Nursing Elites

1. An infant weighed 7 pounds 8 ounces at birth. If growth occurs at a normal rate, what would be the expected weight at 6 months of age?

• A. Double the birth weight
• B. Triple the birth weight
• C. Gain 6 ounces each week
• D. Add 2 pounds each month

Correct answer: A

Rationale: Infants typically double their birth weight by 6 months of age as part of normal growth and development. This doubling of weight is a common milestone used by healthcare providers to assess a baby's growth progress. Tripling the birth weight or adding 2 pounds each month would result in excessive weight gain, which is not typical or healthy for an infant. Similarly, gaining 6 ounces each week would also lead to rapid and abnormal weight gain, making it an incorrect choice.

2. The parents of a 2-year-old child who had an orchiopexy to correct cryptorchidism are provided with discharge instructions by the nurse. Which statement by the parents indicates the need for further instruction?

• A. I'll check his temperature.
• B. I'll give him medication so he'll be comfortable.
• C. I'll check his voiding to be sure there's no problem.
• D. I'll let him decide when to return to his play activities.

Correct answer: D

Rationale: Cryptorchidism is a condition where one or both testes fail to descend into the scrotal sac. Orchiopexy, a surgical correction, may be required. After surgery, it is crucial to restrict vigorous activities for 2 weeks to promote healing and prevent injury. Allowing the child to decide when to return to play activities may lead to delayed healing and increased risk of injury, as 2-year-olds typically want to be active. Checking the child's temperature, administering analgesics as needed, and monitoring urine output are important postoperative care measures to ensure recovery and detect complications early. Therefore, the statement indicating the need for further instruction is the one related to letting the child decide when to resume play activities.

3. A couple asks the nurse about risks of several birth control methods. What is the most appropriate response by the nurse?

• A. Norplant is safe and can be easily removed.
• B. Oral contraceptives should not be used by smokers.
• C. Depo-Provera is convenient with few side effects.
• D. The IUD provides protection against pregnancy and infection.

Correct answer: B

Rationale: The correct answer is that oral contraceptives should not be used by smokers. The use of oral contraceptives in a woman who smokes increases the risk of cardiovascular problems, such as thromboembolic disorders. This is due to the combined effect of smoking and hormonal contraceptives. Choices A, C, and D are incorrect because they do not address the specific risk associated with smoking and oral contraceptives. Norplant's safety and ease of removal, Depo-Provera's convenience with few side effects, and the IUD's protection against pregnancy and infection are important points but not directly related to the increased risks for smokers using oral contraceptives.

4. A serum potassium level of 3.2 mEq/L (3.2 mmol/L) is reported for a patient with cirrhosis who has scheduled doses of spironolactone (Aldactone) and furosemide (Lasix) due. Which action should the nurse take?

• A. Administer both drugs.
• B. Administer the spironolactone.
• C. Withhold the spironolactone and administer the furosemide.
• D. Withhold both drugs until discussed with the healthcare provider.

Correct answer: B

Rationale: A serum potassium level of 3.2 mEq/L is low (hypokalemia), which can be concerning in a patient with cirrhosis who is already at risk for electrolyte imbalances. Spironolactone is a potassium-sparing diuretic that can help increase the patient's potassium level and correct the hypokalemia. Therefore, the appropriate action for the nurse to take in this scenario is to administer the spironolactone. Withholding the spironolactone could further lower the potassium level. Furosemide, on the other hand, is a loop diuretic that can lead to potassium loss and worsen hypokalemia; hence, it should be withheld until the nurse discusses the situation with the healthcare provider. While the healthcare provider should be informed about the low potassium value, immediate administration of spironolactone is necessary to address the hypokalemia in this patient population.

5. You are responsible for reviewing the nursing unit's refrigerator. Which of the following drugs, if found inside the fridge, should be removed?

• A. Nadolol (Corgard)
• B. Opened (in-use) Humulin N injection
• C. Urokinase (Kinlytic)
• D. Epoetin alfa IV (Epogen)

Correct answer: A

Rationale: Nadolol (Corgard) should be removed if found inside the fridge because it is supposed to be stored at room temperature between 59 to 86 �F (15 and 30 �C) away from heat, moisture, and light. Storing it in the refrigerator can alter its effectiveness and stability. Option B, the opened Humulin N injection, should not be stored in the refrigerator as it is an in-use product and can remain at room temperature for a certain period as per manufacturer guidelines. Option C, Urokinase (Kinlytic), and Option D, Epoetin alfa IV (Epogen), do not require refrigeration and can be stored at room temperature. Therefore, Nadolol (Corgard) is the drug that should be removed from the fridge.

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