Nursing Elites

1. A client with myasthenia gravis is receiving pyridostigmine (Mestinon). The nurse should monitor the client for which of the following side effects?

• A. Constipation
• B. Hypertension
• C. Muscle weakness
• D. Bradycardia

Correct answer: D

Rationale: The correct answer is D: Bradycardia. Pyridostigmine, a cholinesterase inhibitor used in myasthenia gravis, can lead to bradycardia as a side effect. Choice A, constipation, is not a common side effect of pyridostigmine. Choice B, hypertension, is unlikely as pyridostigmine is more likely to cause hypotension. Choice C, muscle weakness, is actually a symptom of myasthenia gravis itself and not a side effect of pyridostigmine.

2. The healthcare professional enters the room as a 3-year-old is having a generalized seizure. Which intervention should the healthcare professional do first?

• A. Clear the area of any hazards
• B. Place the child on the side
• C. Restrain the child
• D. Give the prescribed anticonvulsant

Correct answer: B

Rationale: Placing the child on the side is the priority intervention during a generalized seizure as it helps maintain an open airway and prevents aspiration. Clearing the area of any hazards is important but should come after ensuring the child's safety. Restraining the child is not recommended during a seizure as it can lead to injury. Giving the prescribed anticonvulsant is important but should not be the first action during an ongoing seizure.

3. While explaining an illness to a 10-year-old, what should the nurse keep in mind about the cognitive development at this age?

• A. They are able to make simple associations of ideas
• B. They are able to think logically in organizing facts
• C. Interpretation of events originates from their own perspective
• D. Conclusions are based on previous experiences

Correct answer: B

Rationale: Correct answer: At the age of 10, children are in the stage of concrete operational thought, where they can think logically and organize facts. Choice A is incorrect as simple associations of ideas are more characteristic of earlier developmental stages. Choice C is incorrect as while children at this age are developing perspective-taking skills, their interpretations are not solely limited to their own perspective. Choice D is incorrect as while previous experiences influence their thinking, the ability to think logically and organize facts is more prominent in this stage of cognitive development.

4. The nurse is reviewing a depressed client's history from an earlier admission. Documentation of anhedonia is noted. The nurse understands that this finding refers to:

• A. Reports of difficulty falling and staying asleep
• B. Expression of persistent suicidal thoughts
• C. Lack of enjoyment in usual pleasures
• D. Reduced senses of taste and smell

Correct answer: C

Rationale: The correct answer is C: Lack of enjoyment in usual pleasures. Anhedonia is the inability to feel pleasure in normally pleasurable activities. Choice A, reports of difficulty falling and staying asleep, is more indicative of insomnia rather than anhedonia. Choice B, expression of persistent suicidal thoughts, is related to suicidal ideation and not anhedonia. Choice D, reduced senses of taste and smell, is more associated with disturbances in the sense of taste and smell, not anhedonia.

5. In order to determine what specific health teaching should be appropriate for the people of this municipality, which of the following is the best method to use?

• A. interviewing midwives
• B. reviewing records and reports
• C. studying knowledge, attitudes, and practices of the people
• D. reviewing health statistics

Correct answer: C

Rationale: Studying knowledge, attitudes, and practices of the people is the best method to determine appropriate health teaching for a community. This approach provides valuable insights into the specific needs, beliefs, and behaviors of the population, allowing for tailored and effective health education interventions. Interviewing midwives may offer some insights, but focusing on the broader community is more comprehensive. Reviewing records and reports can provide historical data but may not capture current community needs as effectively as studying current knowledge, attitudes, and practices. Reviewing health statistics is important but may not provide the detailed understanding of community perceptions and behaviors that directly impact health education planning.

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