Nursing Elites

1. A school-age child is 4 hours postoperative following perforated appendicitis repair. Which of the following actions should the nurse take?

• A. Maintain the child on a clear liquid diet for 48 hours.
• B. Administer antibiotics for 7 days.
• C. Apply warm compresses to the surgical site every 4 hours.
• D. Keep the child on NPO status for 24 hours.

Correct answer: B

Rationale: Administering antibiotics for 7 days is essential postoperatively to prevent infections and complications in a child who underwent perforated appendicitis repair. This helps in reducing the risk of secondary infections and promoting healing. Clear liquid diets, warm compresses, and prolonged fasting are not the primary interventions indicated in this scenario.

2. When caring for a child with hyponatremia, a nurse delegates care to a licensed vocational nurse (LVN) and instructs the LVN to promptly report which clinical manifestation?

• A. Seizures
• B. Respiratory distress
• C. Hyperthermia
• D. Bradycardia

Correct answer: A

Rationale: Seizures are a significant concern in severe hyponatremia as they indicate potential neurological complications and the need for urgent intervention to prevent further harm to the child. Prompt reporting of seizures allows for timely assessment and appropriate treatment to ensure the child's safety and well-being.

3. Which strategy is most effective in preventing existing challenging behaviors?

• A. Ignoring the behaviors
• B. Individualized interventions
• C. Providing flexible rules
• D. Punishment

Correct answer: B

Rationale: Individualized interventions are tailored to address the specific needs and triggers of the individual's challenging behaviors. By customizing the approach to each person, it increases the likelihood of effectively preventing and managing the existing challenging behaviors.

4. 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.

5. A nurse assesses a male patient who has developed gynecomastia while receiving treatment for peptic ulcers. Which medication from the patient’s history should the nurse recognize as a contributing factor?

• A. Amoxicillin (Amoxil)
• B. Cimetidine (Tagamet)
• C. Metronidazole (Flagyl)
• D. Omeprazole (Prilosec)

Correct answer: B

Rationale: Cimetidine binds to androgen receptors, producing receptor blockade, which can cause enlarged breast tissue, reduced libido, and impotence. All these effects reverse when dosing stops. Amoxicillin, metronidazole, and omeprazole are not associated with gynecomastia.

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