Nursing Elites

1. A healthcare provider is assessing a child with acute lymphocytic leukemia. Which of the following findings is the priority for the healthcare provider to report?

• A. Bruising
• B. Petechiae
• C. Elevated WBC count
• D. Elevated platelet count

Correct answer: B

Rationale: The priority finding to report for a child with acute lymphocytic leukemia is petechiae. Petechiae indicate a low platelet count, which increases the risk of bleeding. Therefore, the healthcare provider should promptly report petechiae to initiate appropriate interventions to prevent bleeding complications.

2. What important information should the nurse provide to a patient taking a tetracycline antibiotic?

• A. Take the medication on an empty stomach.
• B. Avoid exposure to sunlight and tanning beds.
• C. Do not take the medication with milk or other dairy products.
• D. The medication may cause permanent staining of your teeth.

Correct answer: D

Rationale: The correct answer is D. Tetracycline antibiotics can bind to calcium in dairy products, decreasing the absorption of the antibiotic. This may result in reduced effectiveness of the medication. Additionally, tetracycline antibiotics can cause permanent staining of teeth, especially in children below 8 years of age and in pregnant women. Therefore, it is crucial for the patient to be aware of this potential side effect and to discuss any concerns with their healthcare provider. Choices A, B, and C are incorrect because tetracycline antibiotics should be taken with food to reduce gastrointestinal upset, exposure to sunlight is not a significant concern with tetracycline antibiotics, and the issue with dairy products is related to calcium binding and reduced absorption rather than an issue of empty stomach intake.

3. Which clinical manifestations should the nurse anticipate upon assessment for a preschool-age child with a urinary tract infection (UTI)?

• A. Headache, hematuria, and vertigo
• B. Foul-smelling urine, elevated blood pressure (BP), and hematuria
• C. Urgency, dysuria, and fever
• D. Severe flank pain, nausea, and headache

Correct answer: C

Rationale: Preschool-age children with a urinary tract infection commonly present with urgency (feeling the need to urinate urgently), dysuria (painful urination), and fever. These symptoms are indicative of a UTI in this age group and should prompt further assessment and intervention by the nurse. Choice A is incorrect because headache and vertigo are not typical symptoms of UTI in preschool-age children. Choice B is incorrect because while foul-smelling urine and hematuria can be present in UTI, elevated blood pressure is not a common finding in this condition. Choice D is incorrect as severe flank pain and nausea are not typical manifestations of UTI in preschool-age children.

4. A parent of a child with cerebral palsy is being taught about home care by a healthcare provider. Which statement by the parent indicates an understanding of the teaching?

• A. I will perform range-of-motion exercises twice a day.
• B. I will apply a heating pad on my child's legs to reduce spasms.
• C. I will allow my child to rest in a recliner for 1 hour each day.
• D. I will use wrist splints to maintain alignment.

Correct answer: D

Rationale: Using wrist splints can help maintain alignment and prevent contractures in a child with cerebral palsy. This intervention is crucial in managing the condition and supporting the child's mobility and function.

5. A patient in the emergency department reports taking sildenafil (Viagra) and nitroglycerin 1 hr before sexual activity. Which finding should the nurse immediately report to the physician?

• A. WBC of 3200 cells/mm³
• B. RR of 26 breaths/min
• C. Temp of 38°C
• D. BP of 70/50

Correct answer: D

Rationale: The correct answer is D: BP of 70/50. When sildenafil (Viagra) is taken with nitroglycerin, it can cause severe hypotension that is unresponsive to treatment. The combination of these medications can lead to a dangerous drop in blood pressure. It is crucial to immediately report hypotension in this scenario as it poses a significant risk to the patient's life. It is recommended to allow at least 24 hours to elapse between the last dose of sildenafil and nitroglycerin to prevent such adverse effects. The other vital signs and lab values may be abnormal but do not have the immediate life-threatening implications that severe hypotension does in this context.

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