Nursing Elites

1. For which patient diagnosis would a prescription for nifedipine be least appropriate?

• A. Angina Pectoris
• B. Essential HTN
• C. Atrial Fibrillation
• D. Vasospastic Angina

Correct answer: C

Rationale: Nifedipine primarily acts as a calcium channel blocker, exerting its effects on vascular smooth muscle. It is not effective for treating dysrhythmias like Atrial Fibrillation, which involve abnormalities in the heart's electrical system. Nifedipine is commonly prescribed for conditions such as angina pectoris, essential hypertension, and vasospastic angina due to its vasodilatory and anti-anginal properties. Choices A, B, and D are more appropriate as nifedipine can help in managing angina pectoris, hypertension, and vasospastic angina by reducing myocardial oxygen demand and dilating coronary arteries.

2. The mother of a 5-year-old child taking prednisone for nephrotic syndrome tells the nurse he needs to get immunizations to enter kindergarten. What does the nurse clarify about receiving immunizations while on prednisone?

• A. Can interfere with the treatment for nephrosis.
• B. Require that the child have antibiotic coverage.
• C. Can be given in smaller, divided doses.
• D. Should be delayed.

Correct answer: D

Rationale: No vaccinations or immunizations should be administered while the disease is active and during immunosuppressive therapy.

3. When receiving change-of-shift report for children, which child should the nurse assess first?

• A. A toddler who has a concussion and an episode of forceful vomiting
• B. An adolescent with infective endocarditis who reports having a headache
• C. An adolescent who was placed into Halo traction 1 hour ago and rates his pain at a 6 on a 0-10 scale
• D. A school-age child with acute glomerulonephritis and brown-colored urine

Correct answer: A

Rationale: The nurse should assess the toddler with a concussion and an episode of forceful vomiting first when receiving change-of-shift report for children. Forceful vomiting in a toddler with a concussion indicates increased intracranial pressure, requiring immediate assessment and intervention to prevent further complications.

4. Which food should be avoided by a child with acute glomerulonephritis to prevent hyperkalemia, as recommended by the nurse?

• A. Dairy products
• B. Whole-grain cereals
• C. Organ meats
• D. Bananas

Correct answer: D

Rationale: Bananas are rich in potassium, which can contribute to hyperkalemia in individuals with acute glomerulonephritis. It is essential to limit potassium intake to prevent further complications associated with high potassium levels in the blood.

5. A parent of a child with attention deficit hyperactivity disorder (ADHD) is being taught by a nurse. Which instruction should the nurse include in the teaching?

• A. Administer methylphenidate at bedtime.
• B. Increase stimuli in the child's environment.
• C. Administer an extra dose of medication if the child is overactive.
• D. Maintain a consistent bedtime routine.

Correct answer: D

Rationale: Maintaining a consistent bedtime routine is essential for children with ADHD as it helps in managing their symptoms effectively. Consistency in bedtime routines aids in regulating the child's sleep patterns, promoting better rest, and ultimately improving their behavior and focus during the day.

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