Nursing Elites

1. A 16-year-old female student with a history of asthma controlled with both an oral antihistamine and an albuterol (Proventil) metered-dose inhaler (MDI) comes to the school nurse. The student complains that she cannot sleep at night, feels shaky and her heart feels like it is 'beating a mile a minute.' Which information is most important for the nurse to obtain?

• A. When she last took the antihistamine.
• B. When her last asthma attack occurred.
• C. Duration of most asthma attacks.
• D. How often the MDI is used daily.

Correct answer: D

Rationale: The most important information for the nurse to obtain in this scenario is how often the MDI is used daily. This is crucial to assess if the symptoms the student is experiencing, such as insomnia, shakiness, and tachycardia, could be related to overuse of the inhaler. Overuse of albuterol can lead to side effects like tremors, palpitations, and difficulty sleeping, so understanding the frequency of MDI use is key in determining a potential cause for the student's symptoms. Options A, B, and C are not as pertinent in this situation as they do not directly address the possible link between the student's symptoms and the use of the albuterol MDI.

2. The parents of a 9-month-old infant are being educated about preventing iron deficiency anemia. Which statement by the parent indicates a correct understanding of the teaching?

• A. I will start giving my baby whole cow’s milk at 12 months
• B. I will give my baby iron-fortified cereal
• C. I will give my baby fruit juice between meals
• D. I will give my baby water with meals

Correct answer: B

Rationale: The correct answer is B: 'I will give my baby iron-fortified cereal.' Iron-fortified cereal is an excellent source of iron for infants, aiding in the prevention of iron deficiency anemia. Choice A is incorrect as whole cow’s milk should not be introduced until the child is at least 12 months old to prevent iron deficiency. Choice C is incorrect because giving fruit juice between meals can interfere with iron absorption. Choice D is incorrect as giving water with meals can decrease nutrient intake. Therefore, the best choice to prevent iron deficiency anemia in a 9-month-old infant is to give them iron-fortified cereal.

3. What information should be reinforced with the parents about introducing solid foods to their infant?

• A. Begin with one tablespoon of the food.
• B. Introduce each food 4 to 7 days apart.
• C. Mix the new food with rice cereal.
• D. Remove foods when the infant refuses them.

Correct answer: B

Rationale: The correct answer is B. Introducing solid foods 4 to 7 days apart is crucial as it allows time to identify any allergic reactions or intolerances to specific foods. This gradual introduction helps parents monitor their infant's response to new foods and pinpoint any potential issues, ensuring the infant's safety and well-being. Choices A, C, and D are incorrect because starting with one tablespoon of the food, mixing new food with rice cereal, and removing foods when the infant refuses them are not recommended practices for introducing solid foods to infants.

4. An adolescent female who is leaning forward with her hands on her knees to breathe tells the practical nurse that she has been using triamcinolone (Azmacort) inhalation aerosol before coming to the clinic. Which action should the PN implement?

• A. Obtain vital signs and assess breath sounds for wheezing.
• B. Collect a blood sample for white blood cell count.
• C. Give the client a nebulizer breathing treatment.
• D. Administer another dose of Azmacort.

Correct answer: A

Rationale: When a patient presents with breathing difficulties, the first action should be to assess vital signs and breath sounds to evaluate the severity of the condition. This assessment will provide crucial information to determine the appropriate course of action and treatment. Collecting a blood sample for a white blood cell count, giving a nebulizer treatment, or administering another dose of Azmacort would not be the initial priority in this situation. Therefore, option A is the correct choice as it focuses on assessing the patient's respiratory status to guide further interventions.

5. An adolescent’s mother calls the primary HCP’s office to inquire about the results of her daughter’s serum test that was drawn last week. Since it is the teenager’s 18th birthday, how should the nurse respond to this mother’s inquiry?

• A. Ask when the adolescent was last seen in the clinic
• B. Tell the mother to have the teenager call the clinic
• C. Since the serum sample was drawn last week, provide the mother with the findings
• D. Explain that the information cannot be released without the 18-year-old's permission

Correct answer: D

Rationale: When an individual turns 18, they are considered a legal adult and have the right to privacy regarding their medical information. Therefore, the nurse should explain to the mother that without the 18-year-old's permission, the results cannot be disclosed.

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