Nursing Elites

1. When teaching a parent of a toddler with congenital heart disease, which of the following instructions should the nurse include?

• A. Offer small, frequent meals.
• B. Limit the toddler's physical activity.
• C. Provide a low-sodium diet.
• D. Monitor the toddler's intake and output.

Correct answer: A

Rationale: The correct instruction for a parent of a toddler with congenital heart disease is to offer small, frequent meals. This recommendation helps reduce the cardiac workload on the child's heart and supports easier digestion and nutrient absorption, promoting the child's overall health. Limiting physical activity (choice B) may be necessary but is not the priority in this case. While offering a low-sodium diet (choice C) can be beneficial, it is not the most critical instruction. Monitoring the toddler's intake and output (choice D) is important but not as essential as providing small, frequent meals to support the child's heart health.

2. What is the most appropriate nursing consideration for a patient who is prescribed verapamil and digoxin?

• A. Restrict intake of oral fluids and high-fiber foods
• B. Take an apical pulse for 30 seconds before administration
• C. Notify the healthcare provider of nausea, vomiting, and visual changes
• D. Hold the medications if the heart rate is greater than 110 bpm

Correct answer: C

Rationale: When a patient is prescribed verapamil and digoxin, it is crucial to monitor for signs of digoxin toxicity due to the potential interaction between these medications. Verapamil can elevate digoxin blood serum levels, increasing the risk of toxicity. Symptoms of digoxin toxicity include nausea, vomiting, and visual changes. Therefore, the most appropriate nursing consideration is to notify the healthcare provider of these symptoms. Restricting intake of oral fluids and high-fiber foods is not a specific consideration related to this medication combination. Before administering digoxin, it is essential to take an apical pulse for a full minute, not just 30 seconds, to ensure accuracy. Additionally, holding the medications if the heart rate exceeds 110 bpm is not a typical response to the combination of verapamil and digoxin, which can cause bradycardia rather than tachycardia.

3. A patient taking isotretinoin (Accutane) for acne vulgaris. Which statement indicates that the patient teaching has been effective?

• A. I should use a reliable form of birth control.
• B. I will stop taking the drug if my skin is dry.
• C. It is important to increase intake of vitamin A.
• D. I do not need to use sunblock while taking Accutane.

Correct answer: A

Rationale: The correct answer is A. Isotretinoin is highly teratogenic, which means it can cause birth defects. Therefore, it is crucial for patients, especially females of childbearing potential, to use effective forms of birth control to prevent pregnancy while taking this medication. This is a key component of patient teaching to ensure the safe use of isotretinoin. Choice B is incorrect because discontinuing isotretinoin abruptly can lead to a flare-up of acne. Choice C is incorrect because increasing vitamin A intake can be harmful due to the risk of hypervitaminosis A. Choice D is incorrect because isotretinoin makes the skin more sensitive to sunlight, so sunblock is essential to prevent sunburn and skin damage.

4. A healthcare provider is preparing to administer ibuprofen 5 mg per kg every 6 hours PRN for temperatures above 38.0 degrees Celsius or 100.5 degrees Fahrenheit to an infant who weighs 17.6 lb. The infant has a temperature of 38.4 degrees Celsius or 101.2 degrees Fahrenheit. Available is ibuprofen liquid 100 mg/5 ml. How many milliliters should the healthcare provider administer to the infant?

• A. 12 ml
• B. 6 ml
• C. 2 ml
• D. 1 ml

Correct answer: C

Rationale: To calculate the correct dosage, first convert the infant's weight to kilograms: 17.6 lb = 8 kg. The prescribed dose is 5 mg/kg, so for an 8 kg infant, the total dose required is 40 mg. Since the available ibuprofen liquid is 100 mg/5 ml, to find out how many milliliters to administer, divide the total dose (40 mg) by the concentration of the liquid (100 mg/5 ml), which equals 2 ml. Therefore, the healthcare provider should administer 2 ml of ibuprofen to the infant.

5. A child with nephrotic syndrome has not experienced diuresis after a month on corticosteroids. What protocol can the nurse encourage to induce diuresis?

• A. Ibuprofen, an anti-inflammatory agent
• B. Furosemide (Lasix), a diuretic
• C. Ciprofloxacin (Cipro), an antibiotic
• D. Cyclophosphamide (Cytoxan), an immunosuppressant

Correct answer: B

Rationale: To induce diuresis in a child with nephrotic syndrome who has not responded to corticosteroids, a diuretic like Furosemide (Lasix) is appropriate. Furosemide helps increase urine production and reduce fluid retention. Ibuprofen is an anti-inflammatory agent and does not directly induce diuresis. Ciprofloxacin is an antibiotic and is not used to promote diuresis. Cyclophosphamide is an immunosuppressant, not an antisuppressant, and is not typically used to induce diuresis in nephrotic syndrome.

Similar Questions