Nursing Elites

1. The healthcare provider is assessing abdominal girth for a pediatric client who presents with abdominal distension. Which nursing action is appropriate?

• A. Measuring the girth just below the umbilicus
• B. Measuring the girth just below the sternum
• C. Measuring the girth just above the pubic bone
• D. Measuring the girth around the largest portion of the abdomen

Correct answer: D

Rationale: Measuring the girth around the largest portion of the abdomen ensures accurate assessment and tracking of abdominal distension. This method provides a more comprehensive measurement and helps healthcare providers monitor changes effectively.

2. What does the abbreviation BPD mean in a medical chart?

• A. Brain premature deficit
• B. Bronchiopulmonary dysplasia
• C. Bilateral partial disorder
• D. Baby post delivery

Correct answer: B

Rationale: The correct answer is B: Bronchiopulmonary Dysplasia. BPD refers to a chronic lung disorder that primarily affects premature infants or those who have been on ventilator support. It is characterized by abnormal development of the lungs and breathing difficulties. This abbreviation is commonly seen on medical charts in neonatal and pediatric settings.

3. The caregiver is teaching a parent of a young child with a newly diagnosed seizure disorder. The child is prescribed valproic acid (Depakote) for control of seizures. Which parental statement indicates the need for further education?

• A. I will not use carbonated beverages to dilute his medication.
• B. I will give his medication with food to minimize gastrointestinal upset.
• C. I will not let him chew his tablet.
• D. I will bring him to the physician's office for regular blood work to check his blood levels.

Correct answer: B

Rationale: The correct answer is B. Valproic acid should be administered with food to reduce the risk of gastrointestinal upset. Giving it on an empty stomach may increase the likelihood of adverse effects. The other statements are correct: A - Carbonated beverages should not be used to dilute the medication, C - The tablet should not be chewed, and D - Regular blood work is necessary to monitor valproic acid levels and potential side effects.

4. Before administering a live virus vaccine to a patient taking a glucocorticoid medication, what action should the nurse take?

• A. Continue screening and administer the vaccine if appropriate
• B. Note the contraindication but administer the vaccine regardless
• C. Note the contraindication and clarify the order with the healthcare provider
• D. Withhold the vaccine and inform the department of health

Correct answer: C

Rationale: The correct action for the nurse to take when a patient on glucocorticoid medication is to note the contraindication and clarify the order with the healthcare provider. Glucocorticoids can suppress the immune response, potentially reducing the effectiveness of vaccines. Therefore, it is crucial to consult with the healthcare provider to assess the risks and benefits of administering a live virus vaccine in such circumstances. Administering a live virus vaccine to a patient taking glucocorticoids can increase the risk of developing a viral infection, making it essential to seek guidance from the healthcare provider before proceeding.

5. A patient develops hypotension, laryngeal edema, and bronchospasm after eating peanuts. Which medication should the nurse prepare to administer?

• A. Promethazine
• B. Epinephrine
• C. Diphenhydramine
• D. Hydroxyzine

Correct answer: B

Rationale: The patient is exhibiting symptoms of anaphylaxis triggered by a peanut allergy, a severe and potentially life-threatening allergic reaction. The appropriate medication for anaphylaxis is epinephrine. Epinephrine acts quickly to reverse the symptoms by constricting blood vessels, relaxing bronchial muscles, and reducing laryngeal edema, making it the drug of choice for this situation. Promethazine, diphenhydramine, and hydroxyzine are not the first-line treatments for anaphylaxis. Promethazine is an antihistamine with sedative effects, Diphenhydramine is an antihistamine, and Hydroxyzine is also an antihistamine with sedative properties. While these medications can help with mild allergic reactions, they are not as effective or fast-acting as epinephrine in treating the severe manifestations of anaphylaxis.

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