Nursing Elites

1. A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process?

• A. A second nurse enters the prescription into the client's medical record.
• B. Another nurse should listen to the phone call.
• C. The provider can clarify the prescription when he signs the health record.
• D. I should omit the 'read back' if this is a one-time prescription.

Correct answer: B

Rationale: The correct answer is B: 'Another nurse should listen to the phone call.' When taking a telephone prescription, having another nurse listen to the phone call is essential to prevent errors in communication. This process helps ensure accuracy and reduces the risk of misinterpretation. Choice A is incorrect because entering the prescription into the client's medical record is not related to verifying the accuracy of the telephone prescription. Choice C is incorrect as the provider clarifying the prescription upon signing the health record doesn't address the immediate need for verification during the phone call. Choice D is incorrect because the 'read back' is a crucial step in confirming the accuracy of all prescriptions, regardless of whether they are one-time or recurring.

2. A client with prostate cancer is receiving leuprolide. Which of the following findings should the nurse monitor?

• A. Increased testosterone levels
• B. Increased libido
• C. Gynecomastia
• D. Hypoglycemia

Correct answer: C

Rationale: The nurse should monitor the client for gynecomastia, as it is an adverse effect of leuprolide due to decreased testosterone levels. Leuprolide works by decreasing testosterone production, which can lead to gynecomastia, the development of male breast tissue. Monitoring for this side effect is essential for early detection and intervention.

3. 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.

4. A client is admitted for a surgical procedure. Which preexisting condition can be a contraindication for the use of Ketamine as an intravenous anesthetic?

• A. Peptic ulcer disease
• B. Breast cancer
• C. Diabetes mellitus
• D. Schizophrenia

Correct answer: D

Rationale: Ketamine can produce psychological effects like hallucinations. Patients with schizophrenia may be more prone to experiencing exacerbation of their symptoms when exposed to Ketamine due to its potential to worsen psychotic symptoms. Therefore, schizophrenia can be a contraindication for the use of Ketamine as an anesthetic. Peptic ulcer disease, breast cancer, and diabetes mellitus are not contraindications for the use of Ketamine.

5. What is the therapeutic classification of Furosemide?

• A. Antidiuretics
• B. Diuretics
• C. Anticonvulsants
• D. Antidotes

Correct answer: B

Rationale: Furosemide is classified therapeutically as a diuretic. Diuretics are medications used to promote diuresis, which helps the body get rid of excess salt and water. Furosemide is commonly prescribed to treat conditions such as fluid retention and swelling (edema) associated with congestive heart failure, liver disease, or kidney disorders. Choice A, Antidiuretics, is incorrect as Furosemide acts as a diuretic, promoting the production of urine. Choice C, Anticonvulsants, is also incorrect as Furosemide is not used to treat seizures. Choice D, Antidotes, is incorrect as Furosemide is not an antidote but rather a medication used to treat conditions related to fluid retention.

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