Nursing Elites

1. A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the priority action by the nurse?

• A. Elevate the head of the child's bed
• B. Insert a large-bore IV catheter for the child
• C. Determine the allergen that caused the child's reaction
• D. Administer IM epinephrine to the child

Correct answer: D

Rationale: In the management of anaphylaxis, the priority action for the nurse is to administer IM epinephrine to the child. Epinephrine is the first-line treatment for anaphylaxis as it helps reverse the severe manifestations of the reaction by constricting blood vessels, relaxing airway muscles, and decreasing hives and swelling. Elevating the head of the child's bed may be beneficial for respiratory distress but is not the priority over administering epinephrine. Inserting a large-bore IV catheter may be necessary for fluid resuscitation but is not the initial priority. Identifying the allergen is important for prevention and future management but is not the immediate action needed in the acute phase of an anaphylactic reaction.

2. A nurse is providing teaching to the guardian of an infant about home safety. Which of the following statements by the guardian indicates an understanding of the teaching?

• A. I will place my baby on her stomach to sleep
• B. I will put a small pillow in my baby's crib
• C. I will keep my baby's crib away from the radiator
• D. I will use a drop-side crib for my baby

Correct answer: C

Rationale: The nurse should instruct the guardian to keep the baby�s crib away from the radiator to prevent burns.

3. When caring for a child with hyponatremia, a nurse delegates care to a licensed vocational nurse (LVN) and instructs the LVN to promptly report which clinical manifestation?

• A. Seizures
• B. Respiratory distress
• C. Hyperthermia
• D. Bradycardia

Correct answer: A

Rationale: Seizures are a significant concern in severe hyponatremia as they indicate potential neurological complications and the need for urgent intervention to prevent further harm to the child. Prompt reporting of seizures allows for timely assessment and appropriate treatment to ensure the child's safety and well-being.

4. What is the goal of pharmacologic therapy in the treatment of Parkinson�s disease?

• A. To increase the amount of acetylcholine at the pre-synaptic neurons
• B. To reduce the amount of dopamine available in the substantia nigra
• C. To balance cholinergic and dopaminergic activity in the brain
• D. To block dopamine receptors in pre-synaptic and post-synaptic neurons

Correct answer: C

Rationale: Parkinson�s disease results from a decrease in dopaminergic (inhibitory) activity, leaving an imbalance with too much cholinergic (excitatory) activity. With an increase in dopamine, the neurotransmitter activity becomes more balanced, and symptoms are controlled.

5. Which medication is most likely to cause serious respiratory depression as a potential adverse reaction?

• A. Morphine
• B. Pentazocine
• C. Hydrocodone
• D. Nalmefene

Correct answer: A

Rationale: Morphine, as a strong opioid agonist, has the highest likelihood of causing serious respiratory depression due to its potent effects on the central nervous system. While Pentazocine and Hydrocodone can also cause respiratory depression, they are less likely to do so compared to morphine. Nalmefene, an opioid antagonist, is used to reverse respiratory depression caused by opioids rather than causing it.

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