Nursing Elites

1. An 80-year-old patient with a history of renal insufficiency was recently started on cimetidine. Which assessment finding indicates that the patient may be experiencing an adverse effect of the medication?

• A. Pain with urination
• B. New onset disorientation to time and place
• C. HR changes from a baseline of 70-80bpm to 110-120bpm
• D. #ERROR!

Correct answer: B

Rationale: The correct answer is B: New onset disorientation to time and place. Cimetidine can cause adverse effects on the CNS system, especially in elderly patients with renal or hepatic impairment. This may manifest as confusion, hallucinations, lethargy, restlessness, or seizures. Pain with urination (choice A) is not typically associated with cimetidine use, and HR changes (choice C) are more likely related to other factors. Choice D is not a valid option.

2. Which statement by an 18-year-old woman vaccinated with Gardasil indicates that more teaching is necessary?

• A. This vaccination will cure the HPV infection I got when I was 16.
• B. I will still need to have a routine Pap screen performed.
• C. Gardasil can prevent genital warts in males and females.
• D. This drug does not protect against all types of HPV.

Correct answer: A

Rationale: The correct answer is A because Gardasil does not cure existing HPV infections. Gardasil is a preventive vaccine and does not treat existing infections. Choice B is correct as regular Pap screenings are still necessary even after vaccination. Choice C is also correct as Gardasil can prevent genital warts. Choice D is correct as Gardasil does not protect against all types of HPV. Therefore, option A is the statement that indicates the need for more teaching.

3. A healthcare professional is reviewing the laboratory report of an infant who is receiving treatment for severe dehydration. The professional should identify which of the following laboratory values indicates effectiveness of the current treatment?

• A. Potassium 2.9 mEq/L
• B. Sodium 140 mEq/L
• C. Urine specific gravity 1.035
• D. BUN 25 mg/dL

Correct answer: B

Rationale: A sodium level of 140 mEq/L within the expected reference range indicates effective treatment for dehydration. In dehydration, sodium levels are often elevated, so a normal sodium level suggests that the treatment is helping to restore the electrolyte balance in the infant's body.

4. Which question provides information regarding a child's community mobility?

• A. What is the level of supervision provided?
• B. Can the child leave the house and play with friends?
• C. Is the child being bullied?
• D. Is there equipment available so the child can play with peers?

Correct answer: B

Rationale: Choice B directly assesses the child's community mobility by inquiring about their ability to leave the house and engage in play activities with friends. Community mobility involves the child's independence in social and recreational activities outside the home, making this question crucial for understanding their daily functioning and autonomy.

5. While auscultating the lungs of an adolescent with asthma, what should the nurse identify the sound as?

• A. Biots respiration
• B. Chaney-Stokes respiration
• C. Tachypnea
• D. Bradypnea

Correct answer: C

Rationale: The nurse should identify the sound heard during auscultation as tachypnea, which is characterized by a rapid, regular breathing pattern. In the case of an adolescent with asthma, tachypnea can be indicative of increased work of breathing due to airway constriction and inflammation. Biots respiration (choice A) is characterized by an irregular pattern of breathing with periods of apnea. Chaney-Stokes respiration (choice B) is a pattern of breathing characterized by alternating periods of deep, rapid breathing followed by periods of apnea. Bradypnea (choice D) refers to an abnormally slow breathing rate, which is not typically associated with asthma exacerbation.

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