Nursing Elites

1. A healthcare provider is preparing to administer dextrose 5% in water (D5W) 750 mL IV to infuse over 6 hr. How many mL/hr should the IV pump be set to deliver?

• A. 125 mL/hr
• B. 100 mL/hr
• C. 150 mL/hr
• D. 200 mL/hr

Correct answer: A

Rationale: To calculate the flow rate, divide the total volume by the total time: (750 mL / 6 hr) = 125 mL/hr. Therefore, the IV pump should be set to deliver 125 mL/hr to infuse dextrose 5% in water (D5W) over 6 hours. Choice B, 100 mL/hr, is incorrect as it does not match the correct calculation. Choice C, 150 mL/hr, is incorrect as it is higher than the calculated flow rate. Choice D, 200 mL/hr, is incorrect as it is also higher than the calculated flow rate.

2. A client is taking Warfarin for atrial fibrillation. Which of the following client statements indicates a need for further teaching?

• A. I will avoid eating broccoli.
• B. I will use an electric razor to shave.
• C. I will take aspirin for headaches.
• D. I will have my blood tested regularly.

Correct answer: C

Rationale: The correct answer is C. Taking aspirin along with Warfarin can increase the risk of bleeding. Clients should be advised to avoid medications that increase the risk of bleeding when taking Warfarin to prevent complications. Choices A, B, and D are all correct statements indicating good understanding of Warfarin therapy. Avoiding foods high in Vitamin K, using an electric razor to prevent cuts that can lead to bleeding, and regular blood testing to monitor Warfarin levels are all important aspects of managing Warfarin therapy.

3. Which of the following is a potassium-sparing diuretic?

• A. Furosemide
• B. Spironolactone
• C. Hydrochlorothiazide
• D. Bumetanide

Correct answer: B

Rationale: Spironolactone is classified as a potassium-sparing diuretic. It works by antagonizing the aldosterone receptor, leading to potassium retention and sodium excretion. This mechanism makes it a suitable choice for conditions where potassium retention is desired, such as in patients with heart failure or liver cirrhosis. Choices A, C, and D are not potassium-sparing diuretics. Furosemide, hydrochlorothiazide, and bumetanide are loop diuretics and thiazide diuretics, respectively, which promote the excretion of potassium.

4. Which of the following is not a side effect of loop diuretics?

• A. Alkalosis
• B. Nausea
• C. Hypotension
• D. Potassium deficits

Correct answer: B

Rationale: Nausea is not commonly associated with loop diuretics. Loop diuretics are known to cause electrolyte imbalances such as potassium deficits, metabolic alkalosis, and hypotension due to excessive fluid loss. Nausea is not a typical side effect of loop diuretics.

5. A client with chronic renal disease is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

• A. The leukocyte count
• B. The platelet count
• C. The hematocrit (Hct)
• D. The erythrocyte sedimentation rate (ESR)

Correct answer: C

Rationale: The correct answer is C: The hematocrit (Hct). Monitoring the hematocrit is essential to assess the therapeutic effect of epoetin alfa because this medication stimulates red blood cell production in clients with chronic renal disease. The leukocyte count (choice A) and platelet count (choice B) are not directly affected by epoetin alfa therapy. The erythrocyte sedimentation rate (ESR) (choice D) is a non-specific marker of inflammation and is not used to monitor the therapeutic effect of epoetin alfa.

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