Nursing Elites

1. A client with a pulmonary embolism is being cared for by a nurse. Which of the following interventions should the nurse include in the plan of care?

• A. Encourage the client to ambulate frequently.
• B. Place the client in a prone position.
• C. Administer anticoagulants as prescribed.
• D. Initiate seizure precautions.

Correct answer: C

Rationale: Administering anticoagulants as prescribed is a crucial intervention for clients with pulmonary embolism to prevent further clot formation. Encouraging the client to ambulate frequently may dislodge the clot and lead to worsening symptoms. Placing the client in a prone position can compromise respiratory function. Initiating seizure precautions is not directly related to the management of pulmonary embolism.

2. A nurse is preparing to administer dopamine hydrochloride 4 mcg/kg/min via continuous infusion. The client weighs 80 kg. How many mL/hr should the nurse set the IV infusion to deliver?

• A. 6 mL/hr
• B. 8 mL/hr
• C. 12 mL/hr
• D. 16 mL/hr

Correct answer: A

Rationale: To calculate the correct rate, use the formula: (4 mcg/kg/min * 80 kg) / 800 mcg in 250 mL = 6 mL/hr. This calculation is based on the dose ordered (4 mcg/kg/min) multiplied by the patient's weight in kg (80 kg), divided by the concentration of the drug available (800 mcg in 250 mL) to be infused over 1 hour. Therefore, the correct answer is 6 mL/hr. Choices B, C, and D are incorrect as they do not reflect the accurate calculation based on the provided information.

3. A nurse is caring for a client who has a new temporary synchronous pacemaker. Which of the following should the nurse report to the provider?

• A. The client's pulse oximetry level is 96%.
• B. The client develops hiccups.
• C. The ECG shows pacing spikes after the QRS complex.
• D. The client's heart rate is 90 beats per minute.

Correct answer: C

Rationale: The correct answer is C. Pacing spikes after the QRS complex indicate a malfunction of the pacemaker and should be reported. Choice A is not directly related to the pacemaker function. Choice B, hiccups, are common and not typically associated with pacemaker issues. Choice D, a heart rate of 90 beats per minute, is within the normal range and does not indicate a pacemaker malfunction.

4. A nurse is teaching a client who has a new prescription for clopidogrel. Which of the following instructions should the nurse include?

• A. Take this medication with meals to prevent nausea.
• B. Avoid drinking alcohol while taking this medication.
• C. Avoid eating foods high in potassium.
• D. Monitor for signs of infection.

Correct answer: D

Rationale: The correct answer is D: 'Monitor for signs of infection.' Clopidogrel affects platelet levels, increasing the risk of bleeding. Therefore, it is essential for clients taking clopidogrel to monitor for signs of infection, which could indicate a lowered immune response. Choices A, B, and C are incorrect because they do not directly relate to the specific monitoring needs associated with clopidogrel therapy.

5. A nurse is providing teaching to a client who has a new diagnosis of osteoporosis and is prescribed alendronate. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Take this medication with a full glass of water after meals.
• C. Take this medication on an empty stomach with a full glass of water.
• D. You can take this medication at any time of day.

Correct answer: C

Rationale: Correct Answer: C. Alendronate should be taken on an empty stomach with a full glass of water to ensure proper absorption. Choice A is incorrect because alendronate should not be taken with food. Choice B is incorrect because alendronate should be taken on an empty stomach, not after meals. Choice D is incorrect because alendronate should be taken at a specific time following the instructions given.

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