Nursing Elites

1. When educating a patient about sildenafil (Viagra), which adverse effect should be a priority for the patient to report to his prescriber?

• A. Flushing
• B. Diarrhea
• C. Hearing loss
• D. Dyspepsia

Correct answer: C

Rationale: The correct answer is 'C: Hearing loss.' In rare cases, Viagra has been associated with sudden hearing loss, typically in one ear, which can be partial or complete. Any onset of hearing problems while using Viagra should be reported promptly to the prescriber. It is recommended to discontinue the medication if it is used for erectile dysfunction. 'Flushing,' 'Diarrhea,' and 'Dyspepsia' are known adverse effects of Viagra but are generally less serious compared to hearing loss.

2. The healthcare professional is preparing to administer an immunization to a four-year-old child. Which of the following actions should the professional plan to take?

• A. Place the child in a prone position for the immunization
• B. Request that the child's caregiver stay in the room during the immunization
• C. Administer the immunization using a 24-gauge needle
• D. Inject the immunization slowly without aspirating

Correct answer: C

Rationale: When administering an immunization to a four-year-old child, it is important to use a 24-gauge needle to minimize pain and discomfort for the child. Thicker needles can cause more pain and tissue trauma. Using a thinner needle like a 24-gauge is appropriate for pediatric immunizations. Placing the child in a prone position for immunization is not recommended as it can be uncomfortable and may not allow for proper access to the injection site. Having the caregiver stay in the room during the immunization is beneficial for support and comfort for the child. Injecting the immunization slowly without aspirating is correct, as aspirating before administering the immunization is not required for intramuscular injections in current practice.

3. A patient is prescribed Lisinopril as part of the treatment plan for heart failure. Which finding indicates the patient is experiencing the therapeutic effect of this drug?

• A. Weight gain of 5 pounds in 1 week
• B. Potassium level of 3.5mEq/L
• C. Crackles in the lungs are no longer heard
• D. Jugular vein distention

Correct answer: C

Rationale: The correct answer is C. Lisinopril, an ACE inhibitor, promotes venous dilation, which helps reduce pulmonary congestion and peripheral edema. The absence of previously heard crackles in the lungs indicates effectiveness in reducing pulmonary congestion. Edema and jugular vein distention are signs of heart failure and would not indicate the therapeutic effect of Lisinopril. A potassium level of 3.5mEq/L is within the normal range and not directly related to the therapeutic effect of Lisinopril.

4. A nurse is caring for a child who has a new diagnosis of osteomyelitis. Which of the following actions should the nurse take?

• A. Administer aspirin for pain.
• B. Apply ice to the affected area.
• C. Monitor the child�s weight daily.
• D. Limit the child's activity.

Correct answer: C

Rationale: The nurse should monitor the child�s weight daily to assess the effectiveness of treatment for osteomyelitis and detect potential complications.

5. A 9-month-old infant who is not sitting independently has been diagnosed with ataxic cerebral palsy (CP). Which clinical manifestations would the nurse expect to see in the baby?

• A. Hypotonia and muscle instability
• B. Hypertonia and persistence of primitive reflexes
• C. Tremors and exaggerated posturing
• D. Hemiplegia and hypertonia

Correct answer: A

Rationale: In ataxic cerebral palsy, the characteristic features include hypotonia (low muscle tone) and muscle instability. These manifestations contribute to the infant's difficulty in achieving independent sitting. Hypertonia (increased muscle tone) and persistence of primitive reflexes, as mentioned in option B, are more commonly associated with other types of cerebral palsy like spastic CP. Tremors and exaggerated posturing (option C) are not typical features of ataxic CP. Hemiplegia (paralysis of one side of the body) and hypertonia (increased muscle tone) mentioned in option D are more commonly seen in other types of cerebral palsy, such as spastic CP.

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