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. What does a Z-score of -3.00 indicate?

• A. The child's score indicates he is ahead of his peers and performing well
• B. The child's score places him within normal limits on this test item
• C. The test is inconclusive
• D. The child's score falls below the majority of his peers on this test

Correct answer: D

Rationale: A Z-score of -3.00 indicates that the child's performance is significantly below the average of their peers. It represents an extreme low score, indicating a substantial deviation from the mean performance of the group.

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. A toddler is admitted to the surgical unit for a planned closure of a temporary colostomy. Which medical prescription should the nurse question?

• A. Clear liquids today, NPO tomorrow
• B. Type and cross-match for 1 unit of packed red blood cells
• C. Rectal temperatures every 4 hours
• D. Start an intravenous line with D5NS at 20 mL per hour

Correct answer: C

Rationale: The correct answer is C. Rectal temperatures should be avoided in a toddler with a colostomy due to the risk of injury. Choices A, B, and D are appropriate medical prescriptions for a toddler undergoing colostomy closure. Choice A ensures the toddler's intake of clear liquids before being made NPO, choice B prepares for possible blood transfusion needs, and choice D initiates intravenous hydration with D5NS at an appropriate rate.

5. A child is admitted to the hospital for hypercalcemia and is placed on diuretic therapy. Which diuretic would the nurse expect to administer?

• A. Furosemide (Lasix)
• B. Hydrochlorothiazide (Aquazide)
• C. Spironolactone (Aldactone)
• D. Mannitol (Osmitrol)

Correct answer: A

Rationale: Furosemide (Lasix) is a loop diuretic that acts on the ascending loop of Henle in the kidney to increase calcium excretion. In the setting of hypercalcemia, where there is an elevated level of calcium in the blood, Furosemide can help promote the elimination of excess calcium through the urine, thereby aiding in the management of hypercalcemia.

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