Nursing Elites

1. During an assessment, a healthcare professional is evaluating an infant with pneumonia. Which of the following findings should be the priority for the healthcare professional to report to the provider?

• A. Nasal flaring
• B. WBC count of 11,300
• C. Diarrhea
• D. Abdominal distension

Correct answer: A

Rationale: When assessing an infant with pneumonia, the priority finding to report to the provider is nasal flaring. Nasal flaring indicates acute respiratory distress, which can be a life-threatening condition requiring immediate intervention. Monitoring and addressing respiratory distress take precedence over other symptoms or laboratory results in this situation.

2. A nurse is teaching a parent of a child who has asthma. Which of the following instructions should the nurse include?

• A. Use a peak flow meter daily.
• B. Administer the medication with meals.
• C. Provide a low-carbohydrate diet.
• D. Limit exposure to cold air.

Correct answer: A

Rationale: The nurse should instruct the parent to use a peak flow meter daily to monitor the child’s respiratory status and detect early signs of an asthma attack.

3. For which patient diagnosis would a prescription for nifedipine be least appropriate?

• A. Angina Pectoris
• B. Essential HTN
• C. Atrial Fibrillation
• D. Vasospastic Angina

Correct answer: C

Rationale: Nifedipine primarily acts as a calcium channel blocker, exerting its effects on vascular smooth muscle. It is not effective for treating dysrhythmias like Atrial Fibrillation, which involve abnormalities in the heart's electrical system. Nifedipine is commonly prescribed for conditions such as angina pectoris, essential hypertension, and vasospastic angina due to its vasodilatory and anti-anginal properties. Choices A, B, and D are more appropriate as nifedipine can help in managing angina pectoris, hypertension, and vasospastic angina by reducing myocardial oxygen demand and dilating coronary arteries.

4. 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.

5. Which statement is not part of the developmental care approach?

• A. Family-centered care
• B. Care on a sliding payment scale
• C. Healing environment
• D. Protected sleep

Correct answer: B

Rationale: The developmental care approach emphasizes creating an environment that supports the infant's developmental needs, including family-centered care, a healing environment, and promoting protected sleep. Payment scale considerations are not a component of developmental care.

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