Nursing Elites

1. When educating a parent of an infant with a new prescription for digoxin, which instruction should the nurse provide?

• A. Repeat the dose if the infant vomits.
• B. Mix the medication with food.
• C. Give the medication with meals.
• D. Monitor the infant's heart rate prior to administering the medication.

Correct answer: D

Rationale: The correct answer is D: 'Monitor the infant's heart rate prior to administering the medication.' It is crucial for the nurse to monitor the infant's heart rate before giving digoxin to identify any signs of digoxin toxicity early. Heart rate assessment helps in detecting and preventing potential complications associated with digoxin use. Choices A, B, and C are incorrect. Repeating the dose if the infant vomits can lead to overdose, mixing the medication with food may alter its absorption, and giving the medication with meals can affect its effectiveness. Therefore, the priority is to monitor the infant's heart rate to ensure safe administration of digoxin.

2. A healthcare professional is assessing an infant who has heart failure. Which of the following findings should the healthcare professional expect?

• A. Weight gain
• B. Bounding pulses
• C. Hyperactivity
• D. Increased urine output

Correct answer: A

Rationale: In infants with heart failure, one of the key manifestations is weight gain due to fluid retention. The heart's inability to pump effectively can lead to fluid buildup in the body, causing weight gain. Bounding pulses, hyperactivity, and increased urine output are not typically associated with heart failure in infants. Bounding pulses are associated with conditions like aortic regurgitation, hyperactivity can be a sign of other issues, and increased urine output is not a common finding in heart failure.

3. A healthcare professional is reviewing the laboratory report of an infant who is receiving treatment for severe dehydration. The professional should identify which of the following laboratory values indicates effectiveness of the current treatment?

• A. Potassium 2.9 mEq/L
• B. Sodium 140 mEq/L
• C. Urine specific gravity 1.035
• D. BUN 25 mg/dL

Correct answer: B

Rationale: A sodium level of 140 mEq/L within the expected reference range indicates effective treatment for dehydration. In dehydration, sodium levels are often elevated, so a normal sodium level suggests that the treatment is helping to restore the electrolyte balance in the infant's body.

4. A parent of a preschooler is being taught by a nurse about administering ear drops. Which of the following statements by the parent indicates an understanding of the teaching?

• A. I will straighten my child's ear canal by pulling it upward and backward.
• B. I will administer the ear drops immediately after removing them from the refrigerator.
• C. I will pull the ear lobe down and back before administering the ear drops.
• D. I will massage my child's ear after administering the ear drops.

Correct answer: D

Rationale: Correct administration of ear drops includes massaging the child's ear after administering the drops to facilitate proper absorption of the medication. This action helps ensure the effectiveness of the treatment. Choices A, B, and C are incorrect. Choice A describes incorrect positioning of the ear canal, choice B mentions incorrect storage of the ear drops, and choice C describes an incorrect technique for administering ear drops.

5. When receiving change-of-shift report for children, which child should the nurse assess first?

• A. A toddler who has a concussion and an episode of forceful vomiting
• B. An adolescent with infective endocarditis who reports having a headache
• C. An adolescent who was placed into Halo traction 1 hour ago and rates his pain at a 6 on a 0-10 scale
• D. A school-age child with acute glomerulonephritis and brown-colored urine

Correct answer: A

Rationale: The nurse should assess the toddler with a concussion and an episode of forceful vomiting first when receiving change-of-shift report for children. Forceful vomiting in a toddler with a concussion indicates increased intracranial pressure, requiring immediate assessment and intervention to prevent further complications.

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