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. When planning the care for a young adult client diagnosed with anorexia nervosa, which of these concerns should the nurse determine to be the priority for long term mobility?

• A. Digestive problems
• B. Amenorrhea
• C. Electrolyte imbalance
• D. Blood disorders

Correct answer: B

Rationale: The correct answer is B: Amenorrhea. Amenorrhea, or the absence of menstruation, is a common long-term consequence of anorexia nervosa due to low body weight and hormonal imbalances. Addressing amenorrhea is crucial for the patient's overall health and reproductive potential. Choice A, Digestive problems, may also be a concern in anorexia nervosa, but in terms of long-term mobility, amenorrhea takes priority because of its impact on hormonal balance and bone health. Choice C, Electrolyte imbalance, is important to address in anorexia nervosa due to potential cardiac complications, but it is not directly linked to long-term mobility concerns. Choice D, Blood disorders, while they can occur in anorexia nervosa, are not as directly related to long-term mobility as amenorrhea, which can significantly affect bone health and mobility in the future.

3. The increasing number of people who must learn to live with chronic illness in the community implies the need for the PHN to plan and implement a program on:

• A. communicable disease control
• B. health education
• C. child survival
• D. environmental education

Correct answer: B

Rationale: The correct answer is B: health education. Health education is crucial for individuals dealing with chronic illnesses as it helps them learn how to manage their conditions effectively. Communicable disease control (choice A) focuses on preventing the spread of infectious diseases, which is not directly related to managing chronic conditions. Child survival (choice C) pertains to initiatives aimed at reducing child mortality rates, which is not directly related to addressing chronic illnesses. Environmental education (choice D) involves raising awareness about environmental issues, which is also not directly related to helping individuals live with chronic illnesses.

4. A client with multiple sclerosis is receiving baclofen (Lioresal). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Muscle spasms
• C. Drowsiness
• D. Tachycardia

Correct answer: C

Rationale: The correct answer is C: Drowsiness. Baclofen, a muscle relaxant commonly used to treat conditions like multiple sclerosis, can cause drowsiness as a side effect. Monitoring for drowsiness is important to ensure the client's safety and well-being. Choice A, Hypertension, is incorrect because baclofen is not known to cause hypertension. Choice B, Muscle spasms, is not a common side effect of baclofen but rather the symptom it is used to treat. Choice D, Tachycardia, is also incorrect as baclofen is not associated with causing an increase in heart rate.

5. The term 'epidemiology' is best defined as the study of:

• A. The causes of disease
• B. The distribution and determinants of health-related states in populations
• C. The treatment and prevention of disease
• D. The healthcare system and its effectiveness

Correct answer: B

Rationale: Epidemiology is the study of the distribution and determinants of health-related states in populations. Choice A is incorrect because epidemiology focuses on more than just causes but also on distribution and determinants. Choice C is incorrect as it specifically relates to public health and not just treatment and prevention. Choice D is incorrect as epidemiology is broader than just focusing on the healthcare system and its effectiveness.

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