Nursing Elites

1. A nurse is caring for a client who has a prescription for a narcotic medication. After administration, the nurse is left with an unused portion. What should the nurse do?

• A. Discard the medication in the trash
• B. Return the medication to the pharmacy
• C. Discard the medication with another nurse as a witness
• D. Store the medication for future use

Correct answer: C

Rationale: The correct action for the nurse to take when left with an unused portion of a narcotic medication is to discard the medication with another nurse as a witness. This procedure ensures accountability and proper disposal of controlled substances. Choice A is incorrect as discarding in the trash can lead to potential misuse or environmental harm. Choice B is incorrect because returning controlled substances to the pharmacy is not the appropriate method for disposal. Choice D is incorrect as storing the medication for future use is not permitted with controlled substances.

2. A nurse is preparing to administer ampicillin 500 mg in 50 mL of dextrose 5% in water (D5W) to infuse over 15 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the nurse set the manual IV infusion to deliver?

• A. 30 gtt/min
• B. 32 gtt/min
• C. 33 gtt/min
• D. 35 gtt/min

Correct answer: C

Rationale: Calculation: 10 gtt/mL × 50 mL ÷ 15 min = 33.33, rounded to 33 gtt/min. This ensures proper delivery of the medication over the prescribed time. Choice A is incorrect because it does not factor in the precise calculation based on the given data. Choice B is incorrect as it does not reflect the accurate rate of infusion required. Choice D is incorrect as it does not align with the correct calculation based on the drop factor and infusion parameters provided in the question.

3. A client prescribed allopurinol for gout is being taught by a nurse. Which of the following should be included in the teaching?

• A. Take the medication with meals.
• B. Drink at least 2 liters of water per day.
• C. Avoid foods high in purines.
• D. Increase your dietary intake of calcium.

Correct answer: B

Rationale: The correct answer is B: 'Drink at least 2 liters of water per day.' Clients taking allopurinol should be instructed to drink plenty of water to prevent kidney stones, a potential side effect of the medication. Option A is incorrect because allopurinol is usually taken without regard to meals. Option C is not directly related to the teaching about allopurinol, as it pertains more to dietary management of gout. Option D is also unrelated to allopurinol use for gout.

4. A client with type 1 DM is being taught about hypoglycemia by a nurse. Which statement by the client indicates an understanding of the teaching?

• A. “Exercise decreases the risk of hypoglycemia.”
• B. “I should skip my insulin if I don't eat.”
• C. “I can drink 4 oz of regular soda if my blood sugar is low.”
• D. “Oral diabetic medications do not lead to hypoglycemia; only insulin does.”

Correct answer: C

Rationale: The correct answer is C because the client should have a quick-acting source of 15 g of carbohydrates to treat hypoglycemic episodes, such as 4 oz of regular soda. Choice A is incorrect because while exercise can help manage blood sugar levels, it can also increase the risk of hypoglycemia if not properly managed. Choice B is incorrect as skipping insulin when not eating can lead to hyperglycemia, not prevent hypoglycemia. Choice D is incorrect because certain oral diabetic medications can indeed cause hypoglycemia, not just insulin.

5. A client is prescribed furosemide. Which of the following is a potential side effect?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hyponatremia
• D. Hypernatremia

Correct answer: B

Rationale: The correct answer is B: Hypokalemia. Furosemide is a loop diuretic that can lead to potassium loss through urine, causing hypokalemia. Hyperkalemia (choice A) is not a side effect of furosemide. Hyponatremia (choice C) and hypernatremia (choice D) are related to sodium levels rather than potassium, and they are not typically associated with furosemide use.

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