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. Health activities are designed to:

• A. prevent people from being exposed to germs
• B. ignore spiritual factors as they can confuse medical issues
• C. increase communities' control over their health and well-being
• D. ensure that the community health nurse leads health programs

Correct answer: C

Rationale: Health activities are structured to enhance communities' autonomy and influence over their health and well-being, aiming to empower them to make informed choices and take control of their health. Choice A is incorrect as health activities encompass a broader scope beyond just preventing exposure to germs. Choice B is incorrect because spiritual factors are crucial components that should not be disregarded in healthcare. Choice D is incorrect as health activities are not solely about the community health nurse being in charge, but about empowering the community as a whole.

3. A hospitalized child suddenly has a seizure while his family is visiting. The nurse notes whole body rigidity followed by general jerking movements. The child vomits immediately after the seizure. A priority nursing diagnosis for the child is

• A. High risk for infection related to vomiting
• B. Altered family processes related to chronic illness
• C. Fluid volume deficit related to vomiting
• D. Risk for aspiration related to loss of consciousness

Correct answer: D

Rationale: Risk for aspiration is a priority concern following a seizure, especially when the child vomits, as there is a danger of aspirating the vomit into the lungs, leading to respiratory complications. The other options are not the priority in this situation. While infection risk and fluid volume deficit are important, ensuring the child's airway is clear and there is no risk of aspiration takes precedence. Altered family processes may be a concern but addressing the immediate physiological risk is the priority.

4. What title should be given to this professional role in occupational health? A registered nurse who develops researchable questions, conducts research, and communicates the findings to occupational and environmental health professionals, other peers, and the public.

• A. manager
• B. researcher
• C. clinician/practitioner
• D. health promotion specialist

Correct answer: B

Rationale: The correct answer is 'B: researcher.' In this context, the individual is primarily involved in developing research questions, conducting research, and disseminating findings, which aligns with the responsibilities of a researcher. Choice 'A: manager' is incorrect because the role described does not primarily involve managerial duties. Choice 'C: clinician/practitioner' is also incorrect as the focus is on research activities rather than direct clinical practice. Choice 'D: health promotion specialist' does not encompass the full scope of responsibilities described in the scenario.

5. Mark, 9 months old, is given oral rehydration solution because of diarrhea with some dehydration. In your follow-up visit, you observed that Mark's eyes become puffy. Which one of the following would you advise Mark's mother?

• A. continue giving ORS but more slowly
• B. show mother how much solution to give
• C. stop ORS and give plain water or milk
• D. reassess patient to determine how much ORS to give

Correct answer: A

Rationale: In this scenario, observing puffy eyes in a child being treated with oral rehydration solution may indicate fluid overload. Continuing to give ORS but more slowly is the correct course of action as it helps manage hydration without overloading fluids. Choice B is not the best option in this situation as the issue is not about the quantity of the solution, but the rate of administration. Choice C is incorrect because plain water or milk is not a suitable alternative for rehydration in cases of dehydration. Choice D is also incorrect as reassessing the patient does not directly address the issue of puffy eyes, which suggests a need to adjust the administration of ORS.

Similar Questions