Nursing Elites

1. A nurse is planning to administer chlorothiazide 20 mg/kg/day PO divided equally and administered twice daily for a toddler who weighs 28.6 lb. How many mL should the nurse administer per dose? (Round to the nearest tenth)

• A. 2.6 mL
• B. 2.2 mL
• C. 3.5 mL
• D. 5.0 mL

Correct answer: A

Rationale: The correct calculation is as follows: The toddler's weight in kg is 13 kg (28.6 lb / 2.2 lb/kg). The total daily dose is 260 mg (20 mg x 13 kg). Therefore, the dose per administration is 130 mg (260 mg / 2). Given the concentration of 250 mg/5 mL, the dose in mL is 2.6 mL (130 mg / (250 mg/5 mL)). Therefore, the nurse should administer 2.6 mL per dose. Choice B, 2.2 mL, is incorrect as it does not reflect the correct calculation. Choices C and D, 3.5 mL and 5.0 mL, are also incorrect and do not align with the accurate dosage calculation based on the given scenario.

2. A nurse manager is teaching a group of employees about QSEN. What statement by an employee should the nurse manager identify as quality improvement?

• A. We should track the rate of hospital-acquired infections.
• B. We should evaluate patient satisfaction scores.
• C. We should start tracking how soon patients are discharged after laparoscopic versus open surgery.
• D. We should check the patient's temperature before discharge.

Correct answer: C

Rationale: The correct answer is C. QSEN focuses on quality improvement in healthcare. Tracking how soon patients are discharged after different types of surgeries helps in evaluating the quality of care provided and identifying areas for improvement. Choices A and B focus on monitoring outcomes but do not directly relate to quality improvement initiatives. Choice D is more about a routine assessment before discharge and does not involve a quality improvement process.

3. A nurse is caring for a client with chronic obstructive pulmonary disease (COPD). Which of the following should the nurse assess for?

• A. Respiratory rate
• B. Chest pain
• C. Use of accessory muscles
• D. Oxygen saturation

Correct answer: C

Rationale: In a client with COPD, the nurse should assess for the use of accessory muscles. This is important because COPD can lead to increased work of breathing, causing the client to engage accessory muscles to help with respiration. Assessing for the use of accessory muscles provides crucial information about the client's respiratory effort. Respiratory rate (Choice A) is a standard assessment parameter but may not specifically indicate the severity of COPD. Chest pain (Choice B) is not typically associated with COPD unless there are complicating factors. Oxygen saturation (Choice D) is essential to monitor in COPD clients, but assessing for the use of accessory muscles takes priority as it directly reflects the client's respiratory status in COPD.

4. A client with rheumatoid arthritis is taking prednisone. Which of the following findings should the nurse identify as an adverse effect of this medication?

• A. Weight loss
• B. Hypoglycemia
• C. Hypertension
• D. Hyperkalemia

Correct answer: C

Rationale: The correct answer is C: Hypertension. Prednisone, a corticosteroid, can lead to hypertension as an adverse effect. Prednisone can cause sodium and water retention, leading to increased blood pressure. Options A, B, and D are incorrect. Weight loss is not typically associated with prednisone use; instead, weight gain is more common. Hypoglycemia is not a common adverse effect of prednisone; in fact, it can elevate blood sugar levels. Hyperkalemia is also not a typical adverse effect of prednisone; instead, it can cause hypokalemia, or low potassium levels.

5. A healthcare professional is assessing a client for signs of stroke. Which of the following should the healthcare professional look for?

• A. Slurred speech
• B. Increased appetite
• C. Elevated heart rate
• D. Hyperactivity

Correct answer: A

Rationale: Corrected Question: A healthcare professional is assessing a client for signs of stroke. Slurred speech is a common sign of stroke and should be assessed immediately. Choices B, C, and D are incorrect because increased appetite, elevated heart rate, and hyperactivity are not typical signs of a stroke.

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