Module Well Child

Module Report Tutorial: Real Life RN Nursing Care of Children 3.0 Module: Well Child Individual Name: Institution: Program Type: BSN Standard Use Time and Score Date/Time Well Child Time Use 6/28/2022 5:41:11 PM 29 min Score Strong Reasoning Scenario Details Well Child - Use on 6/28/2022 5:12:35 PM Reasoning Scenario Performance Related to Outcomes: *See Score Explanation and Interpretation below for additional details. Body Function Strong Cardiac Output and Tissue Perfusion 100% Cognition and Sensation 100% Ingestion, Digestion, Absorption & Elimination 100% Mobility 100% Regulation and Metabolism 100% NCLEX RN Strong RN Safety and Infection Control 100% RN Health Promotion and Maintenance 100% RN Psychosocial Integrity 100% RN Basic Care and Comfort 100% RN Pharmacological and Parenteral Therapies 100% RN Reduction of Risk Potential 100% Satisfactory Needs Improvement Satisfactory Needs Improvement Page 1 of 10 QSEN Strong Safety 100% Patient-Centered Care 100% Informatics 100% Satisfactory Needs Improvement Decision Log: Optimal Decision Scenario The provider has not seen Kellen since his 6-week checkup. Question Nurse Denise discusses Kellen’s immunization status, and Ms. Ralston appears upset. Which of the following responses by Denise is appropriate? Selected Option "You appear upset. Can we discuss your thoughts regarding immunizations?" Rationale This response acknowledges the client is upset and seeks clarification of her perceptions of immunizations. Scenario Nurse Denise is taking Kellen’s vital signs. Question Nurse Denise auscultates Kellen’s heart. Which of the following heart rates is within the expected range for Kellen? Selected Option 89/min Rationale A heart rate of 89/min is within the expected reference range for a 24-month-old child. Scenario Nurse Denise discusses Kellen’s developmental milestones and gross motor skills. Question Nurse Denise is preparing to assess Kellen’s gross motor development. Which of the following gross motor skills should Kellen accomplish? (Select all that apply.) Selected Ordering Kick a ball forward Walk up and down stairs with two feet on each stepUse a wide stance when running Rationale At age 2, toddlers should kick a ball forward without overbalancing, go up and down stairs alone with two feet on each step, and run reasonably well with a wide stance. At age 2, toddlers are not coordinated enough to balance on one foot or jump off the bottom step. These gross motor skills occur between the ages of 3 and 4. Optimal Decision Optimal Decision Optimal Decision Page 2 of 10 Scenario Nurse Denise completes an assessment of Kellen’s gross motor skills and is preparing to assess Kellen’s fine motor skills. Question Nurse Denise is preparing to assess Kellen’s fine motor development. Which of the following fine motor skills should Denise include in the assessment plan? (Select all that apply.) Selected Ordering Stack six or seven blocksUnscrew lids on a containerTurn each page of a book Rationale At age 2, toddlers can stack six or seven blocks, unscrew lids on a container, and turn each page of a book. At age 2, toddlers are not coordinated enough to draw a circle with eyes and nose or to thread shoelaces through shoe eyelets. These fine motor skills occur in children who are preschool age, 3 or 4. Scenario The nurse assesses Kellen’s language development. Question Nurse Denise assesses Kellen’s language development. Which of the following audio clips represents typical language development for a 24-month-old child? (Click to play the audio file.) Selected Option Video|7280bff40d50437d904a4f2abed097a9 Rationale By 24 months of age, a child should be speaking two- to three-word phrases. Scenario Nurse Denise educates Ms. Ralston prior to administering the measles, mumps, rubella (MMR) and varicella vaccines. Question Nurse Denise is teaching Ms. Ralston about immunizations. Which of the following information should Denise include about measles, mumps, rubella (MMR) and varicella vaccines? (Select all that apply.) Selected Ordering Mild illness is not a reason to delay vaccination with the MMR and varicella vaccines.MMR and varicella vaccines should be administered subcutaneously.The client who has an egg allergy can receive the MMR and varicella vaccines. Rationale Vaccination should not be delayed because of the presence of mild respiratory tract illness or other acute illness with or without fever. The nurse should administer the MMR and varicella vaccines subcutaneously. An allergy to eggs is not a contraindication to administration of the MMR and varicella vaccines; however, a gelatin allergy is a contraindication to receiving the vaccines. There is no causal link between MMR and varicella vaccines and autism. Scenario Nurse Denise calculates the ibuprofen dosage for Kellen. Question Nurse Denise is calculating Kellen’s dose of ibuprofen. Available is a liquid preparation that contains 100 mg/5 mL. The label indicates to administer 10 mg/kg/dose. Kellen weighs 27.5 lb. How many mL should Denise tell Ms. Ralston to administer? (Round the answer to the nearest tenth.) Selected Option 6.3 Rationale Follow these steps for the Ratio and Proportion method of calculation: Step 1: What is the unit of measurement the nurse should calculate? kg Optimal Decision Optimal Decision Optimal Decision Page 3 of 10 Step 2: Set up an equation and solve for X. 2.2 lbClient's weight in lb = 1 kgX kg2.2 lb27.5 lb = 1 kgX kg X kg = 12.5 kg Step 3: Determine whether the weight conversion makes sense. If 1 kg equals 2.2. lb and the client weights 27.5 lb, it makes sense that the client weighs 12.5 kg. Step 4: What is the unit of measurement the nurse should calculate? mg/dose Step 5: Set up an equation and solve for X. X = Dose per kg × Client's weight in kg X mg/dose = 10 mg/kg × 12.5 kg X mg/dose = 125 mg/dose Step 6: What is the unit of measurement the nurse should calculate? mL Step 7: What is the dose the nurse should administer? Dose to administer = Desired 125 mg Step 8: What is the dose available? Dose available = Have 100 mg Step 9: Should the nurse convert the units of measurement? No Step 10: What is the quantity of the dose available? 5 mL Step 11: Set up an equation and solve for X. HaveDesired= QuantityX100 mg125mg=م mLX mL X mL = 6.25 mL Step 12: Round if necessary. 6.25 mL = 6.3 mL Step 13: Determine whether the amount to administer makes sense. If there are 100 mg/5 mL and the prescription reads 125 mg, it makes sense to administer 6.3 mL. The nurse should administer ibuprofen 6.3 mL orally. Follow these steps for the Desired Over Have method of calculation: Step 1: What is the unit of measurement the nurse should calculate? kg Step 2: Set up an equation and solve for X. Client's weight in lb×1 kgXkg=2.2 lb27.5 lb×1 kgXkg=2.2 X kg = 12.5 kg Step 3: Determine whether the weight conversion makes sense. If 1 kg equals 2.2. lb and the client weights 27.5 lb, it makes sense that the client weighs 12.5 kg. Step 4: What is the unit of measurement the nurse should calculate? mg Step 5: Set up an equation and solve for X. X = Dose per kg×Client's weight in kg X mg/dose = 10 mg/kg×12.5 kg X mg/dose = 125 mg/dose Step 6: What is the unit of measurement the nurse should calculate? mL Step 7: What is the dose the nurse should administer? Dose to administer = Desired 125 mg Step 8: What is the dose available? Dose available = Have 100 mg Step 9: Should the nurse convert the units of measurement? No Step 10: What is the quantity of the dose available? 5 mL Step 11: Set up an equation and solve for X. Desired×QuantityX= Have120 mg×1 mLXmL=𧅤 m X mL = 6.25 mL Step 12: Round if necessary. 6.25 = 6.3 mL Step 13: Determine whether the amount to administer makes sense. If there are 100 mg/5 mL and the prescription reads 125 mg, it makes sense to administer 6.3 mL. The nurse should administer ibuprofen 6.3 mL orally. Follow these steps for the Dimensional Analysis method of calculation: Step 1: What is the unit of measurement the nurse should calculate? (Place the unit of measure being calculated on the left side of the equation.) Page 4 of 10 X mL = Step 2: Determine the ratio that contains the same unit as the unit being calculated. (Place the ratio on the right side of the equation, ensuring that the unit in the numerator matches the unit being calculated.) 5 mLXmL=𧅤 mg Step 3: Place any remaining ratios that are relevant to the item on the right side of the equation, along with any needed conversion factors, to cancel out unwanted units of measurement. 5 mL10 mg1 kg27.5 lbXmL= × × ×㺊 kg2.2 lb1 Step 4: Solve for X. X mL = 6.25 mL Step 5: Round if necessary. 6.25 mL = 6.3 mL Step 6: Determine whether the amount to administer makes sense. If there are 100 mg/5 mL and the prescription reads 125 mg, it makes sense to administer 6.3 mL. The nurse should administer ibuprofen 6.3 mL orally. Optimal Decision Scenario Nurse Denise is discussing immunizations with Chloe and her father. Question Nurse Denise is discussing immunizations with Chloe and her father. Which of the following vaccinations should Denise anticipate administering to Chloe today? (Select all that apply.) Selected Ordering Hepatitis A (Hep A)MeningococcalTetanus, diphtheria, acellular pertussis (Tdap)Human Papilloma Virus (HPV) Rationale According to the Centers for Disease Control and Prevention guidelines, this client is missing the Tdap booster, HPV series, Hep A, series and meningococcal immunization. The DTaP series has been completed, and the rotavirus is not initiated 15 weeks or older. Scenario Nurse Denise calculates and plots Chloe’s body mass index (BMI). Question Nurse Denise calculates Chloe’s body mass index (BMI) using this formula: weight (kg) divided by stature (cm) divided by stature (cm) multiplied by 10,000 or weight (lb) divided by stature (in) divided by stature (in) multiplied by 703. Select the area of the chart where Denise should plot Chloe’s BMI. (Selectable areas, or "Hot Spots," can be found by moving your cursor over the artwork until the cursor changes appearance, usually into a hand. Click only on the Hot Spot that corresponds to your answer.) Selected Option 787,463,813,462,814,529,786,529 Rationale The calculated BMI of 30 is correct. Weight in pounds (height in inches x height in inches) x 703 = BMI 200 / (68 x 68) x 703 = 30.4 = 30 Scenario Nurse Denise discusses weight loss ideas with Chloe. Question Nurse Denise prepares to discuss weight loss ideas with Chloe. Which of the following should Denise recommend Chloe integrate on a daily basis? Optimal Decision Optimal Decision Page 5 of 10 Selected Option Be physically active for at least 60 min. Rationale In addition to calorie reduction, the nurse should recommend physical activity for at least 60 min per day. Scenario Beth, the nurse practitioner, and Chloe are discussing her dysmenorrhea. Question Nurse Practitioner Beth, is educating Chloe about the use of ibuprofen (Advil) to minimize dysmenorrhea. Which of the following should Beth include in the teaching? Selected Option Notify the provider immediately if you experience dark tarry stools. Rationale Although research studies show ibuprofen produces less gastric bleeding compared with aspirin, the client should contact the nurse or another health care provider if this occurs. Scenario Nurse practitioner Beth, is completing a physical exam of Chloe and considers additional topics to discuss. Question Nurse practitioner Beth is completing a physical exam of Chloe and considers additional topics to discuss. List three topics Beth should include in her discussion with Chloe. (Fill in the blank and click on the Submit button when you finish.) Selected Option Sexuality School and level of interest Relationships with peers Psychological health Development related to risk of injury Recreational use of substances Rationale 1. School and level of interest: How well does the client do in school and what is her level of interest? Does she take responsibility for schoolwork and complete it on time?2. Relationship with peers: Has the client ever been stalked or bullied in person or online? How does she feel about cyber bullying?3. Sexuality: How is the client responding to developmental changes? Is she in or has she had a heterosexual, and/or homosexual relationship? Has she had oral, vaginal, or anal sex, wanted or unwanted? Has she ever been forced or pressured to do something sexual that she did not want to do? If sexually active, are her partners younger, older, or the same age? Does she use condoms or other contraceptives?4. Psychological health: Is the client moody or does she have outbursts? Does she feel bored, sad, or irritable most of the time? Does she ever feel so sad she wishes she were not alive or wants to die? How does she manage conflict? How does she find ways to deal with stress? Does she overeat when stressed?5. Development related to risk of injury: Does the client tan? Does she wear her car seat belt? Does she wear a helmet or protective gear when biking or participating in roller sports? Does she have someone she can call for a ride if she feels unsafe riding with someone? Does she feel indestructible?6. Recreational use of substances: Has the client ever experimented with smoking, tobacco, alcohol, drugs, or steroids? Has she sniffed, huffed, or breathed anything to get high? Do her friends do any of these activities? Scenario Nurse Denise plots Fay’s height and weight on a growth chart. Optimal Decision Optimal Decision Page 6 of 10 Question Nurse Denise is plotting Fay’s height and weight on the growth chart. Identify the two locations that correspond to Fay’s height and weight at today’s wellbaby check. (Select both options that apply.) Selected Ordering Image|RN_NCC_WC_30_b_800px.jpgImage|RN_NCC_WC_30_d_800px.jpg Rationale The client’s height reflects the 75th percentile and her weight reflects the 80th percentile, which indicates growth within the expected range for a 6-month-old infant. Scenario Nurse Denise begins a developmental screening of fine motor skills. Question Nurse Denise performs a developmental screening of fine motor skills on Fay. Which of the following fine motor skills should Fay demonstrate? Selected Option Holds her bottle when feeding Rationale At 6 months, the client should be able to hold her own bottle. Scenario Nurse Denise reviews appropriate food choices for a 6-month-old with Fay’s parents. Question Nurse Denise plans to review appropriate food choices with Fay’s parents. Which of the following foods are appropriate for Fay? Selected Option Finely mashed peas Rationale The client should start eating pureed, strained, or finely mashed cooked baby foods at 6 months. Scenario Nurse Denise is educating Fay’s parents about home safety. Question Nurse Denise is reviewing home safety with Fay’s parents. Which of the following images illustrates a potential safety hazard for an infant? Selected Option Image|RN_NCC_WC_36_a_800px.jpg Rationale Parents should avoid latex balloons in the home environment because they pose risks of suffocation and aspiration to children. Latex is also a common allergen during childhood. Scenario Ms. Johnson is asking Nurse Denise about immunizations for Fay. Question Nurse Denise prepares the vaccines for administration to Fay. Which of the following vaccines should Denise plan to administer first? Selected Option Rotavirus Rationale Rotavirus is an oral vaccine; therefore, the nurse should administer this vaccine first because it is the least invasive. Optimal Decision Optimal Decision Optimal Decision Optimal Decision Page 7 of 10 Optimal Decision Scenario Nurse Denise reviews infant acetaminophen dosage with Ms. Johnson. Question Nurse Denise reviews the appropriate dosage of acetaminophen with Ms. Johnson. The provider prescribed children’s acetaminophen, which is available as 160 mg/5 mL. The recommended dose is 10 to 15 mg/kg. Fay weighs 18 lb. Which of the following is the dosage range that Denise should tell Fay’s parents to give at home? (Round the answer to the nearest tenth.) Selected Option 2.6 to 3.8 mL Rationale Follow these steps for the Ratio and Proportion method of calculation: Step 1: What is the unit of measurement the nurse should calculate? kg Step 2: Set up an equation and solve for X. 2.2 lbClient's weight in lb = 1 kgX kg2.2 lb18 lb = 1 kgX kg X kg = 8.181818 kg Step 3: Determine whether the weight conversion makes sense. If 1 kg equals 2.2 lb and the client weighs 18 lb, it makes sense that the client weighs 8.181818 kg. Step 4: What is the unit of measurement the nurse should calculate? mL Step 5: What is the lowest dose the nurse should administer? Dose to adminster = Desired 10 mg/kg Step 6: Set up an equation and solve for X. X = mg × kg X mg = 10 mg × 8.181818 kg X mg = 81.81818 mg Step 7: What is the dose available? Dose available = Have 160 mg Step 8: Should the nurse convert the units of measurement? No Step 9: What is the quantity of the dose available? 5 mL Step 10: Set up an equation and solve for X. HaveDesired= QuantityX160 mg81.81818mg=م mLX mL X mL = 2.556818 mL Step 11: Round if necessary. 2.556818 mL = 2.6 mL Step 12: Determine whether the amount to administer makes sense. If there are 160 mg/5 mL and the low safe dose range is 81.81818 mg (10 mg/kg), it makes sense that the low dosage range to administer is 2.6 mL. Step 13: What is the unit of measurement the nurse should calculate? mL Step 14: What is the highest dose the nurse should administer? Dose to adminster = Desired 15 mg/kg Step 15: Set up an equation and solve for X. X = mg×kg X mg = 15mg×8.181818 kg X mg = 122.727272 mg Step 16: What is the dose available? Dose available = Have 160 mg Step 17: Should the nurse convert the units of measurement? No Step 18: What is the quantity of the dose available? 5 mL Step 19: Set up an equation and solve for X. HaveDesired= QuantityX160 mg122.727272mg=م mLX mL X mL = 3.835227 mL Step 20: Round if necessary. 3.835227 mL = 3.8 mL Step 21: Determine whether the amount to administer makes sense. If there are 160 mg/5 mL and the high safe dose range is 122.727272 mg (15 mg/kg), it makes sense that the high dose range to administer is 3.8 mL. The nurse should instruct the parents to administer between 2.6 to 3.8 mL of acetaminophen by Page 8 of 10 mouth. Follow these steps for the Desired Over Have method of calculation: Step 1: What is the unit of measurement the nurse should calculate? kg Step 2: Set up an equation and solve for X. Client's weight in lb×1 kgXkg=2.2 lb18 lb×1 kgXkg=2.2 l X kg = 8.181818 kg Step 3: Determine whether the weight conversion makes sense. If 1 kg equals 2.2 lb and the client weighs 18 lb, it makes sense that the client weighs 8.181818 kg. Step 4: What is the unit of measurement the nurse should calculate? mL Step 5: What is the lowest dose the nurse should administer? Dose to adminster = Desired 10 mg/kg Step 6: Set up an equation and solve for X. X = mg×kg X mg = 10mg×8.181818 kg X mg = 81.81818 mg Step 7: What is the dose available? Dose available = Have 160 mg Step 8: Should the nurse convert the units of measurement? No Step 19: What is the quantity of the dose available? 5 mL Step 10: Set up an equation and solve for X. Desired×QuantityX= Have81.81818 mg×5 mLXmL= X mL = 2.556818 mL Step 11: Round if necessary. 2.556818 mL = 2.6 mL Step 12: Determine whether the amount to administer makes sense. If there are 160 mg/5 mL and the low safe dose range is 81.81818 mg (10 mg/kg), it makes sense that the low dose to administer is 2.6 mL. Step 13: What is the unit of measurement the nurse should calculate? mL Step 14: What is the highest dose the nurse should administer? Dose to adminster = Desired 15 mg/kg Step 15: Set up an equation and solve for X. X = mg×kg X mg = 15mg×8.181818 kg X mg = 122.727272 mg Step 16: What is the dose available? Dose available = Have 160 mg Step 17: Should the nurse convert the units of measurement? No Step 18: What is the quantity of the dose available? 5 mL Step 19: Set up an equation and solve for X. Desired×QuantityX= Have122.727272 mg×5 mLXmL= mg X mL = 3.835227 mL Step 20: Round if necessary. 3.835227 mL = 3.8 mL Step 21: Determine whether the amount to administer makes sense. If there are 160 mg/5 mL and the high safe dose range is 122.727272 mg (15 mg/kg), it makes sense that the high dose to administer is 3.8 mL. The nurse should instruct the parents to administer between 2.6 to 3.8 mL of acetaminophen by mouth. Follow these steps for the Dimensional Analysis method of calculation: Step 1: What is the unit of measurement the nurse should calculate? (Place the unit of measure being calculated on the left side of the equation.) X mL = Step 2: Determine the ratio that contains the same unit as the unit being calculated. (Place the ratio on the right side of the equation, ensuring that the unit in the numerator matches the unit being calculated.) Page 9 of 10 5 mLXmL=𧆠 mg Step 3: Place any remaining ratios that are relevant to the item on the right side of the equation, along with any needed conversion factors, to cancel out unwanted units of measurement. 5 mL10 mg1 kg18 lbXmL= × × ×𧆠 lb1 Step 4: Solve for X. X mL = 2.556818 mL Step 5: Round if necessary. 2.556818 mL = 2.6 mL Step 6: Determine whether the amount to administer makes sense. If there are 160 mg/5 mL and the low safe dose range is 81.81818 mg (10 mg/kg), it makes sense that the lowest dose to administer is 2.6 mL. Step 7: What is the unit of measurement the nurse should calculate? (Place the unit of measure being calculated on the left side of the equation.) X mL = Step 8: Determine the ratio that contains the same unit as the unit being calculated. (Place the ratio on the right side of the equation, ensuring that the unit in the numerator matches the unit being calculated.) 5 mLXmL=𧆠 mg Step 9: Place any remaining ratios that are relevant to the item on the right side of the equation, along with any needed conversion factors, to cancel out unwanted units of measurement. 5 mL15 mg1 kg18 lbXmL= × × ×𧆠 lb1 Step 10: Solve for X. X mL = 3.835227 mL Step 11: Round if necessary. 3.835227 mL = 3.8 mL Step 12: Determine whether the amount to administer makes sense. If there are 160 mg/5 mL and the high safe dose range is 122.727272 mg (15 mg/kg), it makes sense that the highest dose to administer is 3.8 mL. The nurse should instruct the parents to administer between 2.6 to 3.8 mL of acetaminophen by mouth. Page 10 of 10