Nursing Elites

1. Which statement by the parents indicates understanding of the process involved with a kidney transplant for a child with renal failure?

• A. We are happy that our child will not have to take any more medicine after the transplant.
• B. We understand that our child will not be at risk anymore for catching colds from other children at school.
• C. We will be glad that we will not have to bring our child in to see the doctor again.
• D. We know it is important to ensure that our child takes prescribed medications after the transplant.

Correct answer: D

Rationale: The correct answer is D because parents should understand the importance of medication adherence post-transplant to prevent rejection. Following the prescribed medication regimen is crucial for the success of the kidney transplant and the overall health of the child. Monitoring and ensuring the child takes their medications as directed by the healthcare provider are essential components of post-transplant care. Choices A, B, and C are incorrect because they do not address the critical aspect of medication management post-transplant, which is vital for the child's well-being and the success of the procedure.

2. A child is being cared for following a head injury. Which of the following findings should indicate to the healthcare provider that the child is developing diabetes insipidus?

• A. Urine specific gravity of 1.045
• B. Sodium level of 155
• C. Blood glucose level of 45
• D. Urine output of 35 ml per hour

Correct answer: B

Rationale: In a child with a head injury, the development of diabetes insipidus can occur due to pituitary hypofunction, leading to a deficiency of antidiuretic hormone. An elevated sodium level (hypernatremia) is a key finding in diabetes insipidus due to the excessive loss of free water in the urine, resulting in increased sodium concentration in the blood.

3. The nurse provides discharge instructions to a patient prescribed verapamil SR 120mg PO daily for HTN. Which statement by the patient indicates understanding of the medication?

• A. �I will take the medication with grapefruit juice each morning.�
• B. �I should expect occasional loose stools from this medication�
• C. �I�ll need to reduce the amount of fiber in my diet�
• D. �I must swallow the pill whole.�

Correct answer: D

Rationale: �SR� indicates that the drug is sustained release; therefore, the patient must swallow the pill intact, without chewing or crushing, which would result in a bolus effect. Grapefruit juice should be avoided, because it can inhibit intestinal and hepatic metabolism of the drug, thereby raising the drug level. Constipation, not loose stools, is a common side effect. Increasing fluids and dietary fiber can help prevent this adverse effect.

4. The patient with bipolar disorder is being treated with lithium and has a new prescription for captopril for hypertension. The combination of these two drugs makes which assessment particularly important?

• A. Potassium level
• B. Lithium level
• C. Creatinine level
• D. Blood pressure

Correct answer: B

Rationale: When captopril, an ACE inhibitor, is combined with lithium, it can lead to lithium accumulation. Therefore, monitoring lithium levels is crucial to prevent toxicity. While ACE inhibitors like captopril can cause hyperkalemia, renal insufficiency, and hypotension, the risk of these effects is not increased by the combination of lithium and captopril.

5. While auscultating the lungs of an adolescent with asthma, what should the nurse identify the sound as?

• A. Biots respiration
• B. Chaney-Stokes respiration
• C. Tachypnea
• D. Bradypnea

Correct answer: C

Rationale: The nurse should identify the sound heard during auscultation as tachypnea, which is characterized by a rapid, regular breathing pattern. In the case of an adolescent with asthma, tachypnea can be indicative of increased work of breathing due to airway constriction and inflammation. Biots respiration (choice A) is characterized by an irregular pattern of breathing with periods of apnea. Chaney-Stokes respiration (choice B) is a pattern of breathing characterized by alternating periods of deep, rapid breathing followed by periods of apnea. Bradypnea (choice D) refers to an abnormally slow breathing rate, which is not typically associated with asthma exacerbation.

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