Nursing Elites

1. A healthcare professional is preparing to administer morphine 4 mg IV to a client. Available is morphine 10 mg/mL. How many mL should the healthcare professional administer?

• A. 0.2 mL
• B. 0.4 mL
• C. 0.6 mL
• D. 0.8 mL

Correct answer: B

Rationale: To administer 4 mg from a solution of 10 mg/mL, the healthcare professional should administer 0.4 mL. The calculation is done by dividing the desired dose (4 mg) by the concentration of the solution (10 mg/mL), which equals 0.4 mL. Choice A (0.2 mL) is incorrect because it is half of the correct calculation. Choice C (0.6 mL) is incorrect because it is 50% more than the correct calculation. Choice D (0.8 mL) is incorrect because it exceeds the correct calculation.

2. A client has a prescription for Desmopressin for the treatment of Diabetes Insipidus. Which of the following instructions should the nurse include in the teaching?

• A. Decrease fluid intake at the start of treatment.
• B. Monitor for nocturia.
• C. Report a weight loss of 0.5 kg (1.1 lb) per week.
• D. Expect permanent polyuria with this medication.

Correct answer: A

Rationale: Desmopressin is a medication used to reduce diuresis in clients with diabetes insipidus. To prevent water intoxication, clients should be advised to decrease fluid intake at the beginning of treatment. This instruction helps to balance fluid levels in the body and prevent potential complications associated with excessive fluid intake while on Desmopressin therapy. Monitoring for signs of fluid retention, such as weight gain, and adjusting fluid intake accordingly are essential components of client education when initiating treatment with Desmopressin.

3. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone. What is the nurse's priority action?

• A. Administering a supplemental dose of hydrocortisone
• B. Instructing the client about coughing and deep breathing
• C. Collecting additional information from the client about his history of Addison's disease
• D. Inserting an indwelling urinary catheter

Correct answer: A

Rationale: The priority action for a client with Addison's disease undergoing surgery who takes hydrocortisone is to administer a supplemental dose of hydrocortisone. Acute adrenal insufficiency (adrenal crisis) is a significant risk during surgery due to the stress placed on the body. Supplemental doses help prevent acute adrenal insufficiency and ensure the client's safety during the surgical procedure. Instructing the client about coughing and deep breathing is important post-operatively but not the priority before surgery. Collecting additional information about the client's history of Addison's disease is relevant but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority action in this scenario.

4. A client has a new prescription for Atenolol. Which of the following client statements indicates an understanding of the teaching?

• A. I should monitor my blood pressure regularly.
• B. I will take this medication at bedtime.
• C. I will take this medication with a high-fat meal.
• D. I should increase my intake of potassium-rich foods.

Correct answer: A

Rationale: The correct answer is A. Clients taking Atenolol, a beta-blocker, should monitor their blood pressure regularly to ensure the medication is effectively managing their condition. Monitoring blood pressure helps in assessing the drug's effectiveness and identifying any potential side effects that may influence blood pressure levels. Choices B, C, and D are incorrect because taking Atenolol at bedtime, with a high-fat meal, or increasing potassium-rich foods intake are not recommended actions associated with this medication and do not demonstrate an understanding of the teaching.

5. A healthcare provider is planning to administer IV Alteplase to a client who is demonstrating manifestations of a massive Pulmonary Embolism. Which of the following interventions should the healthcare provider plan to take?

• A. Administer IM Enoxaparin along with the Alteplase dose.
• B. Hold direct pressure on puncture sites for up to 30 minutes.
• C. Administer Aminocaproic acid IV prior to alteplase infusion.
• D. Prepare to administer Alteplase within 8 hours of manifestation onset.

Correct answer: B

Rationale: When administering IV Alteplase for a massive Pulmonary Embolism, the healthcare provider should plan to hold direct pressure on puncture sites for 10 to 30 minutes or until oozing of blood stops. This is crucial to prevent bleeding complications at the puncture sites. Choice A is incorrect because Enoxaparin is not usually administered along with Alteplase for a Pulmonary Embolism. Choice C is incorrect because Aminocaproic acid is not typically given prior to alteplase infusion in this situation. Choice D is incorrect because Alteplase should be administered within 2 hours of onset of manifestations for Pulmonary Embolism, not within 8 hours.

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