Nursing Elites

1. Which type of play involves actions such as looking and touching the mother's face, putting hands in one's mouth, and responding to familiar people?

• A. Exploratory
• B. Functional or relational
• C. Pretend
• D. Symbolic or imaginary

Correct answer: A

Rationale: Exploratory play is characterized by exploring sensory experiences and learning about the environment. In this type of play, infants engage in activities like looking, touching, and responding to familiar stimuli to understand the world around them.

2. A patient taking isotretinoin (Accutane) for acne vulgaris. Which statement indicates that the patient teaching has been effective?

• A. I should use a reliable form of birth control.
• B. I will stop taking the drug if my skin is dry.
• C. It is important to increase intake of vitamin A.
• D. I do not need to use sunblock while taking Accutane.

Correct answer: A

Rationale: The correct answer is A. Isotretinoin is highly teratogenic, which means it can cause birth defects. Therefore, it is crucial for patients, especially females of childbearing potential, to use effective forms of birth control to prevent pregnancy while taking this medication. This is a key component of patient teaching to ensure the safe use of isotretinoin. Choice B is incorrect because discontinuing isotretinoin abruptly can lead to a flare-up of acne. Choice C is incorrect because increasing vitamin A intake can be harmful due to the risk of hypervitaminosis A. Choice D is incorrect because isotretinoin makes the skin more sensitive to sunlight, so sunblock is essential to prevent sunburn and skin damage.

3. Prior to hydrotherapy treatment for wound debridement following a burn injury, which of the following actions should be taken?

• A. Apply topical antimicrobial ointment to the child's wound
• B. Place a mesh gauze dressing over the child's wound
• C. Administer an analgesic to the child
• D. Initiate prophylactic antibiotic therapy for the child

Correct answer: C

Rationale: Corrected Rationale: Prior to hydrotherapy for wound debridement, it is crucial to administer an analgesic to the preschooler. The procedure is known to be extremely painful, and providing analgesia or sedation is essential to manage the discomfort and pain experienced by the child during the treatment. Choice A is incorrect because applying topical antimicrobial ointment is not a pre-procedural requirement but rather a post-procedure wound care step. Choice B is incorrect as placing a mesh gauze dressing does not address the pain management aspect. Choice D is also incorrect as prophylactic antibiotic therapy is not the primary intervention needed before hydrotherapy for wound debridement.

4. The nurse is planning care for a school-age client who is postoperative for the surgical removal of the appendix. In addition to pharmacologic pain management, what should the nurse include in the plan of care to address pain?

• A. Applying a warm, moist pack every 4 hours
• B. Applying EMLA cream to the incision site prior to ambulation
• C. Applying a cold, moist pack every 2 hours
• D. Applying a pillow against the abdomen to splint the incision site when coughing

Correct answer: D

Rationale: After an appendectomy, applying a pillow against the abdomen to splint the incision site when coughing helps reduce pain by providing support and minimizing movement that could cause discomfort.

5. When a patient is taking glucocorticoids and digoxin, which electrolyte should the nurse prioritize monitoring?

• A. Calcium
• B. Magnesium
• C. Sodium
• D. Potassium

Correct answer: D

Rationale: The nurse should primarily monitor potassium levels in a patient taking glucocorticoids and digoxin. Glucocorticoids can lead to potassium loss, potentially increasing the risk of digoxin toxicity. Additionally, glucocorticoids may worsen hypokalemia induced by diuretics like thiazides and loops. While calcium, magnesium, and sodium are important electrolytes to monitor in various clinical situations, they are not the priority in this specific scenario of a patient on glucocorticoids and digoxin.

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