Nursing Elites

1. A patient in the emergency department reports taking sildenafil (Viagra) and nitroglycerin 1 hr before sexual activity. Which finding should the nurse immediately report to the physician?

• A. WBC of 3200 cells/mm³
• B. RR of 26 breaths/min
• C. Temp of 38°C
• D. BP of 70/50

Correct answer: D

Rationale: The correct answer is D: BP of 70/50. When sildenafil (Viagra) is taken with nitroglycerin, it can cause severe hypotension that is unresponsive to treatment. The combination of these medications can lead to a dangerous drop in blood pressure. It is crucial to immediately report hypotension in this scenario as it poses a significant risk to the patient's life. It is recommended to allow at least 24 hours to elapse between the last dose of sildenafil and nitroglycerin to prevent such adverse effects. The other vital signs and lab values may be abnormal but do not have the immediate life-threatening implications that severe hypotension does in this context.

2. A toddler is admitted to the surgical unit for a planned closure of a temporary colostomy. Which medical prescription should the nurse question?

• A. Clear liquids today, NPO tomorrow
• B. Type and cross-match for 1 unit of packed red blood cells
• C. Rectal temperatures every 4 hours
• D. Start an intravenous line with D5NS at 20 mL per hour

Correct answer: C

Rationale: The correct answer is C. Rectal temperatures should be avoided in a toddler with a colostomy due to the risk of injury. Choices A, B, and D are appropriate medical prescriptions for a toddler undergoing colostomy closure. Choice A ensures the toddler's intake of clear liquids before being made NPO, choice B prepares for possible blood transfusion needs, and choice D initiates intravenous hydration with D5NS at an appropriate rate.

3. The nurse is reviewing the home medication list with the patient. The nurse recognizes that hydrochlorothiazide is used primarily for which condition?

• A. Hypertension
• B. Edema
• C. Diabetes insipidus
• D. Protection against postmenopausal osteoporosis

Correct answer: A

Rationale: Hydrochlorothiazide is primarily indicated for hypertension (HTN). Thiazides like hydrochlorothiazide are commonly the first-line treatment for hypertension. While hydrochlorothiazide can be used for edema, diabetes insipidus, and postmenopausal osteoporosis to some extent, its main use and efficacy lie in managing hypertension.

4. Which type of play involves actions such as looking and touching the mother's face, putting hands in one's mouth, and responding to familiar people?

• A. Exploratory
• B. Functional or relational
• C. Pretend
• D. Symbolic or imaginary

Correct answer: A

Rationale: Exploratory play is characterized by exploring sensory experiences and learning about the environment. In this type of play, infants engage in activities like looking, touching, and responding to familiar stimuli to understand the world around them.

5. 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.

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