Nursing Elites

1. A patient develops hypotension, laryngeal edema, and bronchospasm after eating peanuts. Which medication should the nurse prepare to administer?

• A. Promethazine
• B. Epinephrine
• C. Diphenhydramine
• D. Hydroxyzine

Correct answer: B

Rationale: The patient is exhibiting symptoms of anaphylaxis triggered by a peanut allergy, a severe and potentially life-threatening allergic reaction. The appropriate medication for anaphylaxis is epinephrine. Epinephrine acts quickly to reverse the symptoms by constricting blood vessels, relaxing bronchial muscles, and reducing laryngeal edema, making it the drug of choice for this situation. Promethazine, diphenhydramine, and hydroxyzine are not the first-line treatments for anaphylaxis. Promethazine is an antihistamine with sedative effects, Diphenhydramine is an antihistamine, and Hydroxyzine is also an antihistamine with sedative properties. While these medications can help with mild allergic reactions, they are not as effective or fast-acting as epinephrine in treating the severe manifestations of anaphylaxis.

2. A healthcare professional is preparing to administer a measles, mumps, and rubella (MMR) vaccine to a 15-month-old child. Which of the following findings is a contraindication to the administration of this vaccine?

• A. Family history of egg allergy
• B. Currently taking antibiotics
• C. History of asthma
• D. Presence of rhinorrhea

Correct answer: B

Rationale: Taking antibiotics is a contraindication to receiving the MMR vaccine because antibiotics can potentially interfere with the effectiveness of the vaccine. It is essential to avoid administering the MMR vaccine while the child is on antibiotics to ensure the vaccine provides the intended protection.

3. In caring for an adolescent with severe abdominal pain due to appendicitis, where should the nurse identify as McBurney's point?

• A. Right lower quadrant
• B. Left lower quadrant
• C. Right upper quadrant
• D. Left upper quadrant

Correct answer: A

Rationale: McBurney's point is located in the right lower quadrant of the abdomen, specifically between the umbilicus and the anterior iliac crest. This point is significant in diagnosing appendicitis, as tenderness at McBurney's point is a classic sign of appendicitis and indicates inflammation near the appendix. Therefore, the correct answer is the 'Right lower quadrant.' Choices B, C, and D are incorrect because McBurney's point is not located in the left lower quadrant, right upper quadrant, or left upper quadrant of the abdomen.

4. As a result of opioid administration, a child's respirations are slow and shallow. Which should the nurse anticipate when assessing the child's arterial blood gas?

• A. Increased PCO2 and respiratory acidosis
• B. Decreased PCO2 and respiratory alkalosis
• C. Low pH and low PCO2
• D. High pH and high PCO2

Correct answer: A

Rationale: When a child's respirations are slow and shallow due to opioid administration, it results in hypoventilation. This leads to retaining carbon dioxide, indicated by an increased PCO2 level on arterial blood gas analysis, and subsequently causes respiratory acidosis due to the buildup of CO2 in the blood. Therefore, choice A, 'Increased PCO2 and respiratory acidosis,' is the correct answer. Choices B, C, and D are incorrect because slow and shallow respirations would not lead to decreased PCO2 or respiratory alkalosis (choice B), low pH and low PCO2 (choice C), or high pH and high PCO2 (choice D).

5. A caregiver is seeking guidance from a healthcare provider concerning a child diagnosed with impetigo. Which of the following instructions should the healthcare provider include?

• A. Apply warm compresses to the affected area.
• B. Keep the child home from school until lesions are crusted over.
• C. Apply antibiotic ointment to the lesions.
• D. Cleanse the affected area with hydrogen peroxide.

Correct answer: C

Rationale: The healthcare provider should recommend applying antibiotic ointment to the lesions to prevent the spread of infection and facilitate healing. Antibiotic ointment helps combat the bacterial infection associated with impetigo and supports the skin's recovery process. This approach aids in reducing symptoms, preventing complications, and promoting a quicker resolution of the condition.

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