Nursing Elites

1. What are the side effects of first-generation over-the-counter (OTC) antihistamines like diphenhydramine (Benadryl) and hydroxyzine (Atarax) in infants and children?

• A. Reye's syndrome.
• B. cholinergic effects.
• C. paradoxical CNS stimulation.
• D. nausea and diarrhea.

Correct answer: C

Rationale: The correct answer is paradoxical CNS stimulation. First-generation OTC antihistamines, such as diphenhydramine and hydroxyzine, can lead to paradoxical CNS stimulation in infants and children. This phenomenon is characterized by symptoms like excitement, euphoria, restlessness, and confusion, rather than the expected sedative effect. Due to this unexpected response, these antihistamines are used less frequently in pediatric populations. Reye's syndrome is a rare systemic response to a virus and is not a side effect of antihistamines. First-generation OTC antihistamines do not typically exhibit cholinergic effects. Nausea and diarrhea are uncommon side effects of these antihistamines and are less commonly observed than paradoxical CNS stimulation.

2. The nurse is caring for a preschool child who is being treated in the hospital for respiratory syncytial virus (RSV). In planning the client's care, the nurse should recognize that the child is likely to view this illness as?

• A. Punishment.
• B. Disturbance to body image.
• C. Rejection from parents.
• D. Change in routine with friends.

Correct answer: A

Rationale: The correct answer is A: Punishment. Preschool children often see illness as a form of punishment, especially when they are unable to understand the cause of their sickness. This perception is rooted in their limited cognitive abilities and understanding of health concepts. Choices B, C, and D are incorrect because preschool children are less likely to associate illness with disturbance to body image, rejection from parents, or changes in routine with friends. These options are not developmentally appropriate for how preschoolers typically interpret illness.

3. The nurse overhears two nursing students talking about a client in the cafeteria. What should the nurse do first?

• A. Report the incident to the nursing supervisor.
• B. Write up a variance report about the incident.
• C. Instruct the students that this is a violation of HIPAA.
• D. Notify the students' faculty regarding the violation.

Correct answer: C

Rationale: The correct answer is to instruct the students that discussing a client in a public area like the cafeteria violates HIPAA regulations. This is important to educate the students about patient confidentiality and the consequences of breaching it. Reporting to the nursing supervisor or faculty should come after addressing the students directly. Writing up a variance report is not the immediate action needed in this situation, as educating the students about their mistake should be the priority. It is essential to address the issue at the source by educating the students first rather than escalating the matter to supervisors or faculty immediately.

4. Nurses should understand the chain of infection because it refers to:

• A. the linkages involved in disease transmission.
• B. the sequence required for transmission of disease.
• C. the clustering of bacteria in a specific pattern.
• D. increasing virulence patterns among microorganisms.

Correct answer: B

Rationale: The chain of infection refers to the sequence required for the transmission of disease, involving steps like the pathogen's presence, movement from a reservoir, and entry into a susceptible host. Understanding this sequence helps healthcare professionals, including nurses, in implementing effective infection control measures. Choices A, C, and D are incorrect because they do not accurately describe the concept of the chain of infection. Choice A is too broad and does not specifically address the sequential nature of disease transmission. Choice C focuses on bacterial clustering rather than the transmission process. Choice D mentions virulence patterns, which are not the primary focus of the chain of infection concept.

5. Assessment of the client with an arteriovenous fistula for hemodialysis should include:

• A. inspection for visible pulsations.
• B. palpation of thrill.
• C. percussion for dullness.
• D. auscultation of blood pressure.

Correct answer: B

Rationale: The correct answer is to palpate for a thrill. A thrill should be present in a functioning arteriovenous fistula (AVF) and indicates good blood flow. The client should be educated to check for this sensation daily at home to monitor the AVF's patency. Visible pulsations are not typically observed in an AVF. Percussion for dullness does not provide relevant information about the AVF. Auscultation of blood pressure is not a standard practice in assessing an AVF. However, auscultation of the AVF for a bruit, a sound indicating turbulent blood flow, is crucial in evaluating the AVF's patency.

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