Nursing Elites

1. When teaching a group of mothers of young children about emergency care for poisoning, which of the following statements should be included?

• A. Induce vomiting immediately after the poison ingestion
• B. Call the local Poison Control Center after inducing vomiting
• C. Call the Poison Control Center prior to any interventions
• D. Take the child to the emergency department before calling the Poison Control Center

Correct answer: C

Rationale: The correct statement to include when teaching about emergency care for poisoning is to call the Poison Control Center prior to any interventions. This is important because the Poison Control Center can provide guidance on the appropriate steps to take based on the type of poisoning, the amount ingested, and the age of the child. Inducing vomiting without professional advice can sometimes do more harm than good. Choice A is incorrect because inducing vomiting immediately is not recommended without consulting with professionals. Choice B is incorrect as it suggests calling the Poison Control Center after inducing vomiting, which is not the recommended sequence. Choice D is incorrect because it is advisable to contact the Poison Control Center first before taking the child to the emergency department.

2. A client with pneumonia is receiving antibiotics and oxygen therapy. What assessment finding requires immediate intervention?

• A. Productive cough with yellow sputum.
• B. Oxygen saturation of 88%.
• C. Respiratory rate of 20 breaths per minute.
• D. Heart rate of 90 beats per minute.

Correct answer: B

Rationale: An oxygen saturation of 88% indicates hypoxemia, which is a critical condition requiring immediate intervention to improve oxygenation. Hypoxemia can lead to tissue hypoxia and further complications. A productive cough with yellow sputum is common in pneumonia but may not require immediate intervention unless it worsens or is associated with other concerning symptoms. A respiratory rate of 20 breaths per minute is within the normal range, indicating adequate ventilation. A heart rate of 90 beats per minute is also within a normal range and may not require immediate intervention unless it is accompanied by other abnormal findings.

3. The healthcare provider prescribes celtazidime for an infant, IM, every 8 hours. The vial is 500 mg with a concentration of 100 mg/ml after reconstitution. How many ml should the nurse administer?

• A. 3 ml.
• B. 0.4 ml.
• C. 1.2 ml.
• D. 0.9 ml.

Correct answer: B

Rationale: To administer 35 mg of celtazidime from a 100 mg/ml solution, the nurse should give 0.4 ml of the reconstituted celtazidime solution. The calculation is 35 mg / 100 mg/ml = 0.35 ml, but since the vial is 500 mg, the answer is 0.35 ml * (500 mg / 100 mg) = 0.4 ml. Therefore, choices A, C, and D are incorrect as they do not reflect the correct calculation based on the provided information.

4. A client with Type 2 diabetes is admitted with frequent hyperglycemic episodes and glycosylated hemoglobin (A1C) of 10%. What actions should the nurse include in the client's plan of care?

• A. Mixing glargine with aspart insulin to manage glucose levels.
• B. Teaching foot care to prevent injuries.
• C. Coordinating carbohydrate-controlled meals and subcutaneous injections.
• D. Reviewing site rotation for insulin injections.

Correct answer: C

Rationale: In managing a client with Type 2 diabetes experiencing frequent hyperglycemic episodes and with a high A1C level, it is crucial to coordinate carbohydrate-controlled meals and subcutaneous injections. This approach helps regulate blood glucose levels effectively. Mixing glargine with aspart insulin (Choice A) is not a recommended practice as these insulins have different onset and peak times. Teaching foot care (Choice B) is important in diabetes management but is not the priority in this scenario. Reviewing site rotation for insulin injections (Choice D) is important to prevent lipodystrophy but is not the immediate action needed to address the client's hyperglycemia and high A1C level.

5. A client is admitted with deep vein thrombosis (DVT) and is receiving heparin therapy. What is the most important laboratory value to monitor during heparin therapy?

• A. Prothrombin time (PT)
• B. International normalized ratio (INR)
• C. Activated partial thromboplastin time (aPTT)
• D. Platelet count

Correct answer: C

Rationale: The activated partial thromboplastin time (aPTT) is the most important laboratory value to monitor during heparin therapy. It measures the intrinsic pathway of coagulation and is used to assess the effectiveness of heparin as an anticoagulant. Keeping the aPTT within the therapeutic range is crucial to prevent complications such as bleeding or clot formation. Prothrombin time (PT) and International normalized ratio (INR) are used to monitor warfarin therapy, not heparin. Platelet count is important to assess for thrombocytopenia, a potential side effect of heparin, but it is not the primary laboratory value to monitor the effectiveness of heparin therapy.

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