P.A.S.S questions - help needed!

[Elleann]

I'm working thru the P.A.S.S online review and I keep bumping my head against questions like this one, where I pick the wrong answer. I don't always agree with their rationales and I need to know if it is my thinking that is skewed here!!

The question is:

When planning care for a child suspected of having bacterial meningitis, the nurse's first priority should be to:

1. Offer cool, clear fluids

2. Administer the antipyretic, per MD's order

3. Administer the antibiotic, per MD's order

4. Check vital signs and perform neurological examination.

Which one would you pick and why?

I'll post my (wrong) answer and their right one with rationale in a little while.

Thanks

Elleann

[Elleann]

Another P.A.S.S question: I also got this one wrong! (Two of the answers are as best as I can remember them - I only have my wrong one and the right one saved to my PC)

A woman who is a victim of suspected rape arrives at the emergency room. What is the first thing that the nurse should do?

1. Assist her to complete the documentation in order to lay a charge against her assailant.

2. Ask her if she used contraception

3. Perform a pelvic examination to check if she has STD's

4. Give her personal hygiene.

So, nurses ... what say you? :-)

Elleann

[dayplay]

My answer would be # 4, to assess your patient first before delivering any form of interventions. Basic understanding of the patient condition at any given time is of utmost important, then you can follow the rest of the orders.

[pinoy_guy]

a woman who is a victim of suspected rape arrives at the emergency room. what is the first thing that the nurse should do?

1. assist her to complete the documentation in order to lay a charge against her assailant.

2. ask her if she used contraception

3. perform a pelvic examination to check if she has std's

4. give her personal hygiene.

well, 4 is wrong because it'll wash away the forensic evidence.

3 is out because you don't do a pelvic exam to check for stds.

1 is out because a nurse will not prioritize documentation and filing of charges against the assailant.

i will go with 2.

this is assessment, and the rn can inform the client about the morning after pill if the client wants it.

[EricJRN, MSN, RN]

I'd get a different review book. :)

In regards to the first question, there's no way that I'd ever give a drug (esp a strong, likely IV, antibiotic that could cause anaphylaxis, etc) without at least taking baseline vitals and performing a basic assessment.

On the second question, I like pinoy_guy's reasoning, but the choices all seem ridiculous if the question is seeking the FIRST thing a nurse should do. Asking about contraception immediately would go against the principles of therapeutic communication, putting the patient on the defensive right away.

[TLC RN]

I say 2 also - same reasons as pinoy_guy.

[AmyD_RN]

yup number 2 for me also, and I agree with Eric! LOL:lol2:

[crb613, BSN, RN]

My answer would be # 4, to assess your patient first before delivering any form of interventions. Basic understanding of the patient condition at any given time is of utmost important, then you can follow the rest of the orders.

:yeahthat: I am w/you!

For the next question.... #2 since this would come w/assessing & getting a hx. I would not ask it in that way...sounds like she planned to get raped!

[Elleann]

First off, I'm thrilled that most of you followed the same course of reasoning that I did in both these questions! Unfortunately, according to the answers, most of us were also wrong. The answer to the second question astounded me:

4. Give personal hygiene.

Rationale: This is the only option that focuses on her, personally, and deals with typical feeling of being "dirty", being violated.

I reasoned this one out exactly as pinoy_guy did, and chose as 2 as the only answer that would 'do no harm' to the patient, even though it was not an intervention that would be particularly helpful either. Imagine letting a rape victim just wash away all the forensic evidence - duh! I also agree with crb, the contraception question was really badly phrased

I had to laugh at Eric's candid comment about getting a different review book! Luckily this is not my main review resource! The section of the P.A.S.S program I'm using is only a 2-week access to a dBase of 1500 NCLEX-style questions - I needed more questions to do the 100 questions a day run up to my nclex, which is coming up real soon. So I bought this, and in fairness, only three questions so far have made me wonder if the program is OK, and I've done about 200 out of 1500.

If anyone is interested, the website for this is www.reviewfornurses.com. I e-mailed them, asking about both these questions, and one other. The tech guy mailed back, saying he would forward my questions to the 'nurse educator'. To date, I haven't heard a thing back!

Thanks to all

Elleann :-)

[Luv2Care]

I am so glad that you have another resource!!!!

[incredibles06]

# 4, i believe....

[crb613, BSN, RN]

4. Give personal hygiene.

Rationale: This is the only option that focuses on her, personally, and deals with typical feeling of being "dirty", being violated.

:trout: :smackingf....and while I am at it, I will cut her nails & scrub them really good, give her a douche...then throw away those nasty clothes! She will be nice & clean then!

[Paleobug]

I would also choose #3 because of the need for an assessment of the physical harm and collection of the evidence of the rape.