Nursing Elites

1. A child with acetaminophen (Tylenol) poisoning has been admitted to the emergency department. What antidote does the nurse anticipate being prescribed?

• A. Carnitine (Carnitor)
• B. Fomepizole (Antizol)
• C. Deferoxamine (Desferal)
• D. N-acetylcysteine (Mucomyst)

Correct answer: D

Rationale: N-acetylcysteine is the specific antidote for acetaminophen poisoning, working by replenishing glutathione and preventing liver damage. The other options are antidotes for different types of poisoning (e.g., Fomepizole for methanol or ethylene glycol poisoning).

2. What is typically the first sign of puberty in females?

• A. Breast development
• B. Menarche
• C. Pubic hair growth
• D. Axillary hair growth

Correct answer: A

Rationale: The correct answer is A: Breast development (thelarche) is usually the first sign of puberty in females, typically beginning between ages 8 and 13. This marks the start of puberty, followed by pubic hair growth, a growth spurt, and eventually menarche (the onset of menstruation). Pubic hair growth and axillary hair growth usually follow breast development in the sequence of pubertal changes. Therefore, the first noticeable change indicating the onset of puberty in females is the development of breast buds.

3. The nurse is providing education to the parent of a child with Beta-thalassemia. Which risk factors about the condition should the nurse include in the teaching?

• A. Hypertrophy of the thyroid
• B. Polycythemia vera
• C. Thrombocytopenia
• D. Chronic hypoxia and iron overload

Correct answer: D

Rationale: The correct answer is D: Chronic hypoxia and iron overload. Children with Beta-thalassemia often suffer from chronic hypoxia due to ineffective erythropoiesis and require frequent blood transfusions, leading to iron overload. These complications must be managed to prevent organ damage. Choices A, B, and C are incorrect. Hypertrophy of the thyroid, polycythemia vera, and thrombocytopenia are not direct risk factors associated with Beta-thalassemia. Therefore, they should not be included in the teaching regarding this condition.

4. The nurse is admitting a 9-year-old child with hemolytic uremic syndrome. What clinical manifestations should the nurse expect to observe? (Select all that apply.)

• A. All are correct
• B. Anorexia
• C. Hypertension
• D. Purpura

Correct answer: A

Rationale: Hemolytic uremic syndrome (HUS) typically presents with hematuria, anorexia, hypertension, and purpura due to the hemolytic anemia, thrombocytopenia, and renal failure that characterize this condition.

5. Which parental statement indicates correct understanding regarding pancreatic enzyme administration in the treatment of cystic fibrosis?

• A. “I will administer this medication 4 times a day.”
• B. “I will administer this medication twice a day.”
• C. “I will administer this medication with meals and snacks.”
• D. “I will administer this medication every 6 hours with meals.”

Correct answer: C

Rationale: The correct answer is C: "I will administer this medication with meals and snacks." Pancreatic enzymes should be administered with meals and snacks to aid in the digestion of nutrients in children with cystic fibrosis. Choices A, B, and D are incorrect because administering the medication without meals and snacks may not provide the necessary support for digestion needed in cystic fibrosis.

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