an IV catheter for the toddler.
Choice C is wrong because inserting an IV catheter is not the priority intervention for a toddler with airway obstruction.
D. Prepare the toddler for nasotracheal intubation.
The nurse should prepare the toddler for nasotracheal intubation first because the toddler is experiencing severe dyspnea and drooling, which are signs of airway obstruction. Nasotracheal intubation will help to secure the toddler’s airway and improve their breathing.
Full Explanation
The nurse should prepare the toddler for nasotracheal intubation first because the toddler is experiencing severe dyspnea and drooling, which are signs of airway obstruction.
Nasotracheal intubation will help to secure the toddler’s airway and improve their breathing.
Choice A is wrong because administering an antibiotic is not the priority intervention for a toddler with airway obstruction.
Choice B is wrong because obtaining a blood culture is not the priority intervention for a toddler with airway obstruction.
Choice C is wrong because inserting an IV catheter is not the priority intervention for a toddler with airway obstruction.
A nurse is preparing to administer an enteral feeding to an adolescent who has an NG tube.
Which of the following actions should the nurse take first?
A. Flush the tube with water.
Choice A is wrong because flushing the tube with water should be done after confirming the placement of the NG tube.
B. Attach the feeding bag tubing to the end of the NG tube.
Choice B is wrong because attaching the feeding bag tubing to the end of the NG tube should be done after confirming the placement of the NG tube.
C. Check the pH of the gastric secretions.
The nurse should first check the pH of the gastric secretions to confirm the placement of the NG tube before administering the enteral feeding.
D. Set the administration rate on the feeding pump.
Choice D is wrong because setting the administration rate on the feeding pump should be done after confirming the placement of the NG tube.
Full Explanation
The nurse should first check the pH of the gastric secretions to confirm the placement of the NG tube before administering the enteral feeding.
Choice A is wrong because flushing the tube with water should be done after confirming the placement of the NG tube.
Choice B is wrong because attaching the feeding bag tubing to the end of the NG tube should be done after confirming the placement of the NG tube.
Choice D is wrong because setting the administration rate on the feeding pump should be done after confirming the placement of the NG tube.
A nurse is planning care for a school-age child who was admitted from the emergency department 2 hr ago.
Which of the following interventions should the nurse include to promote adequate sleep for the child?
A. Follow the child's home sleep routine to reduce anxiety.
Following the child’s home sleep routine can help reduce anxiety and promote adequate sleep. Children thrive on routine and consistency, and maintaining their usual sleep routine can provide a sense of familiarity and comfort in an unfamiliar environment.
B. Leave the lights on in the child's room to promote safety.
Choice B is wrong because leaving the lights on can disrupt the child’s sleep.
C. Allow the child to adjust their bedtime to promote autonomy.
Choice C is wrong because allowing the child to adjust their bedtime may disrupt their sleep routine and lead to inadequate sleep.
D. Provide the child with calming activities prior to bedtime to reduce stress.
Choice D is a good option, but following the child’s home sleep routine is the best way to promote adequate sleep.
Full Explanation
Following the child’s home sleep routine can help reduce anxiety and promote adequate sleep.
Children thrive on routine and consistency, and maintaining their usual sleep routine can provide a sense of familiarity and comfort in an unfamiliar environment.
Choice B is wrong because leaving the lights on can disrupt the child’s sleep.
Choice C is wrong because allowing the child to adjust their bedtime may disrupt their sleep routine and lead to inadequate sleep.
Choice D is a good option, but following the child’s home sleep routine is the best way to promote adequate sleep.