Nursing Elites

1. A client with peptic ulcer disease is prescribed ranitidine (Zantac). Which statement by the client indicates the need for further teaching?

• A. I will take this medication at bedtime.
• B. I need to avoid smoking while taking this medication.
• C. I should take this medication with meals.
• D. This medication will help reduce stomach acid.

Correct answer: C

Rationale: The client's statement that they should take ranitidine with meals indicates a need for further teaching. Ranitidine is typically taken at bedtime or before meals to be most effective in reducing stomach acid. Taking it with meals may not provide the optimal therapeutic effect.

2. The mother of a 9-month-old who was diagnosed with respiratory syncytial virus (RSV) yesterday calls the clinic to inquire if it will be all right to take her infant to the first birthday party of a friend's child the following day. What response should the nurse provide this mother?

• A. The child can be around other children but should wear a mask at all times.
• B. The child will no longer be contagious, no need to take any further precautions.
• C. Make sure there are no children under the age of 6 months around the infected child.
• D. Do not expose other children. RSV is very contagious even without direct oral contact.

Correct answer: D

Rationale: The correct response is to advise the mother not to expose other children to the infected child. RSV is highly contagious, and transmission can occur even without direct oral contact. It is crucial to prevent the spread of the virus to protect other children from getting infected.

3. A client with Addison's disease is being treated with fludrocortisone (Florinef). Which electrolyte imbalance should the nurse monitor for?

• A. Hyperkalemia.
• B. Hyponatremia.
• C. Hypernatremia.
• D. Hypocalcemia.

Correct answer: C

Rationale: Fludrocortisone, such as Florinef, is a mineralocorticoid that promotes sodium retention and potassium excretion, which can lead to hypernatremia. Therefore, the nurse should closely monitor for hypernatremia when a client with Addison's disease is being treated with fludrocortisone. Hyperkalemia (Choice A) is incorrect because fludrocortisone promotes potassium excretion, leading to hypokalemia rather than hyperkalemia. Hyponatremia (Choice B) is incorrect as fludrocortisone promotes sodium retention. Hypocalcemia (Choice D) is unrelated to the action of fludrocortisone.

4. During an admission physical assessment, the nurse is examining a newborn who is small for gestational age (SGA). Which finding should the nurse report immediately to the pediatric healthcare provider?

• A. Heel stick glucose of 65 mg/dL.
• B. Head circumference of 35 cm (14 inches).
• C. Widened, tense, bulging fontanel.
• D. High-pitched shrill cry.

Correct answer: C

Rationale: A widened, tense, bulging fontanel is a critical finding in a newborn as it can indicate increased intracranial pressure. This condition requires immediate attention and intervention to prevent further complications. Monitoring fontanel status is crucial in assessing the newborn's neurological well-being and ensuring early detection of potential issues.

5. The nurse is administering sevelamer (RenaGel) during lunch to a client with end-stage renal disease (ESRD). The client asks the nurse to bring the medication later. The nurse should describe which action of RenaGel as an explanation for taking it with meals?

• A. Prevents indigestion associated with the ingestion of spicy foods.
• B. Binds with phosphorus in foods and prevents absorption.
• C. Promotes stomach emptying and prevents gastric reflux.
• D. Buffers hydrochloric acid and prevents gastric erosion.

Correct answer: B

Rationale: Sevelamer (RenaGel) binds with phosphorus in foods and prevents its absorption. By taking RenaGel with meals, the binding of phosphorus helps to reduce the phosphorus load absorbed from food, thus aiding in the management of hyperphosphatemia in clients with ESRD.

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