Nursing Elites

1. A caregiver is providing teaching about car seat use to the mother of a six-month-old infant. Which of the following statements by the mother indicates an understanding of the teaching?

• A. I should secure the car seat using lower anchors and tethers instead of the seat belt
• B. I should position the car seat harness one inch above my baby's shoulders
• C. I will make sure that the car seat is placed at a 90-degree angle
• D. I will pad my baby's car seat with a blanket for traveling long distances

Correct answer: A

Rationale: The correct answer is A. Lower anchors and tethers, known as the LATCH child safety seat system, should be used to secure an infant's car seat in the vehicle. This system provides a safer and more secure way of installing the car seat compared to using the seat belt alone. Using the lower anchors and tethers ensures proper installation and reduces the risk of car seat movement during travel, providing optimal protection for the infant. Choices B, C, and D are incorrect. Choice B is incorrect because the car seat harness should be positioned at or below the baby's shoulders, not above. Choice C is incorrect because the car seat should be positioned at the correct recline angle recommended by the car seat manufacturer, which may not necessarily be 90 degrees. Choice D is incorrect because adding padding like a blanket to the car seat is not recommended as it can interfere with the proper fit and function of the car seat, potentially compromising the safety of the infant.

2. The patient taking spironolactone (Aldactone) makes a statement indicating effective teaching. Which statement shows understanding of the teaching?

• A. I will use salt substitutes to lower my sodium intake
• B. I will increase my intake of foods that are high in potassium
• C. I will call my doctor if I begin having menstrual irregularities
• D. I will take this medication at bedtime each evening

Correct answer: C

Rationale: The correct answer is C because spironolactone is a potassium-sparing diuretic that can cause endocrine effects like menstrual irregularities. Therefore, the patient recognizing the need to report such changes indicates effective teaching. Choices A and B are incorrect as salt substitutes and high-potassium foods should be avoided with spironolactone. Choice D is also incorrect because diuretics, including spironolactone, are ideally taken in the morning to prevent disturbances in sleep due to nocturia.

3. 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.

4. What is the probable cause recognized by the nurse when a 5-year-old boy is admitted to the hospital with acute glomerulonephritis?

• A. Recovery from German measles 2 months ago
• B. Dysuria since the previous night
• C. A history of allergy
• D. A sore throat 2 weeks ago

Correct answer: D

Rationale: Acute glomerulonephritis typically develops 1 to 3 weeks after a streptococcal infection, such as a sore throat, which triggers an allergic-type response that affects the glomeruli's function. This immune response leads to inflammation and damage to the glomeruli, resulting in acute glomerulonephritis.

5. During a well-child visit, a nurse is assessing a three-year-old toddler. Which of the following manifestations should the nurse report to the provider?

• A. Blood pressure 90/50
• B. Respiratory rate 45/min
• C. Weight 14.5 kg or 32 lb
• D. Heart rate 110/min

Correct answer: B

Rationale: A respiratory rate of 45/min is above the expected reference range for a 3-year-old toddler and may indicate respiratory dysfunction or acute respiratory distress. It is essential for the nurse to report this finding promptly to the healthcare provider for further evaluation and intervention.

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