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. The nurse provides discharge instructions to a patient prescribed verapamil SR 120mg PO daily for HTN. Which statement by the patient indicates understanding of the medication?

• A. “I will take the medication with grapefruit juice each morning.”
• B. “I should expect occasional loose stools from this medication”
• C. “I’ll need to reduce the amount of fiber in my diet”
• D. “I must swallow the pill whole.”

Correct answer: D

Rationale: “SR” indicates that the drug is sustained release; therefore, the patient must swallow the pill intact, without chewing or crushing, which would result in a bolus effect. Grapefruit juice should be avoided, because it can inhibit intestinal and hepatic metabolism of the drug, thereby raising the drug level. Constipation, not loose stools, is a common side effect. Increasing fluids and dietary fiber can help prevent this adverse effect.

3. When developing a home program for self-care, which approach is the most effective?

• A. Require the parent to practice the steps regularly and track progress.
• B. Introduce new home programs weekly with clear instructions for the parent to follow.
• C. List all the steps and have the parent teach them to the child without practicing.
• D. Practice the new steps until the child is ready to independently perform them at home.

Correct answer: D

Rationale: The most effective approach when developing a home program for self-care is to practice the new steps with the child until they are capable of independently carrying them out at home. This method ensures that the child has mastered the skills before transitioning to independent implementation. It is essential for the child's success in self-care activities and promotes their autonomy and confidence. Requiring the parent to practice the steps regularly and track progress, introducing new programs weekly, or having the parent teach the steps without practice may not be as beneficial in fostering the child's independence and skill acquisition.

4. A child is being assessed for Kawasaki disease. Which of the following findings should be expected?

• A. Decreased heart rate
• B. Dry, scaly skin
• C. Fever unresponsive to antipyretics
• D. Nontender cervical lymphadenopathy

Correct answer: C

Rationale: In Kawasaki disease, a child typically presents with a fever that is unresponsive to antipyretics because the disease is characterized by systemic inflammation. The persistent fever is a hallmark feature of the disease and can last for more than five days despite treatment with antipyretics.

5. What type of mode best describes Kasey's approach when meeting with the principal to change the cafeteria to better accommodate her client with difficulty eating in a noisy and distracting environment?

• A. Collaborating
• B. Instructing
• C. Advocating
• D. Encouraging

Correct answer: C

Rationale: Advocating best describes Kasey's approach in this scenario. Advocating involves presenting stories, research, and ideas to support and champion for a specific cause or individual, in this case, advocating for changes to better meet the child's needs in the cafeteria. Collaborating involves working together with others towards a common goal, instructing involves providing guidance or directions, and encouraging involves giving support or motivation, none of which fully capture Kasey's proactive and supportive advocacy actions in this context.

Similar Questions