Nursing Elites

1. The nurse is discussing negativism with the parents of a 30-month-old child. How should the nurse advise the parents to best respond to this behavior?

• A. Reprimand the child and give a 15-minute 'time out'
• B. Maintain a permissive attitude for this behavior
• C. Use patience and a sense of humor to deal with this behavior
• D. Assert authority over the child through limit setting

Correct answer: C

Rationale: Use patience and a sense of humor to deal with this behavior. The nurse should help the parents understand that negativism is a normal part of a toddler's growth towards autonomy. Reacting with patience and humor can help diffuse the situation and maintain a positive relationship with the child. Reprimanding the child and giving a 'time out' (Choice A) may not be effective for addressing negativism and can lead to power struggles. Maintaining a permissive attitude (Choice B) may reinforce negative behavior. Asserting authority through limit setting (Choice D) may be necessary in some situations, but using patience and humor is a more effective initial approach for handling negativism.

2. Which of the following glands found in the skin secretes a liquid called Sebum?

• A. Apocrine Glands
• B. Sebaceous Glands
• C. Lacrimal Glands
• D. Sweat Glands

Correct answer: B

Rationale: Sebum is a liquid secreted by glands in the skin known as sebaceous glands. Sebum's primary function is to lubricate the skin and help maintain its integrity. Apocrine glands secrete a different type of sweat that is odorless but can develop an odor when combined with bacteria on the skin. Lacrimal glands produce tears to keep the eyes moist, and sweat glands secrete sweat to regulate body temperature through evaporation. Therefore, the correct answer is Sebaceous Glands because they specifically secrete sebum, distinguishing them from the other gland types mentioned.

3. When administering a-interferon and ribavirin (Rebetol) to a patient with chronic hepatitis C, the nurse should monitor for which complication?

• A. Leukopenia.
• B. Hypokalemia.
• C. Polycythemia.
• D. Hypoglycemia.

Correct answer: B

Rationale: When administering a-interferon and ribavirin (Rebetol) for chronic hepatitis C, the nurse should monitor for hypokalemia. This combination therapy is known to cause leukopenia, not polycythemia or hypoglycemia. Hypokalemia is a common electrolyte imbalance that can occur with these medications, making it the correct answer to monitor for in this case.

4. After a bronchoscopy, what is the most appropriate intervention for a patient with a chronic cough?

• A. Elevate the head of the bed to 80 to 90 degrees.
• B. Keep the patient NPO until the gag reflex returns.
• C. Place the patient on bed rest for at least 4 hours after bronchoscopy.
• D. Notify the health care provider about blood-tinged mucus.

Correct answer: B

Rationale: The correct intervention is to keep the patient NPO until the gag reflex returns after a bronchoscopy. This is important because a local anesthetic is used during the procedure to suppress the gag and cough reflexes. Monitoring the return of these reflexes helps prevent the risk of aspiration and ensures the patient can safely resume oral intake. While blood-tinged mucus can occur after bronchoscopy, it is a common occurrence and not a cause for immediate concern. Placing the patient on bed rest for an extended period is unnecessary, and elevating the head of the bed to a high-Fowler's position is not specifically required post-bronchoscopy.

5. Which assessment finding would the nurse need to report most quickly to the health care provider regarding a patient with acute pancreatitis?

• A. Nausea and vomiting
• B. Hypotonic bowel sounds
• C. Abdominal tenderness and guarding
• D. Muscle twitching and finger numbness

Correct answer: D

Rationale: The correct answer is muscle twitching and finger numbness. These symptoms indicate hypocalcemia, which can lead to tetany if not promptly addressed with calcium gluconate administration. Nausea and vomiting, hypotonic bowel sounds, and abdominal tenderness and guarding are important findings in acute pancreatitis but do not require the same urgent intervention as hypocalcemia to prevent potential severe complications.

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