Nursing Elites

1. A client has a new diagnosis of celiac disease. Which of the following clinical manifestations should the nurse expect?

• A. Steatorrhea
• B. Projectile vomiting
• C. Sunken abdomen
• D. Weight gain

Correct answer: A

Rationale: Celiac disease is a condition where individuals are unable to digest gluten, leading to damage in the bowel cells and subsequent malabsorption. This malabsorption commonly presents with symptoms such as steatorrhea, which is characterized by foul-smelling, greasy, and bulky stools due to high fat content. Projectile vomiting and sunken abdomen are not typical manifestations of celiac disease. Weight gain is unlikely in individuals with celiac disease due to malabsorption and nutrient deficiencies. Therefore, the nurse should expect steatorrhea as a clinical manifestation in clients with celiac disease.

2. Which is NOT one of the functions of challenging behaviors?

• A. Avoiding a situation
• B. Escaping from an undesired object or event
• C. to make others happy
• D. Sensory functions

Correct answer: C

Rationale: Challenging behaviors often serve functions related to avoiding, escaping, obtaining, or sensory needs. The question is asking for the function that does not typically apply to challenging behaviors. Choices A, B, C, and D align with the common functions associated with challenging behaviors. Therefore, 'E' is the correct answer as it does not represent a typical function of challenging behaviors.

3. 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.

4. A patient develops hypotension, laryngeal edema, and bronchospasm after eating peanuts. Which medication should the nurse prepare to administer?

• A. Promethazine
• B. Epinephrine
• C. Diphenhydramine
• D. Hydroxyzine

Correct answer: B

Rationale: The patient is exhibiting symptoms of anaphylaxis triggered by a peanut allergy, a severe and potentially life-threatening allergic reaction. The appropriate medication for anaphylaxis is epinephrine. Epinephrine acts quickly to reverse the symptoms by constricting blood vessels, relaxing bronchial muscles, and reducing laryngeal edema, making it the drug of choice for this situation. Promethazine, diphenhydramine, and hydroxyzine are not the first-line treatments for anaphylaxis. Promethazine is an antihistamine with sedative effects, Diphenhydramine is an antihistamine, and Hydroxyzine is also an antihistamine with sedative properties. While these medications can help with mild allergic reactions, they are not as effective or fast-acting as epinephrine in treating the severe manifestations of anaphylaxis.

5. A school-age child is 2 hours postoperative following a tonsillectomy. Which of the following actions should the nurse include in the plan of care?

• A. Place a heating pad at the surgical site.
• B. Encourage the child to cough every 2 hours.
• C. Administer analgesics to the child on a regular schedule.
• D. Apply an ice collar to the child's neck.

Correct answer: D

Rationale: After a tonsillectomy, applying an ice collar to the child's neck helps decrease pain and swelling. Heat should be avoided as it can increase bleeding. Encouraging coughing may increase the risk of bleeding. Administering analgesics on a regular schedule is essential for pain management, but the immediate postoperative period may require additional interventions like ice collar application.

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