Nursing Elites

1. When teaching a parent of a toddler with a new prescription for liquid ferrous sulfate, which of the following instructions should the nurse include?

• A. Mix the medication with milk.
• B. Give the medication with orange juice.
• C. Give the medication with meals.
• D. Administer the medication with an antacid.

Correct answer: B

Rationale: The correct answer is to give the medication with orange juice. Orange juice helps increase the absorption of iron from ferrous sulfate. This acidic environment aids in the absorption of iron, making it a suitable choice for administration. Mixing the medication with milk or an antacid may decrease iron absorption, and giving it with meals may not optimize its absorption as effectively as with orange juice.

2. 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.

3. A child with croup has an increased PCO2, a decreased pH, and a normal HCO3 blood gas value. Which finding does the nurse report to the healthcare provider based on these data?

• A. Uncompensated metabolic alkalosis
• B. Uncompensated metabolic acidosis
• C. Uncompensated respiratory acidosis
• D. Uncompensated respiratory alkalosis

Correct answer: C

Rationale: The blood gas values indicate uncompensated respiratory acidosis. In respiratory acidosis, there is an increased PCO2, decreased pH, and a normal HCO3 level. This condition requires immediate attention to address the underlying respiratory problem causing the acidosis.

4. What important information should the nurse provide to a patient taking a tetracycline antibiotic?

• A. Take the medication on an empty stomach.
• B. Avoid exposure to sunlight and tanning beds.
• C. Do not take the medication with milk or other dairy products.
• D. The medication may cause permanent staining of your teeth.

Correct answer: D

Rationale: The correct answer is D. Tetracycline antibiotics can bind to calcium in dairy products, decreasing the absorption of the antibiotic. This may result in reduced effectiveness of the medication. Additionally, tetracycline antibiotics can cause permanent staining of teeth, especially in children below 8 years of age and in pregnant women. Therefore, it is crucial for the patient to be aware of this potential side effect and to discuss any concerns with their healthcare provider. Choices A, B, and C are incorrect because tetracycline antibiotics should be taken with food to reduce gastrointestinal upset, exposure to sunlight is not a significant concern with tetracycline antibiotics, and the issue with dairy products is related to calcium binding and reduced absorption rather than an issue of empty stomach intake.

5. Which parental statement at the end of a teaching session by the nurse indicates correct understanding of colostomy stoma care for the infant client?

• A. We will change the colostomy bag with each wet diaper.
• B. We will expect a moderate amount of bleeding after cleansing the area around the stoma.
• C. We will watch for skin irritation around the stoma.
• D. We will use adhesive enhancers when we change the bag.

Correct answer: C

Rationale: Choosing option C, 'We will watch for skin irritation around the stoma,' demonstrates understanding of proper colostomy stoma care. Monitoring for skin irritation is crucial as it can indicate issues such as leakage, improper sealing, or infection. Options A, B, and D are incorrect. Changing the colostomy bag with each wet diaper (option A) is unnecessary unless indicated by a healthcare provider to prevent skin breakdown. Expecting bleeding after cleansing (option B) is not normal and may signal a problem that requires medical attention. Using adhesive enhancers (option D) should be done based on specific recommendations and not necessarily with every bag change.

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