Nursing Elites

1. In the emergency department, a child is admitted for accidental ingestion of a poison. The practical nurse (PN) should know that inducing vomiting is recommended for which child?

• A. An 8-month-old who ingested four to six ibuprofen tablets
• B. A 3-year-old who drank an unknown amount of charcoal lighter fluid
• C. A 16-month-old who ingested 2 ounces of acetaminophen elixir
• D. A 2-year-old who ate a handful of automatic dishwasher detergent

Correct answer: C

Rationale: Inducing emesis is recommended for the child who ingested a large dose of acetaminophen elixir because this medication is hepatotoxic. Acetaminophen overdose can lead to severe liver damage, and prompt removal from the stomach can help reduce absorption and potential harm.

2. When educating a client about the adverse effects of conjunctivitis, what is a serious condition that requires prompt attention?

• A. Contact lens irritation
• B. Decreased sex drive
• C. Brown spots on the skin
• D. Epigastric pain unrelieved by antacids

Correct answer: D

Rationale: Epigastric pain unrelieved by antacids is a concerning symptom that may indicate a more serious underlying condition such as a perforated ulcer. This symptom requires immediate medical attention to prevent further complications.

3. A client with a diagnosis of generalized anxiety disorder is prescribed fluvoxamine. The nurse should instruct the client that this medication may have which potential side effect?

• A. Drowsiness
• B. Dry mouth
• C. Insomnia
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Drowsiness. Fluvoxamine is known to cause drowsiness as a potential side effect. Patients should be advised to avoid activities like driving that require alertness until they understand how the medication affects them. Dry mouth, insomnia, and headache are potential side effects of other medications used for anxiety disorders but are not typically associated with fluvoxamine.

4. A client with a diagnosis of generalized anxiety disorder is prescribed paroxetine. The nurse should instruct the client that this medication may have which potential side effect?

• A. Drowsiness
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Drowsiness. Paroxetine, used for generalized anxiety disorder, can cause drowsiness. Clients should be advised not to drive or operate heavy machinery until they know how the medication affects them. Dry mouth, nausea, and headache are potential side effects of other medications but are not commonly associated with paroxetine. Drowsiness is a common side effect for paroxetine and can impact a client's ability to perform tasks that require alertness.

5. A client with chronic pain is prescribed oxycodone. What instruction should the practical nurse (PN) include in the client's teaching plan?

• A. Take the medication with meals to avoid gastrointestinal upset.
• B. Avoid taking the medication with alcohol.
• C. Increase fluid intake to avoid constipation.
• D. Report any signs of respiratory depression to the healthcare provider.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid taking oxycodone with alcohol. Mixing oxycodone with alcohol can lead to serious side effects, including respiratory depression. Taking the medication with meals may not always be necessary, and instructions about fluid intake to avoid constipation are important but not the priority when considering the immediate risks associated with oxycodone. While reporting signs of respiratory depression is crucial, preventing it by avoiding alcohol is key in the client's safety.

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