Nursing Elites

1. A 3-year-old child was brought to the pediatric clinic after the sudden onset of findings that include irritability, thick muffled voice, croaking on inspiration, being hot to the touch, sitting leaning forward, tongue protruding, drooling, and suprasternal retractions. What should the nurse do first?

• A. Prepare the child for an X-ray of the upper airways
• B. Examine the child's throat
• C. Collect a sputum specimen
• D. Notify the healthcare provider of the child's status

Correct answer: D

Rationale: The correct initial action is to notify the healthcare provider of the child's status. The presenting symptoms described, such as irritability, thick muffled voice, croaking on inspiration, being hot to the touch, sitting leaning forward, tongue protruding, drooling, and suprasternal retractions, are indicative of epiglottitis, a potentially life-threatening condition. Immediate medical attention is crucial in such cases. While preparing for an X-ray or examining the throat may be necessary, the priority is to ensure prompt evaluation and intervention by the healthcare provider. Collecting a sputum specimen is not relevant in this situation and would cause unnecessary delay. Therefore, the nurse should prioritize communication with the healthcare provider to expedite appropriate management and treatment.

2. In which of the following conditions would a healthcare provider not administer erythromycin?

• A. Campylobacteriosis infection
• B. Legionnaires disease
• C. Pneumonia
• D. Multiple Sclerosis

Correct answer: D

Rationale: Erythromycin is an antibiotic used to treat bacterial infections. Multiple sclerosis (MS) is an autoimmune disease affecting the central nervous system, involving the brain and spinal cord. Since MS is not caused by bacteria, administering erythromycin would not be appropriate. Campylobacteriosis infection, Legionnaires disease, and pneumonia are bacterial infections that can be treated with erythromycin, making them incorrect choices for conditions where erythromycin would not be administered.

3. A patient is being discharged from the med-surgical unit. The patient has a history of gastritis. The nurse questions the patient on their usual routine at home. Which of these statements would alert the nurse that additional teaching is required?

• A. I avoid NSAIDs. I only take a daily aspirin for my heart health.
• B. I always avoid eating hot and spicy foods.
• C. I will continue taking my antacids with or immediately after meals.
• D. I will only drink coffee once a week, if even that often.

Correct answer: A

Rationale: The correct answer is, 'I avoid NSAIDs. I only take a daily aspirin for my heart health.' Aspirin is classified as an NSAID and can exacerbate existing stomach problems, such as gastritis. Therefore, patients with gastritis should avoid aspirin just like any other NSAID. Choice B, 'I always avoid eating hot and spicy foods,' is a good practice for a patient with gastritis. Choice C, 'I will continue taking my antacids with or immediately after meals,' indicates understanding of the correct timing for antacid use. Choice D, 'I will only drink coffee once a week, if even that often,' shows a suitable limitation of coffee intake, which is beneficial for patients with gastritis.

4. A patient asks a nurse, "My doctor recommended I increase my intake of folic acid. What type of foods contain the highest concentration of folic acid?'

• A. Green vegetables and liver
• B. Yellow vegetables and red meat
• C. Carrots
• D. Milk

Correct answer: A

Rationale: Green vegetables and liver are rich sources of folic acid. Green vegetables like spinach, asparagus, and broccoli are high in folic acid content. Liver, especially from chicken or beef, is also a good source of folic acid. Yellow vegetables and red meat (choice B) do not contain as high a concentration of folic acid as green vegetables and liver. Carrots (choice C) are nutritious but do not have the highest concentration of folic acid. Milk (choice D) is not a significant source of folic acid compared to green vegetables and liver.

5. A client is undergoing radiation therapy for treatment of thyroid cancer. Following the radiation, the client develops xerostomia. Which of the following best describes this condition?

• A. Cracks in the corners of the mouth
• B. Peeling skin from the tongue and gums
• C. Increased dental caries
• D. Dry mouth

Correct answer: D

Rationale: Xerostomia, also known as dry mouth, is a common side effect of radiation therapy in the head and neck region. It occurs when the salivary glands are damaged during treatment, reducing saliva production and causing a dry sensation in the mouth. The correct answer is 'Dry mouth' (option D). Choice A, 'Cracks in the corners of the mouth,' describes angular cheilitis, a condition linked to nutritional deficiencies or candida infection. Choice B, 'Peeling skin from the tongue and gums,' is more indicative of conditions like oral thrush or mucositis. Choice C, 'Increased dental caries,' is a consequence of reduced saliva flow but does not specifically describe xerostomia.

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