Nursing Elites

1. A 4-month-old child taking digoxin (Lanoxin) has a blood pressure of 92/78; resting pulse of 78; respirations 28, and a potassium level of 4.8 mEq/L. The client is irritable and has vomited twice since the morning dose of digoxin. Which finding is most indicative of digoxin toxicity?

• A. Bradycardia
• B. Lethargy
• C. Irritability
• D. Vomiting

Correct answer: A

Rationale: Bradycardia (abnormally slow heart rate) is a key sign of digoxin toxicity. In this scenario, the child's symptoms of irritability, vomiting, along with the resting pulse of 78 despite being on digoxin, suggest an impending bradycardia due to digoxin toxicity. Lethargy can also be a sign, but in this case, the child is irritable rather than lethargic. Vomiting, though a symptom, is not as specific to digoxin toxicity as bradycardia. Irritability, while present, is not the most indicative finding of digoxin toxicity compared to bradycardia.

2. Which of the following is a major focus of tertiary prevention?

• A. Preventing the onset of disease
• B. Early detection and treatment
• C. Reducing the impact of an ongoing illness
• D. Health education

Correct answer: C

Rationale: The correct answer is C, 'Reducing the impact of an ongoing illness.' Tertiary prevention aims to minimize the effects of a disease or condition that is already established. Choices A, 'Preventing the onset of disease,' and B, 'Early detection and treatment,' are aspects of primary and secondary prevention, respectively. Choice D, 'Health education,' is more related to promoting awareness and knowledge rather than specifically focusing on reducing the impact of an ongoing illness.

3. A client presents at a community-based clinic with complaints of shortness of breath, headache, dizziness, and nausea. During the assessment, the nurse learns that the client is a migrant worker who often uses a gasoline-powered pressure washer to clean equipment and farm buildings. Which type of poisoning is the most likely etiology of this client's symptoms?

• A. asbestos
• B. silica dust
• C. histoplasmosis
• D. carbon monoxide

Correct answer: D

Rationale: The client's symptoms of shortness of breath, headache, dizziness, and nausea are indicative of carbon monoxide poisoning, which can result from exposure to gasoline-powered equipment like pressure washers. Asbestos (Choice A) exposure would typically present with respiratory issues and cancer but not the rapid onset of symptoms described. Silica dust (Choice B) exposure is associated with respiratory conditions like silicosis, not the multisystem symptoms in the scenario. Histoplasmosis (Choice C) is a fungal infection that primarily affects the lungs and is not related to the client's exposure to a gasoline-powered pressure washer.

4. True or False: Vertical transmission is the disease-causing agent (pathogen) from mother to baby during the period immediately before and after birth.

• A. TRUE
• B. FALSE
• C.
• D.

Correct answer: A

Rationale: Vertical transmission is the transfer of a disease-causing agent (pathogen) from mother to baby during the period immediately before and after birth. This process can lead to the baby acquiring infections or diseases from the mother. Choice A is correct because it accurately describes vertical transmission. Choices B, C, and D are incorrect as they do not reflect the definition of vertical transmission.

5. The nurse is assessing a 12-year-old who has Hemophilia A. Which finding would the nurse anticipate?

• A. An excess of red blood cells
• B. An excess of white blood cells
• C. A deficiency of clotting factor VIII
• D. A deficiency of clotting factors VIII and IX

Correct answer: C

Rationale: The correct answer is C: A deficiency of clotting factor VIII. Hemophilia A is characterized by a lack of clotting factor VIII, which is crucial for blood clotting. This deficiency results in prolonged bleeding. Choices A, B, and D are incorrect. There is no association between Hemophilia A and an excess of red blood cells (Choice A) or an excess of white blood cells (Choice B). Additionally, Hemophilia A specifically involves a deficiency of clotting factor VIII, not both factors VIII and IX (Choice D).

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