Nursing Elites

1. In the emergency department, a child is admitted for accidental ingestion of a poison. The practical nurse (PN) should know that inducing vomiting is recommended for which child?

• A. An 8-month-old who ingested four to six ibuprofen tablets
• B. A 3-year-old who drank an unknown amount of charcoal lighter fluid
• C. A 16-month-old who ingested 2 ounces of acetaminophen elixir
• D. A 2-year-old who ate a handful of automatic dishwasher detergent

Correct answer: C

Rationale: Inducing emesis is recommended for the child who ingested a large dose of acetaminophen elixir because this medication is hepatotoxic. Acetaminophen overdose can lead to severe liver damage, and prompt removal from the stomach can help reduce absorption and potential harm.

2. A male client receives a scopolamine transdermal patch 2 hours before surgery. Four hours after surgery, the client tells the nurse that he is experiencing pain and asks why the patch is not working. Which action should the nurse take?

• A. Advise the client that the effects of the medication have worn off
• B. Explain that the medication is not given to relieve pain
• C. Check for the correct placement of the patch on the client
• D. Offer to apply a new transdermal patch to address the pain

Correct answer: B

Rationale: The correct answer is B. Scopolamine is not a pain medication; it is commonly used to prevent nausea and vomiting, particularly in surgical settings. It works on the central nervous system to help control these symptoms, not to relieve pain. Therefore, it is important for the nurse to explain to the client that the medication is not intended to relieve pain but rather to manage other specific symptoms. Checking the correct placement of the patch is also important to ensure proper administration, but addressing the misconception about the medication's purpose is the priority in this scenario. Offering to apply a new patch would not address the client's pain as scopolamine is not meant for pain relief. Advising the client that the effects have worn off is inaccurate because the medication is not used for pain management.

3. A client with a history of atrial fibrillation is prescribed warfarin. The nurse should monitor for which sign of potential bleeding?

• A. Elevated blood pressure
• B. Bruising
• C. Shortness of breath
• D. Nausea and vomiting

Correct answer: B

Rationale: Warfarin is an anticoagulant that increases the risk of bleeding. Bruising is a common sign of potential bleeding in clients taking warfarin. Monitoring for bruising is essential as it can indicate a risk of bleeding that needs further assessment and management. Elevated blood pressure, shortness of breath, nausea, and vomiting are not direct signs of potential bleeding associated with warfarin therapy.

4. A client is taking levodopa-carbidopa for Parkinson's disease. The nurse should include which instruction when educating the client about this medication?

• A. Increase fluid intake to prevent dehydration.
• B. Take medication with food to improve absorption.
• C. Take medication at bedtime to avoid daytime drowsiness.
• D. It can cause nausea and dizziness.

Correct answer: A

Rationale: The correct instruction for a client taking levodopa-carbidopa for Parkinson's disease is to increase fluid intake to prevent dehydration. Levodopa-carbidopa should be taken with food to reduce gastrointestinal upset and improve absorption. Taking medication at bedtime is not necessary to avoid daytime drowsiness. It is crucial to prevent dehydration due to the medication's side effects. Choice B is incorrect because the medication should be taken with food, not at bedtime. Choice C is incorrect as taking the medication with food, rather than on an empty stomach, aids in absorption and reduces gastrointestinal side effects. Choice D is incorrect as it states the side effects of the medication rather than providing specific instructions on its administration.

5. The patient is prescribed cimetidine (Tagamet) orally. What should the nurse consider about administering this drug?

• A. Administer the drug with the first bite of food
• B. Administer the drug immediately after meals
• C. Administer the drug 30 minutes after meals
• D. Administer the drug 30 minutes before meals

Correct answer: D

Rationale: Cimetidine is best absorbed when taken 30 minutes before meals to decrease stomach acid. Administering it before meals allows for optimal absorption and effectiveness of the medication. Choices A, B, and C are incorrect because administering cimetidine with food, immediately after meals, or 30 minutes after meals may not provide the best conditions for absorption. Taking it before meals ensures that the drug is absorbed properly and can exert its intended effects.

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