Nursing Elites

1. What action should the nurse implement to prepare a client for the potential side effects of a newly prescribed medication?

• A. Assess the client for health alterations that may be impacted by the effects of the medication
• B. Teach the client how to administer the medication to promote the best absorption
• C. Administer a half dose and observe the client for side effects before administering a full dosage
• D. Encourage the client to drink plenty of fluids to promote effective drug distribution

Correct answer: A

Rationale: Before initiating a new medication, the nurse should conduct a thorough assessment of the client to identify any pre-existing health conditions or risk factors that could be affected by the medication. This assessment helps in establishing a baseline for monitoring potential side effects and determining the medication's appropriateness for the client. Choice B is incorrect as teaching the client how to administer the medication does not directly address preparing for potential side effects. Choice C is incorrect because administering a half dose without a proper assessment could be unsafe. Choice D is incorrect as encouraging fluid intake is not directly related to preparing for potential side effects of a medication.

2. A client is admitted with a diagnosis of left-sided heart failure. Which assessment finding is most consistent with this diagnosis?

• A. Dependent edema.
• B. Ascites.
• C. Nocturia.
• D. Orthopnea.

Correct answer: D

Rationale: Orthopnea (D) is most consistent with left-sided heart failure. It is characterized by difficulty breathing when lying flat and is relieved by sitting up or standing. Dependent edema (A), ascites (B), and nocturia (C) are more commonly associated with right-sided heart failure. Dependent edema refers to swelling due to fluid accumulation, ascites is the accumulation of fluid in the peritoneal cavity, and nocturia is the excessive need to urinate during the night, all of which are more indicative of right-sided heart failure.

3. How many drops per minute should a client weighing 182 pounds receive if a nurse mixes 50 mg of Nipride in 250 ml of D5W and plans to administer the solution at a rate of 5 mcg/kg/min? The drip factor is 60 gtt/ml.

• A. 31 gtt/min.
• B. 62 gtt/min.
• C. 93 gtt/min.
• D. 124 gtt/min.

Correct answer: D

Rationale: To determine the drops per minute for the client, first convert the client's weight from pounds to kilograms: 182/2.2 = 82.73 kg. Calculate the dosage by multiplying 5 mcg by the client's weight in kg: 5 mcg/kg/min × 82.73 kg = 413.65 mcg/min. Find the concentration of the solution in mcg/ml by dividing 250 ml by 50,000 mcg (50 mg): 250 ml/50,000 mcg = 200 mcg/ml. As the client needs 413.65 mcg/min and the solution is 200 mcg/ml, the client should receive 2.07 ml per minute. Finally, using the drip factor of 60 gtt/ml, multiply the ml per minute by the drip factor: 60 gtt/ml × 2.07 ml/min = 124.28 gtt/min, which rounds to 124 gtt/min. Therefore, the client should receive 124 drops per minute. Choice D is the correct answer. Choices A, B, and C are incorrect because they do not reflect the accurate calculation based on the client's weight, dosage, concentration of the solution, and drip factor.

4. UAP has lowered the head of the bed to change the linens for a client who is bedbound with a foley catheter and enteral tube feeds. Which change from the client warrants the most immediate intervention by the nurse?

• A. A feeding is infusing at 40 mL/hr through an enteral feeding tube
• B. The urine meter attached to the urinary drainage bag is completely full
• C. There is a large dependent loop in the client’s urinary drainage tubing
• D. Purulent drainage is present around the insertion site of the feeding tube

Correct answer: D

Rationale: Purulent drainage indicates infection at the insertion site, which requires immediate attention to prevent complications.

5. A healthcare professional stops at a motor vehicle collision site to render aid until the emergency personnel arrive and applies pressure to a groin wound that is bleeding profusely. Later, the client has to have the leg amputated and sues the healthcare professional for malpractice. What is the most likely outcome of this lawsuit?

• A. The Patient's Bill of Rights protects clients from malicious intents, so the healthcare professional could lose the case.
• B. The lawsuit may be settled out of court, but the healthcare professional's license is likely to be revoked.
• C. There will be no judgment against the healthcare professional, whose actions were protected under the Good Samaritan Act.
• D. The client will win because the four elements of negligence (duty, breach, causation, and damages) can be proved.

Correct answer: C

Rationale: The Good Samaritan Act protects healthcare professionals who provide care in good faith and offer reasonable assistance in emergencies. This law shields them from malpractice claims, even if the outcome for the client is unfavorable. In this scenario, the healthcare professional is likely to be protected from judgment under the Good Samaritan Act. Choice A is incorrect because the situation does not involve the Patient's Bill of Rights, but rather the Good Samaritan Act. Choice B is incorrect as the license revocation is not a typical outcome in Good Samaritan cases. Choice D is incorrect as the Good Samaritan Act provides immunity from liability in such emergency situations.

Similar Questions