Nursing Elites

1. A child is being assessed for Kawasaki disease. Which of the following findings should be expected?

• A. Decreased heart rate
• B. Dry, scaly skin
• C. Fever unresponsive to antipyretics
• D. Nontender cervical lymphadenopathy

Correct answer: C

Rationale: In Kawasaki disease, a child typically presents with a fever that is unresponsive to antipyretics because the disease is characterized by systemic inflammation. The persistent fever is a hallmark feature of the disease and can last for more than five days despite treatment with antipyretics.

2. What is the most important statement to include when teaching a patient who is prescribed metronidazole (Flagyl)?

• A. Take the medication with food.
• B. Avoid alcohol consumption.
• C. If you experience a metallic taste in your mouth, call your doctor.
• D. You can stop taking the medication once you feel better.

Correct answer: B

Rationale: The most crucial statement to include when teaching a patient prescribed metronidazole (Flagyl) is to avoid alcohol consumption. Mixing metronidazole and alcohol can lead to a disulfiram-like reaction, causing severe symptoms such as nausea, vomiting, and headache. Therefore, it is essential to emphasize to the patient the importance of abstaining from alcohol while taking this medication to prevent adverse reactions.

3. A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the priority action by the nurse?

• A. Elevate the head of the child's bed
• B. Insert a large-bore IV catheter for the child
• C. Determine the allergen that caused the child's reaction
• D. Administer IM epinephrine to the child

Correct answer: D

Rationale: In the management of anaphylaxis, the priority action for the nurse is to administer IM epinephrine to the child. Epinephrine is the first-line treatment for anaphylaxis as it helps reverse the severe manifestations of the reaction by constricting blood vessels, relaxing airway muscles, and decreasing hives and swelling. Elevating the head of the child's bed may be beneficial for respiratory distress but is not the priority over administering epinephrine. Inserting a large-bore IV catheter may be necessary for fluid resuscitation but is not the initial priority. Identifying the allergen is important for prevention and future management but is not the immediate action needed in the acute phase of an anaphylactic reaction.

4. When teaching an adolescent about managing tinea pedis, which statement indicates an understanding of the teaching?

• A. I should buy some plastic shoes to wear at the swimming pool
• B. I should wear sandals as much as possible
• C. I should place the permethrin cream between my toes twice daily
• D. I should seal my non-washable shoes in plastic bags for a couple of weeks

Correct answer: B

Rationale: Wearing sandals allows air circulation around the feet, reducing perspiration and eliminating the environment for bacteria and fungus to thrive. This promotes the healing of the fungal infection. Therefore, the correct answer is B.

5. When teaching a parent of a toddler with congenital heart disease, which of the following instructions should the nurse include?

• A. Offer small, frequent meals.
• B. Limit the toddler's physical activity.
• C. Provide a low-sodium diet.
• D. Monitor the toddler's intake and output.

Correct answer: A

Rationale: The correct instruction for a parent of a toddler with congenital heart disease is to offer small, frequent meals. This recommendation helps reduce the cardiac workload on the child's heart and supports easier digestion and nutrient absorption, promoting the child's overall health. Limiting physical activity (choice B) may be necessary but is not the priority in this case. While offering a low-sodium diet (choice C) can be beneficial, it is not the most critical instruction. Monitoring the toddler's intake and output (choice D) is important but not as essential as providing small, frequent meals to support the child's heart health.

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