Nursing Elites

1. In a patient with diabetes, which of the following is a sign of hypoglycemia?

• A. Polydipsia
• B. Polyuria
• C. Dry skin
• D. Sweating

Correct answer: D

Rationale: Sweating is a common sign of hypoglycemia in patients with diabetes. When blood sugar levels drop too low, the body releases stress hormones like adrenaline, leading to symptoms such as sweating, shakiness, and palpitations. Polydipsia (excessive thirst) and polyuria (excessive urination) are more commonly associated with hyperglycemia (high blood sugar levels) in diabetes. Dry skin is not a typical symptom of hypoglycemia.

2. The nurse is preparing to administer amoxicillin (Amoxil) to a patient and learns that the patient previously experienced a rash when taking penicillin. Which action will the nurse take?

• A. Administer the amoxicillin and have epinephrine available.
• B. Ask the provider to order an antihistamine.
• C. Contact the provider to discuss using a different antibiotic.
• D. Request an order for a beta-lactamase-resistant drug.

Correct answer: C

Rationale: When a patient has a history of rash from penicillin, it indicates a potential allergic reaction to penicillin and other related drugs, such as amoxicillin. It is crucial to avoid administering penicillins to such patients unless there is no alternative. The nurse's best action in this situation is to contact the provider to discuss using a different antibiotic from a different class. This approach helps prevent potential severe allergic reactions. While epinephrine and antihistamines are used to manage allergic reactions, administering amoxicillin despite the known allergy is not advisable and could lead to serious consequences. Requesting a beta-lactamase-resistant drug does not address the issue of potential allergic reactions in this scenario.

3. Which of the following is a key symptom of appendicitis?

• A. Right lower quadrant pain.
• B. Left lower quadrant pain.
• C. Generalized abdominal pain.
• D. Rebound tenderness.

Correct answer: A

Rationale: Corrected Choice A: Right lower quadrant pain is a classic and key symptom of appendicitis. Pain in the right lower quadrant is typically the initial symptom and is a result of inflammation and irritation of the appendix. This pain can start around the umbilicus and then migrate to the right lower quadrant. It is important to note that appendicitis rarely presents with pain in the left lower quadrant or generalized abdominal pain. Rebound tenderness, indicated in Choice D, is a sign of peritoneal irritation and is associated with appendicitis, but it is not as characteristic as the right lower quadrant pain in the initial presentation of appendicitis.

4. The healthcare provider is caring for a 7-year-old patient who will receive oral antibiotics. Which antibiotic order will the healthcare provider question for this patient?

• A. Azithromycin (Zithromax)
• B. Clarithromycin (Biaxin)
• C. Clindamycin (Cleocin)
• D. Tetracycline (Sumycin)

Correct answer: D

Rationale: The correct answer is D, Tetracycline (Sumycin). Tetracyclines should not be given to children younger than 8 years of age because they irreversibly discolor the permanent teeth. Azithromycin, Clarithromycin, and Clindamycin are antibiotics that are generally safe for use in children and do not have the same tooth discoloration side effect as Tetracycline. Therefore, these antibiotics would be more appropriate choices for a 7-year-old patient.

5. To evaluate the positive effect of furosemide (Lasix) 40 mg/day in a client with chronic kidney disease (CKD), what is the best action for the nurse to take?

• A. Obtain daily weights of the client.
• B. Auscultate heart and breath sounds.
• C. Palpate the client’s abdomen.
• D. Assess the client’s diet history.

Correct answer: A

Rationale: The correct answer is A. Furosemide (Lasix) is a loop diuretic used to manage fluid overload and hypertension in clients with CKD. Monitoring daily weights is crucial as weight changes reflect fluid status. Each kilogram of weight change approximately corresponds to 1 liter of fluid retention or loss, making it essential for evaluating the medication's effectiveness. Auscultating heart and breath sounds is more relevant for heart failure cases with fluid retention, not specifically for assessing the effect of furosemide in CKD. Palpating the abdomen is not a direct indicator of furosemide's effectiveness; instead, assessing for edema would be appropriate. While assessing the client's diet history is important to monitor electrolyte balance due to potassium loss with furosemide, it does not directly evaluate the medication's efficacy.

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