The nurse is caring for a school aged child with glomerulonephritis. Which of the following findings requires IMMEDIATE attention?

The child's urine output is 190mL in an 8-hour period and their urine is dark brown

The child is lethargic, confused and complains of a headache and double vision

The child's BUN, creatinine, and erythrocyte sedimentation rate are elevated

The child sleeps most of the day, is irritable when awake, and the BP is 138/80

Answer and Explanation

The Correct Answer is B

A. Decreased urine output and dark brown urine are concerning but not immediately life-threatening.
B. Lethargy, confusion, headache, and double vision are signs of severe hypertension and possibly hypertensive encephalopathy, which require immediate attention.
C. Elevated BUN, creatinine, and ESR are indicative of kidney dysfunction but are not as immediately concerning as neurological symptoms.
D. While elevated BP and irritability are concerning, they are not as immediately critical as the neurological symptoms in option B.

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Correct Answer is B

Explanation

A. It is inappropriate to dismiss suspicions of abuse based on the assumption that toddlers frequently fall and have multiple injuries.
B. The nurse has a legal and ethical obligation to report suspicions of child abuse to the proper authorities, regardless of the physician's opinion. Reporting ensures that the child’s safety is prioritized and that an investigation can be conducted.
C. While discussing findings with the physician can be part of the process, it does not take precedence over the mandatory reporting of suspected abuse.
D. Confronting the caregivers directly is not appropriate and may put the child at further risk.

A. Hallucinations B. Paranoia C. Drowsiness D. Increased Hunger E. Tachycardia F. Hypertension

Correct Answer is ["A","B","E","F"]

Explanation

A. Hallucinations can occur as a result of methylphenidate overdose.
B. Paranoia is a possible psychological effect of a stimulant overdose.
C. Drowsiness is not typical; stimulant overdose usually causes increased alertness and agitation.
D. Increased hunger is not associated with stimulant overdose; appetite suppression is more common.
E. Tachycardia is a common cardiovascular effect of stimulant overdose.
F. Hypertension can occur due to the increased stimulant effect on the cardiovascular system.

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The nurse is caring for a school aged child with glomerulonephritis. Which of the following findings requires IMMEDIATE attention?

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Naxlex Comprehensive Predictor Exams

An emergency room nurse is assessing a toddler with multiple bruises and burns in various stages of healing. The nurse suspects that the toddler has been abused, however the physician disagrees. What is the nurse's priority at this time?

Correct Answer is B

Explanation

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Correct Answer is ["A","B","E","F"]

Explanation

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