Nursing Elites

1. A 14-year-old adolescent with a history of substance abuse is brought to the emergency department by the parents, who suspect that the adolescent has relapsed. What is the nurse’s priority action?

• A. Obtain a urine sample for toxicology screening
• B. Discuss treatment options with the parents
• C. Establish a therapeutic relationship with the adolescent
• D. Administer a medication to reverse the effects of the substance

Correct answer: A

Rationale: In this scenario, the nurse's priority action should be to obtain a urine sample for toxicology screening. This step is crucial in identifying the substances involved in the relapse, which will guide appropriate treatment strategies. By knowing the specific substances, healthcare providers can tailor treatment plans effectively. Establishing a therapeutic relationship and discussing treatment options come after obtaining necessary diagnostic information to ensure a comprehensive care plan. Administering a medication to reverse substance effects is not the initial priority; identification of the substances through toxicology screening should precede any treatment intervention.

2. What is the most important information for the PN to reinforce with the parents when caring for a child diagnosed with acute rheumatic fever?

• A. Complete the full course of prescribed antibiotics.
• B. Ensure the child gets plenty of physical exercise.
• C. Keep the child on a low-sodium diet.
• D. Administer prescribed pain medications as needed.

Correct answer: A

Rationale: Completing the full course of antibiotics is crucial in the management of acute rheumatic fever as it helps prevent recurrence and complications. Antibiotics are essential in eradicating the underlying infection that triggers the autoimmune response leading to rheumatic fever. Reinforcing the importance of completing the prescribed antibiotic regimen is vital to ensure the child's recovery and prevent further health issues. Choices B, C, and D are not as critical as completing the antibiotic treatment. While physical exercise, a low-sodium diet, and pain management are important aspects of overall health, they are not the primary focus when managing acute rheumatic fever.

3. What is the most suitable toy for a 3-year-old boy receiving weekly chemotherapy treatment?

• A. Bouncy ball
• B. Coloring book with crayons
• C. Duck that squeaks
• D. Remote-controlled car

Correct answer: B

Rationale: A coloring book with crayons is the best choice as it is safe, engaging, and can provide a distraction during treatment without posing any safety risks. Coloring activities can help keep the child occupied, promote creativity, and offer a calming and therapeutic outlet during chemotherapy sessions.

4. When reviewing the dietary guidelines for a child with nephrotic syndrome, which diet should the practical nurse reinforce with the parents?

• A. High protein.
• B. Low sodium.
• C. Low fat.
• D. High carbohydrate.

Correct answer: B

Rationale: The correct diet that the practical nurse should reinforce with the parents of a child with nephrotic syndrome is a low-sodium diet. This diet is crucial for managing fluid retention and reducing the risk of edema, which are common concerns in children with nephrotic syndrome.

5. After reinforcing information on treating a sprained ankle, what statement by the adolescent indicates to the practical nurse that further instruction is needed?

• A. Keep the leg elevated when sitting.
• B. Wrap the ankle in an elastic bandage for support.
• C. Apply warm compresses to the ankle for the first 24 hours.
• D. Put an ice pack on the ankle, alternating 30 minutes on and 30 minutes off.

Correct answer: C

Rationale: The correct answer is C. Applying warm compresses to a sprained ankle within the first 24 hours is incorrect as it can increase swelling and inflammation. Instead, cold compresses are recommended to help reduce swelling and pain. Option A, keeping the leg elevated, helps in reducing swelling. Option B, wrapping the ankle in an elastic bandage, provides support. Option D, using an ice pack in intervals, is effective in reducing swelling and pain. Therefore, the statement about applying warm compresses indicates the need for further instruction.

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