Nursing Elites

1. The healthcare professional is preparing to administer an immunization to a four-year-old child. Which of the following actions should the professional plan to take?

• A. Place the child in a prone position for the immunization
• B. Request that the child's caregiver stay in the room during the immunization
• C. Administer the immunization using a 24-gauge needle
• D. Inject the immunization slowly without aspirating

Correct answer: C

Rationale: When administering an immunization to a four-year-old child, it is important to use a 24-gauge needle to minimize pain and discomfort for the child. Thicker needles can cause more pain and tissue trauma. Using a thinner needle like a 24-gauge is appropriate for pediatric immunizations. Placing the child in a prone position for immunization is not recommended as it can be uncomfortable and may not allow for proper access to the injection site. Having the caregiver stay in the room during the immunization is beneficial for support and comfort for the child. Injecting the immunization slowly without aspirating is correct, as aspirating before administering the immunization is not required for intramuscular injections in current practice.

2. 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.

3. The nurse is reviewing the home medication list with the patient. The nurse recognizes that hydrochlorothiazide is used primarily for which condition?

• A. Hypertension
• B. Edema
• C. Diabetes insipidus
• D. Protection against postmenopausal osteoporosis

Correct answer: A

Rationale: Hydrochlorothiazide is primarily indicated for hypertension (HTN). Thiazides like hydrochlorothiazide are commonly the first-line treatment for hypertension. While hydrochlorothiazide can be used for edema, diabetes insipidus, and postmenopausal osteoporosis to some extent, its main use and efficacy lie in managing hypertension.

4. What is the priority nursing intervention when caring for a neonate born with bladder exstrophy?

• A. Measuring intake and output
• B. Inserting a Foley catheter
• C. Covering the defect with sterile plastic wrap
• D. Palpating the bladder mass to ensure urine is expelled

Correct answer: C

Rationale: The priority nursing intervention when caring for a neonate born with bladder exstrophy is to cover the defect with sterile plastic wrap. This intervention helps prevent infection and maintains a moist environment, promoting optimal healing and reducing the risk of complications.

5. A pediatric client is admitted to the emergency department with a traumatic brain injury (TBI) that caused a loss of consciousness. The last set of vital signs showed heart rate 48, blood pressure (BP) 148/74 mmHg, respiratory rate 28 and irregular. What does the nurse suspect based on these data?

• A. Spinal cord injury
• B. Increased intracranial pressure
• C. Typical for sleep
• D. Improvement

Correct answer: B

Rationale: The vital signs of bradycardia, hypertension, and irregular respirations indicate increased intracranial pressure. Bradycardia (heart rate of 48), hypertension (blood pressure of 148/74 mmHg), and irregular respirations are typical signs of increased intracranial pressure in a pediatric client with a traumatic brain injury and loss of consciousness.

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