Nursing Elites

1. A client with increased intracranial pressure is receiving Mannitol. Which finding should the nurse report to the provider?

• A. Blood glucose 150 mg/dL
• B. Urine output 40 mL/hr
• C. Dyspnea
• D. Bilateral equal pupil size

Correct answer: C

Rationale: The correct answer is C: Dyspnea. Dyspnea is a concerning finding in a client receiving Mannitol as it can be a manifestation of heart failure, which is an adverse effect of the medication. The nurse should promptly notify the provider, discontinue the Mannitol, and initiate appropriate interventions to address the dyspnea and monitor the client's condition closely. Choice A, Blood glucose of 150 mg/dL, is within normal limits and not directly related to Mannitol administration. Choice B, Urine output of 40 mL/hr, could indicate decreased renal perfusion, but it is not the most critical finding compared to dyspnea. Choice D, Bilateral equal pupil size, is a normal neurological finding and not directly related to Mannitol therapy.

2. A healthcare professional is preparing to administer acetaminophen 650 mg PO every 6 hr PRN for pain. The amount available is acetaminophen liquid 500 mg/5 mL. How many mL should the healthcare professional administer per dose?

• A. 6.5 mL
• B. 7 mL
• C. 5 mL
• D. 8 mL

Correct answer: A

Rationale: To calculate the volume to administer: (Desired dose / Concentration) = Volume to administer. In this case, (650 mg / 500 mg) x 5 mL = 6.5 mL. Therefore, the healthcare professional should administer 6.5 mL of acetaminophen per dose to achieve the desired 650 mg dose for pain relief. Choice A is correct because it accurately calculates the volume required based on the concentration of the liquid acetaminophen. Choices B, C, and D are incorrect as they do not reflect the correct calculation based on the concentration of the liquid medication and the desired dose.

3. A healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The healthcare provider should inform the client this medication is contraindicated in which of the following conditions?

• A. Atrophic vaginitis
• B. Dysfunctional uterine bleeding
• C. Osteoporosis
• D. Thrombophlebitis

Correct answer: D

Rationale: Conjugated equine estrogens are contraindicated in individuals with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is a condition characterized by inflammation and blood clot formation in the veins, and estrogen therapy can exacerbate this condition, leading to serious complications such as deep vein thrombosis. Therefore, caution is advised when considering estrogen therapy in clients with a history of thrombophlebitis to prevent adverse outcomes. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and dysfunctional uterine bleeding may actually be conditions for which estrogen therapy is indicated. Osteoporosis can also be managed with estrogen therapy in certain cases to help prevent bone density loss.

4. A client has a prescription for a Nicotine transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch at the same time each day.
• B. Remove the patch at bedtime.
• C. Apply the patch to the same location daily.
• D. Place the patch over an area of the body with hair.

Correct answer: A

Rationale: The correct instruction for a client using a Nicotine transdermal patch is to apply the patch at the same time each day. This helps maintain consistent blood levels of nicotine throughout the treatment period, which can aid in reducing cravings for smoking. Consistency in the application time is essential for the effectiveness of the patch. Choices B, C, and D are incorrect. Removing the patch at bedtime may disrupt the continuous delivery of nicotine, applying the patch to the same location daily can cause skin irritation, and placing the patch over an area with hair may affect its adhesion and absorption.

5. Which of the following conditions is not typically treated with Hydrochlorothiazide?

• A. CHF
• B. HTN
• C. Nephritis
• D. Hypercalciuria

Correct answer: C

Rationale: Nephritis is not commonly treated with Hydrochlorothiazide. Hydrochlorothiazide is primarily used for managing hypertension (HTN) and congestive heart failure (CHF) by reducing blood pressure and fluid retention. It is not a standard treatment for nephritis, which involves inflammation of the kidneys. Hypercalciuria, characterized by excessive calcium excretion in the urine, is not typically treated with Hydrochlorothiazide either.

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