Nursing Elites

1. The healthcare provider is preparing to administer digoxin (Lanoxin) to a 6-month-old infant with heart failure. The healthcare provider notes that the infant’s heart rate is 90 beats per minute. What should the healthcare provider do next?

• A. Administer the medication as prescribed
• B. Hold the medication and notify the healthcare provider
• C. Reassess the heart rate in 30 minutes
• D. Administer half the prescribed dose

Correct answer: B

Rationale: In this scenario, the correct action is to hold the medication and notify the healthcare provider. Digoxin should be withheld if the infant’s heart rate is below 100 beats per minute. Administering digoxin in this situation can further slow down the heart rate in infants with heart failure, leading to potential adverse effects. Reassessing the heart rate in 30 minutes is not the best immediate action to take, as prompt notification and withholding of the medication are crucial. Administering the medication as prescribed or giving half the dose can exacerbate the situation by potentially further lowering the heart rate.

2. A child with a fever of 39°C (102.2°F) and a sore throat is brought to the clinic. The practical nurse suspects the child has streptococcal pharyngitis. Which diagnostic test should the practical nurse prepare the child for?

• A. Rapid antigen detection test.
• B. Throat culture.
• C. Complete blood count (CBC).
• D. Chest X-ray.

Correct answer: A

Rationale: A rapid antigen detection test is the appropriate diagnostic test for suspected streptococcal pharyngitis. This test is commonly used due to its quick results, helping in the prompt diagnosis and appropriate treatment of the condition. It specifically detects the presence of streptococcal antigens in the throat, aiding in confirming the diagnosis and guiding the healthcare provider in determining the most suitable treatment plan. Throat culture (Choice B) is a confirmatory test but is not as rapid as the rapid antigen detection test. Complete blood count (Choice C) and Chest X-ray (Choice D) are not specific tests for streptococcal pharyngitis and would not aid in confirming the diagnosis.

3. The practical nurse (PN) is caring for an adolescent who has been diagnosed with mononucleosis. Which activity should the PN advise the adolescent to avoid?

• A. Playing video games.
• B. Drinking caffeinated beverages.
• C. Participating in contact sports.
• D. Eating spicy foods.

Correct answer: C

Rationale: Contact sports should be avoided in mononucleosis due to the risk of spleen rupture, which is a serious complication of the disease. The spleen can enlarge in mononucleosis, making it more susceptible to injury from contact sports, potentially leading to a life-threatening situation if rupture occurs.

4. When should oral hygiene practices start for an infant according to the American Dental Association guidelines?

• A. There is no need to begin until after all of the child's baby teeth are in.
• B. You don't have to worry about that until your child can handle a toothbrush.
• C. You can begin now using toothpaste on a gauze pad and wiping the gums.
• D. Begin wiping the teeth with a washcloth and water when the first tooth appears.

Correct answer: D

Rationale: According to the American Dental Association guidelines, oral hygiene practices should start as soon as the first tooth appears. At this stage, using a soft cloth and water to clean the infant's gums and teeth is recommended to establish good oral hygiene habits early on and prevent dental issues. Choice A is incorrect as waiting until all baby teeth are in is too late for starting oral hygiene practices. Choice B is incorrect as it is essential to start oral hygiene before the child can handle a toothbrush. Choice C is incorrect as using toothpaste on a gauze pad is not recommended for infants with emerging teeth.

5. Which nursing intervention is most important to include in the plan of care for a child with acute glomerulonephritis?

• A. Encourage fluid intake.
• B. Promote complete bed rest.
• C. Weigh the child daily.
• D. Administer vitamin supplements.

Correct answer: C

Rationale: Weighing the child daily is crucial in managing a child with acute glomerulonephritis as it helps in monitoring fluid retention, which is a key concern in this condition. Daily weight monitoring allows healthcare providers to assess changes in fluid status and adjust treatment accordingly. It is an essential component of the care plan to ensure the child's health status is closely monitored during the management of acute glomerulonephritis. Encouraging fluid intake (Choice A) is generally beneficial but may not be the priority in this case where fluid retention needs close monitoring. Promoting complete bed rest (Choice B) can be important but may not be the most critical intervention. Administering vitamin supplements (Choice D) may not directly address the immediate concerns related to fluid retention in acute glomerulonephritis.

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