Nursing Elites

1. A nurse is caring for a client who wears glasses. What action should the nurse take?

• A. Store the glasses in a labeled case.
• B. Clean the glasses with hot water.
• C. Clean the glasses with a paper towel.
• D. Store the glasses on the bedside table.

Correct answer: A

Rationale: The correct action for the nurse to take is to store the glasses in a labeled case. This helps prevent damage and loss of the glasses, ensuring they are kept safe when not in use. Cleaning the glasses with hot water (choice B) can damage the lenses or frames, while cleaning with a paper towel (choice C) might lead to scratches. Storing the glasses on the bedside table (choice D) increases the risk of misplacement or damage.

2. What is the priority intervention for a patient with fluid overload?

• A. Administer diuretics
• B. Administer IV fluids
• C. Provide oral fluids
• D. Provide chest physiotherapy

Correct answer: A

Rationale: The correct answer is to administer diuretics. Diuretics help reduce excess fluid in cases of fluid overload, making it the priority intervention. Administering additional IV fluids (choice B) would exacerbate the problem by adding more fluid. Providing oral fluids (choice C) is not the priority as the excess fluid needs to be removed first. Chest physiotherapy (choice D) is not the primary intervention for fluid overload.

3. Which electrolyte imbalance is a common concern in patients receiving loop diuretics?

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

Correct answer: C

Rationale: The correct answer is Hypokalemia (Choice C). Loop diuretics can lead to potassium loss in the urine, resulting in hypokalemia. This electrolyte imbalance is a common concern with loop diuretic therapy and necessitates regular monitoring. Hyperkalemia (Choice A) is not typically associated with loop diuretics but with conditions like renal failure. Hyponatremia (Choice B) is more common with thiazide diuretics. Hypercalcemia (Choice D) is not a typical concern with loop diuretic use.

4. A client with chronic kidney disease is being taught about dietary modifications by a nurse. Which of the following foods should the nurse instruct the client to avoid?

• A. Grilled chicken.
• B. Fresh fruit.
• C. White bread.
• D. Cheddar cheese.

Correct answer: D

Rationale: Cheddar cheese is high in phosphorus, which should be avoided by clients with chronic kidney disease. Fresh fruit is generally a healthy choice unless the client needs to limit potassium intake. Grilled chicken is a good protein source for clients with chronic kidney disease. White bread is low in phosphorus and can be included in the diet of clients with kidney disease unless they need to watch their carbohydrate intake.

5. A nurse is preparing to administer dopamine hydrochloride at 4 mcg/kg/min for a client weighing 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, you first need to convert the weight to micrograms: 4 mcg/kg/min * 80 kg = 320 mcg/min. Then, convert micrograms to milligrams: 320 mcg/min / 1000 = 0.32 mg/min. Next, calculate how many milligrams per hour: 0.32 mg/min * 60 min/hr = 19.2 mg/hr. Finally, determine the mL/hr rate by using the concentration provided: 19.2 mg/hr / 800 mg in 250 mL = 6 mL/hr. Therefore, the correct answer is 6 mL/hr. Choice B, 8 mL/hr, is incorrect as it does not reflect the accurate calculation based on the weight and drug concentration. Choices C and D, 12 mL/hr and 16 mL/hr, are also incorrect as they do not align with the correct calculation of the infusion rate for dopamine hydrochloride based on the client's weight and the medication concentration.

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