Nursing Elites

1. How should a healthcare professional respond to a patient who is experiencing confusion after surgery?

• A. Administer oxygen
• B. Reposition the patient
• C. Encourage deep breathing exercises
• D. Perform a neurological exam

Correct answer: A

Rationale: Administering oxygen is the most appropriate initial response to a patient experiencing confusion after surgery. Confusion can be a sign of hypoxia, which is inadequate oxygen supply to the brain. Administering oxygen helps ensure that the patient is getting enough oxygen, addressing a potential cause of the confusion. Repositioning the patient, encouraging deep breathing exercises, or performing a neurological exam may be necessary depending on the situation, but addressing potential hypoxia should be the priority in a confused post-operative patient.

2. A nurse is caring for a client who has severe preeclampsia and is receiving magnesium sulfate intravenously. The nurse discontinues the magnesium sulfate after the client displays toxicity. Which of the following actions should the nurse take?

• A. Position the client supine.
• B. Prepare an IV bolus of dextrose 5% in water.
• C. Administer methylergonovine IM.
• D. Administer calcium gluconate IV.

Correct answer: D

Rationale: Administering calcium gluconate IV is the correct action when a client displays toxicity from magnesium sulfate. Calcium gluconate is used as the antidote for magnesium sulfate toxicity as it counteracts the effects. Positioning the client supine (Choice A) is not the immediate action needed. Administering dextrose 5% in water (Choice B) is not indicated for magnesium sulfate toxicity. Administering methylergonovine IM (Choice C) is used in postpartum hemorrhage, not for magnesium sulfate toxicity.

3. A client who has a new prescription for lisinopril is being taught by a nurse. Which of the following client statements indicates an understanding of the teaching?

• A. I should avoid using salt substitutes while taking this medication.
• B. I should take this medication with food to prevent nausea.
• C. I should increase my intake of potassium-rich foods while taking this medication.
• D. I should limit my fluid intake while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Lisinopril can increase potassium levels, so clients should avoid salt substitutes that contain potassium. Choice B is incorrect because lisinopril is usually taken on an empty stomach. Choice C is incorrect because lisinopril can lead to hyperkalemia, so increasing potassium-rich foods is not recommended. Choice D is incorrect because lisinopril can cause increased urination, so fluid intake should not be limited.

4. A nurse is preparing to administer dopamine hydrochloride 4 mcg/kg/min via continuous infusion. The client weighs 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, use the formula: (4 mcg/kg/min * 80 kg) / 800 mcg in 250 mL = 6 mL/hr. This calculation is based on the dose ordered (4 mcg/kg/min) multiplied by the patient's weight in kg (80 kg), divided by the concentration of the drug available (800 mcg in 250 mL) to be infused over 1 hour. Therefore, the correct answer is 6 mL/hr. Choices B, C, and D are incorrect as they do not reflect the accurate calculation based on the provided information.

5. A nurse is providing teaching to a client who is postoperative following a cataract extraction. Which of the following statements should the nurse include?

• A. You should expect to have eye pain for the first 2 days after surgery.
• B. You should bend at the waist to pick up objects from the floor.
• C. You should avoid sleeping on the side of the body that was operated on.
• D. You should wear an eye shield at night for 2 weeks.

Correct answer: D

Rationale: The correct answer is D. After cataract surgery, wearing an eye shield at night for 2 weeks is essential to protect the eye during the initial healing period. Choice A is incorrect because significant eye pain should not be expected for the first 2 days after surgery. Choice B is incorrect as bending at the waist can increase intraocular pressure, which should be avoided postoperatively. Choice C is incorrect as there is no need to avoid sleeping on the side of the body that was operated on after cataract surgery.

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