Nursing Elites

1. 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.

2. A nurse is planning care for a client who had gastric bypass surgery 1 week ago and has signs of early dumping syndrome. Which of the following findings should the nurse expect?

• A. Facial flushing
• B. Syncope
• C. Diaphoresis
• D. Bradycardia

Correct answer: A

Rationale: Facial flushing is a common symptom of early dumping syndrome, which occurs when food moves too quickly into the small intestine. This rapid movement triggers the release of vasoactive peptides causing vasodilation, leading to facial flushing. Syncope (choice B) is not a typical finding in early dumping syndrome. Diaphoresis (choice C) and bradycardia (choice D) are also not characteristic symptoms of early dumping syndrome.

3. A nurse is preparing to administer a dose of digoxin to a client who has heart failure. Which of the following actions should the nurse take prior to administering the medication?

• A. Monitor the client's respiratory rate.
• B. Assess the client's apical pulse.
• C. Review the client's potassium level.
• D. Monitor the client's fluid intake.

Correct answer: B

Rationale: The correct action the nurse should take prior to administering digoxin is to assess the client's apical pulse. Digoxin is known to affect the heart rate, potentially causing bradycardia. Monitoring the client's respiratory rate (Choice A) is not directly related to administering digoxin. Reviewing the client's potassium level (Choice C) is important but not a direct prerequisite for administering digoxin. Monitoring the client's fluid intake (Choice D) is also important but not a specific action to take just before administering digoxin.

4. A client who is 48 hours postoperative following abdominal surgery is being assessed by a nurse. Which of the following findings should the nurse report to the provider?

• A. Heart rate of 80/min
• B. Sanguineous drainage on the surgical dressing
• C. Temperature of 37.5°C (99.5°F)
• D. Serous drainage on the surgical dressing

Correct answer: B

Rationale: Sanguineous drainage from the surgical site 48 hours after surgery could indicate a complication such as hemorrhage or infection and should be reported. Sanguineous drainage is typically seen in the early postoperative period due to the presence of blood. Serous drainage, on the other hand, is normal in the later stages of wound healing. A heart rate of 80/min is within the normal range for an adult. A temperature of 37.5°C (99.5°F) is slightly elevated but not a concerning finding in the absence of other symptoms.

5. A nurse is assessing a client who is receiving a continuous heparin infusion. Which of the following findings should the nurse report to the provider?

• A. Platelet count of 200,000/mm³
• B. aPTT of 50 seconds
• C. Hemoglobin of 14 g/dL
• D. INR of 1.0

Correct answer: D

Rationale: The correct answer is D because an INR of 1.0 is below the therapeutic range for clients receiving heparin, indicating a potential need for dosage adjustment. Platelet count (choice A) within normal range, aPTT (choice B) within therapeutic range, and hemoglobin level (choice C) are not directly related to the monitoring of heparin therapy and would not require immediate reporting to the provider.

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