Question

A patient weighs 44 pounds. The doctor orders Cefazolin 90 mg/kg/day every 8 hours (3 doses per day). What is the appropriate dose (in mg) for this patient?

Answer 1

Correct Answers:

600

Rationale :

✍️Weight = 44 lb

✍️Ordered = 90 mg/kg/day

✍️Divided every 8 hours = 3 doses per day

✍️Step 1:

✔️Convert pounds to kilograms

✔️ 44÷2.2=20 kg

✍️Step 2:

✔️Calculate total daily dose

✔️90 mg×20 kg=1800 mg/day

✍️Step 3:

✔️Divide by 3 doses per day

✔️1800÷3

✅600 mg per dose

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 2

Correct Answers:

subcostal retractions during feeding.

Rationale :

🔷Subcostal retractions during feeding are a classic sign of increased work of breathing and respiratory distress, indicating the infant is struggling to coordinate suck–swallow–breathe.

🔷In infants with congenital heart disease, any rise in respiratory effort can rapidly lead to fatigue, hypoxemia, and aspiration risk, so the safest action is to pause the feeding immediately.

🔷Retractions reflect negative intrathoracic pressure generation to move air, which is unsustainable during oral feeds and can precipitate feeding intolerance and desaturation.

🔷Early pausing allows for rest, repositioning, and supportive measures (e.g., pacing, slower-flow nipple, or gavage consideration) to maintain adequate oxygenation.

🔷Recognizing objective distress signs (retractions, nasal flaring, head bobbing, tachypnea, color change) is critical to prevent aspiration and decompensation in CHD infants.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 3

Correct Answers:

"Chest physiotherapy helps break up thick secretions for ease of breathing."
"Give pancreatic enzymes with or immediately before meals and snacks"
"Feed your child foods that are high in protein."
"Give your child high-calorie foods and snacks."

Rationale :

Chest physiotherapy helps break up thick secretions for ease of breathing.

🟦Airway clearance techniques (percussion, vibration, postural drainage; or HFCWO vests) are cornerstone therapies in CF to mobilize viscous mucus caused by abnormal chloride transport.

🟦By reducing mucus plugging, they improve ventilation, decrease infection risk, and support gas exchange.

🟦Regular CPT—often multiple sessions daily—is paired with nebulized mucolytics (e.g., dornase alfa) and bronchodilators to enhance secretion mobilization.

🟦Consistent airway clearance reduces exacerbations and slows lung function decline, improving quality of life.

“Give pancreatic enzymes with or immediately before meals and snacks.”

🟦Pancreatic enzyme replacement therapy (PERT) corrects pancreatic insufficiency to enable fat, protein, and carbohydrate digestion.

🟦Administering with or just before every meal/snack ensures enzymes are present in the duodenum when food arrives, optimizing nutrient absorption.

🟦Proper dosing (based on lipase units/kg/meal) prevents steatorrhea, malabsorption, and poor growth.

🟦Enzymes should be swallowed intact (no crushing) to protect enteric coating and efficacy.

“Feed your child foods that are high in protein.”

🟦Children with CF have higher metabolic demands and malabsorption, so high-protein intake supports growth, tissue repair, and immune function.

🟦Adequate protein helps counter recurrent infections and increased work of breathing that elevate caloric expenditure.

🟦Combining high protein with PERT enhances nitrogen balance and lean body mass.

🟦Registered dietitian–guided plans ensure age-appropriate targets and sustained weight/height velocity.

“Give your child high-calorie foods and snacks.”

🟦CF nutrition plans emphasize calorie-dense intake (often 120–150% of standard energy needs) to achieve appropriate BMI percentiles.

🟦Frequent high-calorie snacks mitigate increased energy expenditure from chronic respiratory effort and infections.

🟦Calorie fortification (oils, powdered milk, nut butters) plus fat-soluble vitamins (A, D, E, K) supports growth and bone health.

🟦With PERT, higher calories—including dietary fats—are better absorbed, reducing failure to thrive.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 4

Correct Answers:

Electroencephalogram (EEG).

Rationale :

💠An EEG is the standard diagnostic tool to confirm seizures and classify seizure type by detecting abnormal cortical electrical activity.

💠Characteristic epileptiform discharges (spikes, sharp waves) guide differentiation of focal vs generalized seizures and influence antiseizure medication selection.

💠EEG can be performed interictally, during sleep deprivation, or with video-EEG monitoring to capture events and correlate behavior with brain activity.

💠Accurate classification is essential for treatment planning, prognosis, and counseling on safety and triggers.

💠While imaging (MRI) identifies structural lesions, the EEG establishes electrical patterns that define seizure syndrome and management.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 5

Correct Answers:

Nighttime bedwetting

Rationale :

🔸Nocturnal enuresis specifically denotes involuntary urination during sleep beyond the age when nighttime continence is expected.

🔸It can be primary (never achieved dry nights) or secondary (resumed bedwetting after ≥6 months of dryness), but the defining feature is nighttime occurrence.

🔸Assessment focuses on voiding patterns, constipation, sleep arousal, and family history, with daytime symptoms suggesting broader dysfunction.

🔸Management includes behavioral strategies (fluid timing, bladder training), enuresis alarms, and, in select cases, desmopressin.

🔸Clear terminology helps parents understand expectations, prognosis, and the non-volitional nature of the condition, reducing stigma.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 6

Correct Answers:

Administer antibiotics as per provider's order.

Rationale :

🟥The triad of high fever, photophobia, and nuchal rigidity is concerning for bacterial meningitis, a medical emergency requiring prompt empiric antibiotics.

🟥Early antibiotic administration (after rapid blood cultures and without delaying for imaging if no contraindications) reduces mortality and neurologic sequelae.

🟥Droplet isolation, hemodynamic monitoring, and supportive care accompany antimicrobials, but definitive infection control hinges on timely antibiotics.

🟥Unvaccinated status increases risk for H. influenzae type b, N. meningitidis, and S. pneumoniae, guiding empiric coverage per age/local patterns.

🟥Nurses expedite cultures, IV access, and first-dose delivery, recognizing that time-to-antibiotics is a critical outcome determinant.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 7

Correct Answers:

Olive-shaped mass in the right upper quadrant. This represents the stenosed pylorus muscle.

Rationale :

🟢Hypertrophic pyloric stenosis classically presents with progressively forceful (projectile) non-bilious vomiting in a 2–8-week-old infant.

🟢On exam, the hallmark is a small, firm, “olive-shaped” mass in the RUQ/epigastrium, representing the hypertrophied pyloric muscle.

🟢Additional findings include visible peristaltic waves, hungry-vomiter behavior, weight loss, and hypochloremic, hypokalemic metabolic alkalosis.

🟢Abdominal ultrasound confirms diagnosis, showing elongated pyloric channel and thickened muscle.

🟢Management involves fluid/electrolyte correction followed by pyloromyotomy, with excellent outcomes.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 8

Correct Answers:

Acquired heart disease develops as a result of an illness or infection after birth.

Rationale :

◼️Acquired heart disease refers to cardiac conditions that develop after birth due to external factors such as infections (e.g., rheumatic fever, Kawasaki disease, endocarditis) or autoimmune/inflammatory processes.

◼️It differs from congenital heart disease (CHD), which results from structural malformations present at birth that form during fetal cardiac development.

◼️Common acquired disorders include rheumatic heart disease, infective endocarditis, and myocarditis, all of which can lead to valvular or myocardial damage.

◼️Early recognition and treatment of infections are essential to prevent progression to permanent heart damage or cardiomyopathy.

◼️Nurses play a vital role in monitoring cardiac function, administering medications, and educating families on infection prevention.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 9

Correct Answers:

Pinch the nostrils together and lean forward during a nosebleed.

Rationale :

🔷The first-line intervention for active epistaxis is to have the child sit upright and lean forward, preventing blood aspiration and airway obstruction.

🔷Applying firm pressure to the soft part of the nose (below the nasal bone) for at least 10 minutes promotes clot formation and controls bleeding.

🔷Leaning forward avoids swallowing blood, which can lead to nausea, vomiting, or coughing.

🔷Once bleeding stops, the nurse should advise avoiding nose blowing, picking, or strenuous activity for 24 hours to prevent rebleeding.

🔷Applying a cool compress over the nasal bridge may aid in vasoconstriction, but manual pressure and forward posture are most effective.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 10

Correct Answers:

Paraphimosis is a more serious, emergent disorder

Rationale :

🔶 Phimosis is a normal condition in young boys where the foreskin cannot be retracted over the glans; it typically resolves naturally with growth.

🔶 Paraphimosis, however, occurs when the retracted foreskin becomes trapped behind the glans, leading to venous congestion, edema, and possible ischemia — a urologic emergency.

🔶 If untreated, it can cause necrosis of penile tissue due to impaired blood flow.

🔶 Nurses must recognize swelling, discoloration, and severe pain as critical indicators requiring immediate intervention to restore circulation.

🔶 Teaching parents gentle hygiene and avoidance of forced retraction helps prevent both conditions.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

NUR 227 DFB FALL 2025 EXAM 2

No.

1 :
A patient weighs 44 pounds. The doctor orders Cefazolin 90 mg/kg/day every 8 hours (3 doses per day). What is the appropriate dose (in mg) for this patient?

2 :
A nurse is feeding a newborn with congenital heart disease (CHD). Which finding would the nurse interpret as indicating respiratory distress and to pause the feeding.

3 :
The nurse is teaching the parent of a child with cystic fibrosis about respiratory and nutrition requirements for the child. What should be included in this teaching? (SELECT ALL THAT APPLY)

4 :
Which of the following is used to officially diagnose seizures and seizure types:

5 :
The nurse is caring for a patient diagnosed with nocturnal enuresis. The parents ask what this means. The nurse is correct in responding:

6 :
The nurse is caring for an unvaccinated child with 104F fever, photophobia, neck rigidity. The RN knows that in order to address the infection the primary interventions

8 :
A pediatric nurse is providing care to a child with acquired heart disease. The nurse understands that this type of heart disease is different from congenital heart in what way:

9 :
A child with recurrent epistaxis is seen in the clinic. Which of the following is the most appropriate nursing interventions to prioritize for a patient with a nose bleed?

10 :
A parent of an uncircumcised child asked the nurse about disorders of the foreskin and difference between phimosis and paraphimosis. The nurse's response should been?

Connect With Us

NUR 227 DFB FALL 2025 EXAM 2

No.

1 : A patient weighs 44 pounds. The doctor orders Cefazolin 90 mg/kg/day every 8 hours (3 doses per day). What is the appropriate dose (in mg) for this patient?

2 : A nurse is feeding a newborn with congenital heart disease (CHD). Which finding would the nurse interpret as indicating respiratory distress and to pause the feeding.

3 : The nurse is teaching the parent of a child with cystic fibrosis about respiratory and nutrition requirements for the child. What should be included in this teaching? (SELECT ALL THAT APPLY)

4 : Which of the following is used to officially diagnose seizures and seizure types:

5 : The nurse is caring for a patient diagnosed with nocturnal enuresis. The parents ask what this means. The nurse is correct in responding:

6 : The nurse is caring for an unvaccinated child with 104F fever, photophobia, neck rigidity. The RN knows that in order to address the infection the primary interventions

8 : A pediatric nurse is providing care to a child with acquired heart disease. The nurse understands that this type of heart disease is different from congenital heart in what way:

9 : A child with recurrent epistaxis is seen in the clinic. Which of the following is the most appropriate nursing interventions to prioritize for a patient with a nose bleed?

10 : A parent of an uncircumcised child asked the nurse about disorders of the foreskin and difference between phimosis and paraphimosis. The nurse's response should been?

1 :
A patient weighs 44 pounds. The doctor orders Cefazolin 90 mg/kg/day every 8 hours (3 doses per day). What is the appropriate dose (in mg) for this patient?

2 :
A nurse is feeding a newborn with congenital heart disease (CHD). Which finding would the nurse interpret as indicating respiratory distress and to pause the feeding.

3 :
The nurse is teaching the parent of a child with cystic fibrosis about respiratory and nutrition requirements for the child. What should be included in this teaching? (SELECT ALL THAT APPLY)

4 :
Which of the following is used to officially diagnose seizures and seizure types:

5 :
The nurse is caring for a patient diagnosed with nocturnal enuresis. The parents ask what this means. The nurse is correct in responding:

6 :
The nurse is caring for an unvaccinated child with 104F fever, photophobia, neck rigidity. The RN knows that in order to address the infection the primary interventions

8 :
A pediatric nurse is providing care to a child with acquired heart disease. The nurse understands that this type of heart disease is different from congenital heart in what way:

9 :
A child with recurrent epistaxis is seen in the clinic. Which of the following is the most appropriate nursing interventions to prioritize for a patient with a nose bleed?

10 :
A parent of an uncircumcised child asked the nurse about disorders of the foreskin and difference between phimosis and paraphimosis. The nurse's response should been?