Nursing Elites

1. The healthcare provider calculates the IV flow rate for a patient receiving lactated Ringer's solution. The patient needs to receive 2000mL of Lactated Ringer's over 36 hours. The IV infusion set has a drop factor of 15 drops per milliliter. How many drops per minute should the healthcare provider set the IV to deliver?

• A. 8
• B. 10
• C. 14
• D. 18

Correct answer: C

Rationale: To determine the drops per minute, we use the formula Drops Per Minute = (Milliliters x Drop Factor) / Time in Minutes. In this case, Drops Per Minute = (2000mL x 15 drops/mL) / (36 hours x 60 minutes/hour) = 30000 / 2160 = 13.89 (approximately 14). Therefore, the correct answer is 14 drops per minute. Choice A (8), Choice B (10), and Choice D (18) are incorrect as they do not correctly calculate the drops per minute based on the given information.

2. A nurse frequently treats patients in the 72-hour period after a stroke has occurred. The nurse would be most concerned about which of these assessment findings?

• A. INR is 3 seconds long
• B. Heart rate is 110 beats per minute
• C. Intracranial Pressure is 22 mmHg
• D. Blood pressure is 140/80

Correct answer: C

Rationale: The nurse would be most concerned about the assessment finding of an Intracranial Pressure (ICP) reading of 22 mmHg in a patient 72 hours post-stroke. Elevated ICP can indicate increased risk of edema and further brain damage. A target ICP should ideally be maintained at less than or equal to 15-20 mmHg. While the other options may also be important to monitor, an elevated ICP poses a more immediate threat to the patient's neurological status and requires prompt attention.

3. The nurse is caring for a patient who has recently had a successful catheter ablation. Which assessment finding demonstrates a successful outcome of this procedure?

• A. The patient is free of electrolyte imbalances
• B. The patient's WBC count is within normal limits
• C. The patient's EKG reading is regular
• D. The patient's urine output is 45 mL/hour

Correct answer: C

Rationale: A successful outcome of a catheter ablation procedure for arrhythmias, particularly SVT, is indicated by a regular EKG reading. Catheter ablation involves the use of radiofrequency energy to destroy the conduction fiber in the heart responsible for the arrhythmia. This destruction helps in preventing further episodes of arrhythmia. While choices A, B, and D are important assessments in patient care, they are not specific indicators of the success of a catheter ablation procedure. Electrolyte imbalances, WBC count, and urine output can be affected by various factors and are not directly related to the effectiveness of a catheter ablation in treating arrhythmias.

4. The nurse is assigned to care for a child who is scheduled for an appendectomy. Select the prescriptions that the nurse anticipates will be prescribed. Select one that doesn't apply.

• A. Initiate an IV line.
• B. Maintain an NPO status.
• C. Administer a Fleet enema.
• D. Administer intravenous antibiotics.

Correct answer: C

Rationale: For a child scheduled for an appendectomy, the administration of a Fleet enema is not typically required. An IV line is often initiated for fluid and medication administration, maintaining NPO status is necessary to prevent aspiration during surgery, and administering intravenous antibiotics may be part of the preoperative regimen. Therefore, the correct choice that does not apply in this case is administering a Fleet enema.

5. Which interventions should the nurse include when creating a care plan for a child with hepatitis? Select one that doesn't apply.

• A. Providing a low-fat, well-balanced diet.
• B. Teaching the child effective hand-washing techniques.
• C. Notifying the primary health care provider (PHCP) if jaundice is present.
• D. Instructing the parents to avoid administering medications unless prescribed.

Correct answer: D

Rationale: The correct answer is instructing the parents to avoid administering medications unless prescribed. This choice is not directly related to the care of a child with hepatitis. It is essential for the nurse to educate the child and family about providing a low-fat, well-balanced diet to support the liver, teaching effective hand-washing techniques to prevent the spread of infection, and notifying the primary health care provider if jaundice is present to monitor the progression of the disease and adjust the treatment plan accordingly. Avoiding unnecessary medications is crucial, but it should be done under healthcare provider guidance, so the statement should be revised to reflect this aspect. Therefore, the other options are appropriate for the care of a child with hepatitis.

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