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 43-year-old female client who has had a thyroidectomy due to Grave's disease is prescribed a thyroid replacement hormone. Which signs and symptoms are associated with thyroid hormone toxicity and should be reported promptly to the healthcare provider?

• A. Tinnitus and dizziness
• B. Tachycardia and chest pain
• C. Dry skin and intolerance to cold
• D. Weight gain and increased appetite

Correct answer: B

Rationale: The correct answer is B: Tachycardia and chest pain. Signs and symptoms of thyroid hormone toxicity, especially in cases of excessive dosage, include tachycardia (rapid heart rate) and chest pain. These symptoms are consistent with hyperthyroidism, where the body is receiving an excessive amount of thyroid hormone. It is crucial to report these symptoms promptly to the healthcare provider to adjust the medication dosage and prevent potential complications. Choices A, C, and D are not indicative of thyroid hormone toxicity. Tinnitus and dizziness (Choice A) are not typical symptoms of thyroid hormone toxicity. Dry skin and intolerance to cold (Choice C) are more common in hypothyroidism, while weight gain and increased appetite (Choice D) are associated with hypothyroidism as well, not thyroid hormone toxicity.

3. A client is prescribed ondansetron for nausea and vomiting. The nurse should monitor the client for which potential adverse effect?

• A. Headache
• B. Diarrhea
• C. Constipation
• D. Increased appetite

Correct answer: C

Rationale: The correct answer is C: Constipation. Ondansetron is known to cause constipation as a potential adverse effect. It is important for the nurse to monitor the client for constipation while on this medication to address any issues promptly. Choices A, B, and D are incorrect because headache, diarrhea, and increased appetite are not common adverse effects associated with ondansetron.

4. A client with diabetes mellitus type 2 is prescribed metformin. What instruction should the nurse include in the client's teaching plan?

• A. Take this medication with meals.
• B. Avoid alcohol while taking this medication.
• C. Take this medication on an empty stomach.
• D. Report any signs of lactic acidosis to the healthcare provider.

Correct answer: A

Rationale: The correct instruction for a client prescribed metformin is to take the medication with meals. Taking metformin with meals helps to minimize gastrointestinal side effects, which are common with this medication. Choice B, avoiding alcohol, is a good practice due to the increased risk of lactic acidosis when alcohol is consumed with metformin; however, it is not the priority teaching point in this scenario. Taking metformin on an empty stomach (Choice C) is incorrect because it can increase the risk of gastrointestinal side effects. Reporting signs of lactic acidosis (Choice D) is important, but it is more related to monitoring for adverse effects rather than a primary teaching point for administration.

5. What class of laxative would the nurse recommend to a patient asking about the best way to prevent constipation?

• A. Stimulant laxatives
• B. Bulk-forming laxatives
• C. Emollient laxatives
• D. Hyperosmotic laxatives

Correct answer: B

Rationale: The correct answer is B: Bulk-forming laxatives. These laxatives are recommended to prevent constipation because they work by absorbing liquid in the intestines, forming a bulky, soft stool that is easier to pass. They are safe and considered the most natural option. Stimulant laxatives (choice A) work by promoting bowel movements through intestinal contractions and are more suitable for treating occasional constipation rather than preventing it. Emollient laxatives (choice C) soften the stool by increasing the incorporation of water into the feces and are more suitable for patients who need to avoid straining during defecation. Hyperosmotic laxatives (choice D) work by drawing water into the intestine through osmosis and are typically used for more severe cases of constipation, not for prevention.

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