Nursing Elites

1. Sometimes, people with congestive heart failure develop arrhythmias of the heart. These irregular rhythms can be conducive to developing a blood clot. Physicians frequently treat people with 'blood thinning' medicines that require regulation of the density of the blood. Which of these is the name for a blood-thinner?

• A. Erythromycin
• B. Tetracycline
• C. Warfarin
• D. Amoxicillin

Correct answer: C

Rationale: Warfarin is a medication commonly used as a blood thinner to prevent blood clot formation. It works by inhibiting the clotting factors in the blood, thereby reducing the risk of clot formation and helping in the management of conditions like congestive heart failure and arrhythmias. Choices A, B, and D are antibiotics and do not have blood-thinning properties like Warfarin.

2. Which position is MOST appropriate for a mother in labor with a prolapsed umbilical cord?

• A. Supine with legs elevated
• B. Supine with hips elevated
• C. Left lateral recumbent
• D. Left side with legs elevated

Correct answer: B

Rationale: The most appropriate position for a mother in labor with a prolapsed umbilical cord is supine with hips elevated. This position helps reduce pressure on the cord, preventing further complications and ensuring optimal blood flow to the fetus.

3. A 4-year-old boy with a tracheostomy tube is experiencing respiratory distress. He has intercostal retractions, a heart rate of 80 beats/min, and an oxygen saturation of 85%. During his attempts to breathe, a gurgling sound is heard in the tracheostomy tube. You should:

• A. Ventilate through the tracheostomy tube.
• B. Place an oxygen mask over the tracheostomy tube.
• C. Remove the tracheostomy tube and clean it.
• D. Carefully suction the tracheostomy tube.

Correct answer: D

Rationale: In this scenario, the 4-year-old boy with a tracheostomy tube is showing signs of respiratory distress, including intercostal retractions, a low heart rate, and decreased oxygen saturation. The gurgling sound indicates a possible airway obstruction. Correctly, the immediate action should be to carefully suction the tracheostomy tube. Suctioning can help clear any secretions or obstructions, thus improving the child's ability to breathe effectively. Ventilating through the tube, placing an oxygen mask over it, or removing and cleaning the tube would not address the potential obstruction and could worsen the respiratory distress.

4. Which of the following statements regarding febrile seizures in children is correct?

• A. They can occur even after a child has had a fever for longer than 24 hours.
• B. They can be caused by viral or bacterial meningitis.
• C. They do not typically occur on the first day of a fever.
• D. They typically last less than 15 minutes and often do not have a postictal phase.

Correct answer: D

Rationale: The correct answer is D. Febrile seizures in children typically last less than 15 minutes and often do not have a postictal phase, meaning there is usually no prolonged recovery period or confusion after the seizure. They are commonly associated with the rapid rise in body temperature at the onset of a fever, rather than the duration of the fever itself. Choices A, B, and C are incorrect because febrile seizures can occur even after a child has had a fever for longer than 24 hours, they can be caused by viral or bacterial meningitis, and they do not have a typical pattern of occurring on the first day of a fever.

5. The Andrews family has been taking good care of their youngest, Archie, who was diagnosed with asthma. Which of the following statements indicate a need for further home care teaching?

• A. He should increase his fluid intake regularly to thin secretions.
• B. We'll make sure he avoids exercise to prevent attacks.
• C. He is to use his bronchodilator inhaler before the steroid inhaler.
• D. We need to identify what triggers his attacks.

Correct answer: B

Rationale: The correct answer is B. Avoiding exercise entirely is not recommended for asthma management. Regular exercise can actually help strengthen the lungs and improve overall respiratory function. Teaching should focus on appropriate exercise routines that are suitable for individuals with asthma to prevent attacks. Choices A, C, and D are all appropriate and indicate good understanding of asthma management. Increasing fluid intake helps thin secretions, using the bronchodilator inhaler before the steroid inhaler follows the correct order of inhaler administration, and identifying triggers is essential for asthma control.

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