Nursing Elites

1. A patient who has PUD and is receiving magnesium hydroxide (MOM) is experiencing an increased number of BM. Which is the nurse�s priority action?

• A. Ask the HCP for a reduction in dose
• B. Encourage the patient to increase dietary fiber
• C. Administer the drug with an aluminum hydroxide antacid
• D. Instruct patient to keep an accurate stool count

Correct answer: C

Rationale: MOM is a rapid-acting antacid with a prominent adverse effect of diarrhea. To compensate, it usually is administered in combo with aluminum hydroxide which promotes constipation. A reduction in dose might be necessary if the diarrhea is severe, but this is not a priority action. Increasing dietary fiber and keeping a stool count are appropriate actions to implement after adding an antacid to counteract the diarrhea effect.

2. A patient is taking a first-generation H1 blocker for the treatment of allergic rhinitis. It is most important for the nurse to assess for which adverse effect?

• A. Skin flushing
• B. Wheezing
• C. Insomnia
• D. Dry mouth

Correct answer: D

Rationale: Adverse Effect of Histamine � First Generation H1 blockers include dry mouth.

3. The healthcare professional is completing the intake and output record for a child admitted for fluid volume deficit. The child has had the following intake and output during the shift: 4 oz of Pedialyte, One-half of an 8-oz cup of clear orange Jell-O, Two graham crackers, 200 mL of D5 1/2 sodium chloride IV. Output: 345 mL of urine, 50 mL of loose stool. How many milliliters should the healthcare professional document as the client's total intake? Give the numerical answer only. Do not include any units of measurement.

• A. 440
• B. 400
• C. 410
• D. 450

Correct answer: A

Rationale: The total intake is 440 mL (4 oz of Pedialyte = 120 mL, half of an 8 oz cup of Jell-O = 120 mL, and 200 mL of IV fluids). The graham crackers are not counted as intake. Therefore, the correct answer is 440. Choice B (400) is incorrect because it does not account for the intake of Jell-O. Choice C (410) is incorrect as it does not include the Pedialyte intake. Choice D (450) is incorrect because it overestimates the total intake by including the graham crackers.

4. A child is admitted to the hospital for hypercalcemia and is placed on diuretic therapy. Which diuretic would the nurse expect to administer?

• A. Furosemide (Lasix)
• B. Hydrochlorothiazide (Aquazide)
• C. Spironolactone (Aldactone)
• D. Mannitol (Osmitrol)

Correct answer: A

Rationale: Furosemide (Lasix) is a loop diuretic that acts on the ascending loop of Henle in the kidney to increase calcium excretion. In the setting of hypercalcemia, where there is an elevated level of calcium in the blood, Furosemide can help promote the elimination of excess calcium through the urine, thereby aiding in the management of hypercalcemia.

5. A toddler in the emergency department has partial thickness burns on his right arm. Which of the following actions should the nurse take?

• A. Insert a nasogastric tube
• B. Initiate prophylactic antibiotic therapy
• C. Cleanse the affected area with mild soap and water
• D. Apply a topical corticosteroid to the affected area

Correct answer: C

Rationale: When a toddler has partial thickness burns, the nurse should cleanse the affected area with mild soap and water. This action helps remove any loose tissue that could lead to infection and prepares the area for appropriate wound care. Inserting a nasogastric tube (Choice A) is not indicated for a toddler with burns. Initiating prophylactic antibiotic therapy (Choice B) is not necessary for partial thickness burns unless there are signs of infection. Applying a topical corticosteroid (Choice D) is not recommended for initial management of burns as it can delay wound healing.

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