Nursing Elites

1. What is the most important statement to include when teaching a patient who is prescribed metronidazole (Flagyl)?

• A. Take the medication with food.
• B. Avoid alcohol consumption.
• C. If you experience a metallic taste in your mouth, call your doctor.
• D. You can stop taking the medication once you feel better.

Correct answer: B

Rationale: The most crucial statement to include when teaching a patient prescribed metronidazole (Flagyl) is to avoid alcohol consumption. Mixing metronidazole and alcohol can lead to a disulfiram-like reaction, causing severe symptoms such as nausea, vomiting, and headache. Therefore, it is essential to emphasize to the patient the importance of abstaining from alcohol while taking this medication to prevent adverse reactions.

2. The healthcare professional is completing the intake and output record for a child admitted for fluid volume deficit. The child has had the following intake and output during the shift: 4 oz of Pedialyte, One-half of an 8-oz cup of clear orange Jell-O, Two graham crackers, 200 mL of D5 1/2 sodium chloride IV. Output: 345 mL of urine, 50 mL of loose stool. How many milliliters should the healthcare professional document as the client's total intake? Give the numerical answer only. Do not include any units of measurement.

• A. 440
• B. 400
• C. 410
• D. 450

Correct answer: A

Rationale: The total intake is 440 mL (4 oz of Pedialyte = 120 mL, half of an 8 oz cup of Jell-O = 120 mL, and 200 mL of IV fluids). The graham crackers are not counted as intake. Therefore, the correct answer is 440. Choice B (400) is incorrect because it does not account for the intake of Jell-O. Choice C (410) is incorrect as it does not include the Pedialyte intake. Choice D (450) is incorrect because it overestimates the total intake by including the graham crackers.

3. Which strategy is most effective in preventing existing challenging behaviors?

• A. Ignoring the behaviors
• B. Individualized interventions
• C. Providing flexible rules
• D. Punishment

Correct answer: B

Rationale: Individualized interventions are tailored to address the specific needs and triggers of the individual's challenging behaviors. By customizing the approach to each person, it increases the likelihood of effectively preventing and managing the existing challenging behaviors.

4. A young child admitted to the pediatric unit has fever, irritability, and vomiting with suspected bacterial meningitis. Which cerebrospinal fluid (CSF) result should the nurse anticipate based on these data?

• A. Decreased protein count
• B. Clear, straw-colored fluid
• C. Positive for red blood cells (RBCs)
• D. Decreased glucose level

Correct answer: D

Rationale: In bacterial meningitis, the glucose level in the cerebrospinal fluid (CSF) is typically decreased due to the increased utilization of glucose by the infecting bacteria. This metabolic change leads to a decrease in CSF glucose levels, making choice D the correct answer in this scenario. Choices A, B, and C are incorrect because bacterial meningitis usually results in an increased protein count, cloudy appearance of the CSF due to the presence of bacteria, and absence of red blood cells (RBCs) in the CSF unless there is a traumatic tap, respectively.

5. The nurse provides discharge instructions to a patient prescribed verapamil SR 120mg PO daily for HTN. Which statement by the patient indicates understanding of the medication?

• A. �I will take the medication with grapefruit juice each morning.�
• B. �I should expect occasional loose stools from this medication�
• C. �I�ll need to reduce the amount of fiber in my diet�
• D. �I must swallow the pill whole.�

Correct answer: D

Rationale: �SR� indicates that the drug is sustained release; therefore, the patient must swallow the pill intact, without chewing or crushing, which would result in a bolus effect. Grapefruit juice should be avoided, because it can inhibit intestinal and hepatic metabolism of the drug, thereby raising the drug level. Constipation, not loose stools, is a common side effect. Increasing fluids and dietary fiber can help prevent this adverse effect.

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