Nursing Elites

1. When a pediatric client is taking the beta-adrenergic blocking agent propranolol, what signs of overdose should the nurse instruct the parents to report?

• A. Seizures
• B. Increased respiratory rate
• C. Bradycardia
• D. Irritability

Correct answer: C

Rationale: When a pediatric client is taking propranolol, the nurse should instruct the parents to report signs of overdose, including bradycardia. Propranolol is a beta-blocker that can lead to dangerously slow heart rate as a sign of overdose. While increased respiratory rate, seizures, and irritability may occur in some cases, bradycardia is the most critical symptom indicating an overdose of this medication.

2. The nurse assesses a 72-year-old client who was admitted for right-sided congestive heart failure. Which of the following would the nurse anticipate finding?

• A. Decreased urinary output
• B. Jugular vein distention
• C. Pleural effusion
• D. Bibasilar crackles

Correct answer: B

Rationale: Correct! In right-sided congestive heart failure, jugular vein distention is a common finding due to the backup of blood in the systemic circulation. This results in increased venous pressure, leading to jugular vein distention. Choices A, C, and D are incorrect because decreased urinary output, pleural effusion, and bibasilar crackles are more commonly associated with other conditions such as kidney dysfunction, lung issues, and pulmonary edema.

3. Which information is a priority for the RN to reinforce to an older client after intravenous pyelography?

• A. Eat a light diet for the remainder of the day
• B. Rest for the next 24 hours as the preparation and the test are tiring
• C. Drink at least 1 8-ounce glass of fluid every waking hour for the next 2 days
• D. Measure the urine output for the next day and promptly notify the healthcare provider if it decreases

Correct answer: D

Rationale: After intravenous pyelography, it is crucial for the client to measure urine output in the next day to monitor for any potential complications, such as kidney issues. Promptly notifying the healthcare provider in case of decreased urine output is essential for timely intervention. While rest and hydration are important post-procedure, monitoring urine output takes precedence due to its direct correlation with potential complications.

4. A client with peripheral artery disease reports leg cramps while walking. What intervention should the nurse recommend?

• A. Encourage the client to rest immediately when cramping occurs.
• B. Recommend that the client increase their intake of potassium-rich foods.
• C. Advise the client to take a short break, then continue walking.
• D. Recommend that the client avoid walking altogether to prevent cramps.

Correct answer: C

Rationale: For clients with peripheral artery disease, advising the client to take a short break when leg cramps occur and then continue walking is the appropriate intervention. This approach, known as interval walking, helps manage pain from intermittent claudication and improves circulation over time. Choice A is incorrect because immediate rest may not be necessary, and encouraging the client to resume walking after a short break is more beneficial. Choice B is incorrect since increasing potassium-rich foods may not directly address the underlying issue of peripheral artery disease causing cramps. Choice D is incorrect as avoiding walking altogether can lead to further deconditioning and worsen symptoms over time.

5. A client is receiving a blood transfusion and develops a fever. What is the nurse's first action?

• A. Administer an antipyretic as prescribed.
• B. Stop the transfusion and notify the healthcare provider.
• C. Slow the rate of the transfusion.
• D. Continue the transfusion and reassess in 15 minutes.

Correct answer: B

Rationale: The correct first action when a client receiving a blood transfusion develops a fever is to stop the transfusion and notify the healthcare provider. This is crucial to prevent further reactions and ensure prompt intervention. Administering an antipyretic (Choice A) may mask symptoms and delay appropriate treatment. Slowing the rate of the transfusion (Choice C) might not address the underlying cause of the fever. Continuing the transfusion and reassessing in 15 minutes (Choice D) could worsen the client's condition if there is a severe reaction occurring.

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