Nursing Elites

1. A caregiver is learning about administering digoxin to a toddler. Which statement by the caregiver indicates an understanding of the teaching?

• A. I will mix the medication with a small amount of juice.
• B. I will give the medication with meals.
• C. I will give a second dose if my child vomits.
• D. I will give my child water after giving the medication.

Correct answer: D

Rationale: The correct statement is D because giving the child water after administering digoxin helps ensure the medication is swallowed properly. Mixing the medication with juice (choice A) may affect its absorption. Giving the medication with meals (choice B) may interfere with its effectiveness. Administering a second dose if the child vomits (choice C) is not recommended as it may lead to an overdose.

2. During a well-child visit, a nurse is assessing a three-year-old toddler. Which of the following manifestations should the nurse report to the provider?

• A. Blood pressure 90/50
• B. Respiratory rate 45/min
• C. Weight 14.5 kg or 32 lb
• D. Heart rate 110/min

Correct answer: B

Rationale: A respiratory rate of 45/min is above the expected reference range for a 3-year-old toddler and may indicate respiratory dysfunction or acute respiratory distress. It is essential for the nurse to report this finding promptly to the healthcare provider for further evaluation and intervention.

3. Which statement best reflects the role of the therapeutic relationship in fostering positive behaviors in children?

• A. It may be used as an intervention strategy to help a child with positive behaviors
• B. The relationship with parents or teachers is more important
• C. It is not essential for the child's behaviors
• D. Children will not pay attention to the therapist

Correct answer: A

Rationale: A strong therapeutic relationship can significantly influence the development of positive behaviors in children. When a child feels connected, understood, and supported by a therapist, it can lead to better outcomes in promoting positive behaviors and emotional well-being.

4. The nurse is planning care for a school-age client who is postoperative for the surgical removal of the appendix. In addition to pharmacologic pain management, what should the nurse include in the plan of care to address pain?

• A. Applying a warm, moist pack every 4 hours
• B. Applying EMLA cream to the incision site prior to ambulation
• C. Applying a cold, moist pack every 2 hours
• D. Applying a pillow against the abdomen to splint the incision site when coughing

Correct answer: D

Rationale: After an appendectomy, applying a pillow against the abdomen to splint the incision site when coughing helps reduce pain by providing support and minimizing movement that could cause discomfort.

5. A patient in the emergency department reports taking sildenafil (Viagra) and nitroglycerin 1 hr before sexual activity. Which finding should the nurse immediately report to the physician?

• A. WBC of 3200 cells/mm³
• B. RR of 26 breaths/min
• C. Temp of 38°C
• D. BP of 70/50

Correct answer: D

Rationale: The correct answer is D: BP of 70/50. When sildenafil (Viagra) is taken with nitroglycerin, it can cause severe hypotension that is unresponsive to treatment. The combination of these medications can lead to a dangerous drop in blood pressure. It is crucial to immediately report hypotension in this scenario as it poses a significant risk to the patient's life. It is recommended to allow at least 24 hours to elapse between the last dose of sildenafil and nitroglycerin to prevent such adverse effects. The other vital signs and lab values may be abnormal but do not have the immediate life-threatening implications that severe hypotension does in this context.

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