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Question 1 of 5.

A child presents to the Emergency Department with documented acetaminophen poisoning. In order to provide counseling and education for the parents, which principle must the nurse understand?

A. The problem occurs in stages with recovery within 12-24 hours

B. Hepatic problems may occur and may be life-threatening

C. Full and rapid recovery can be expected in most children

D. This poisoning is usually fatal, as no antidote is available

Explanation: Hepatic problems may occur and may be life-threatening. Clinical manifestations associated with acetaminophen poisoning occur in 4 stages. The third stage is hepatic involvement which may last up to 7 days and be permanent. Clients who do not die in the hepatic stage gradually recover.

Question 2 of 5.

Which laboratory test should the nurse monitor for the client receiving the intravenous steroid Solu-Medrol?

A. Potassium level.

B. Sputum culture and sensitivity.

C. Glucose level.

D. Arterial blood gases.

Explanation: Solu-Medrol (methylprednisolone) can cause hyperglycemia, requiring glucose monitoring, especially IV. Potassium, sputum, or ABGs are less directly affected.

Question 3 of 5.

The nurse administers 18 units of Humulin N, an intermediate-acting insulin, at 1630. Which priority intervention should the nurse implement?

A. Monitor the client's hemoglobin A1c.

B. Make sure the client eats the evening meal.

C. Check the a.c. blood glucometer reading.

D. Ensure the client eats a snack.

Explanation: Humulin N peaks in 4-12 hours; evening meal prevents hypoglycemia during peak action. A1c, a.c. checks, or snacks are less immediate.

Question 4 of 5.

The nurse is administering a.m. medications. Which medication should the nurse administer first?

A. The daily digoxin to the client diagnosed with congestive heart failure.

B. The loop diuretic to the client with a serum potassium level of 3.1 mEq/L.

C. The mucosal barrier Carafate to the client diagnosed with peptic ulcer disease.

D. Solu-Medrol IVP to a client diagnosed with chronic lung disease.

Explanation: Carafate (sucralfate) forms a protective barrier and must be given on an empty stomach, 30-60 minutes before other meds, to be effective for PUD.

Question 5 of 5.

The client's vital signs are T 99.2°F, AP 59, R 20, and BP 108/72. Which medication would the nurse question administering?

A. Theo-Dur, a bronchodilator.

B. Inderal, a beta blocker.

C. Ampicillin, an antibiotic.

D. Cardizem, a calcium channel blocker.

Explanation: Inderal (propranolol) slows HR; an apical pulse of 59 warrants holding it, per guidelines, to avoid bradycardia. Other meds are unaffected by HR.

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