Nursing Elites

1. A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40mg daily, but the client reports she has been taking extra doses to promote weight loss. Which of the following indicates she is dehydrated?

• A. Urine specific gravity of 1.035
• B. Urine specific gravity of 444
• C. Urine specific gravity of 2000
• D. Urine specific gravity of 1111.1

Correct answer: A

Rationale: A urine specific gravity greater than 1.030 indicates dehydration. In this case, a urine specific gravity of 1.035 suggests concentrated urine, indicating dehydration. Choices B, C, and D have values that are not within the normal range for urine specific gravity and do not indicate dehydration. A urine specific gravity of 444, 2000, or 1111.1 are not physiologically possible values and are therefore incorrect.

2. A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching?

• A. Take hydrochlorothiazide as needed for edema.
• B. Check your weight once weekly.
• C. Take the hydrochlorothiazide on an empty stomach.
• D. Take the hydrochlorothiazide in the morning.

Correct answer: D

Rationale: The correct answer is to take hydrochlorothiazide in the morning. This medication is usually advised to be taken in the morning to prevent nocturia, which is excessive urination at night. Option A is incorrect because hydrochlorothiazide should be taken daily as prescribed, not as needed for edema. Option B is incorrect as monitoring weight weekly may not be specifically related to hydrochlorothiazide therapy. Option C is incorrect as hydrochlorothiazide does not need to be taken on an empty stomach.

3. A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the client reports she has been taking extra doses to promote weight loss. Which of the following indicates she is dehydrated?

• A. Urine specific gravity of 1.035
• B. Oliguria
• C. Increased urine concentration
• D. Dry mucous membranes

Correct answer: A

Rationale: The correct answer is A: Urine specific gravity of 1.035. A urine specific gravity greater than 1.030 indicates dehydration as the kidneys conserve water in response to dehydration. Choice B, oliguria, refers to decreased urine output, which can be a sign of dehydration but is not specific to it. Choice C, increased urine concentration, is a general term and does not directly indicate dehydration. Choice D, dry mucous membranes, can be a sign of dehydration but is not as specific as a urine specific gravity greater than 1.030.

4. A nurse is preparing to administer ampicillin 500 mg in 50 ml of dextrose 5% in water (D5W) to infuse over 15 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the nurse set the manual IV infusion to deliver? (Round to the nearest whole number)

• A. 33 gtt/min
• B. 66 gtt/min
• C. 10 gtt/min
• D. 14 gtt/min

Correct answer: A

Rationale: To calculate the IV flow rate, you multiply the drop factor (10 gtt/mL) by the volume to be infused per minute (50 mL / 15 min). This gives you 10 gtt/mL × 50 mL / 15 min = 33.33. Rounding to the nearest whole number, the nurse should set the manual IV infusion to deliver 33 gtt/min. Choice B (66 gtt/min) is incorrect as it is the result of doubling the correct answer. Choice C (10 gtt/min) is incorrect as it only considers the drop factor without accounting for the volume to be infused. Choice D (14 gtt/min) is incorrect as it miscalculates the infusion rate based on the given information.

5. A nurse is providing discharge teaching to a client who has heart failure and a new prescription for digoxin 0.215 mg PO daily and furosemide 20 mg PO daily. Which of the following statements by the client indicates an understanding of the teaching?

• A. I know that blurred vision is something I will expect to happen while taking digoxin.
• B. I will measure my urine output each day and document it in my diary.
• C. I will skip a dose of my digoxin if my resting heart rate is below 72 beats per minute.
• D. I will eat fruits and vegetables that have high potassium content every day.

Correct answer: D

Rationale: Clients taking digoxin and furosemide are at risk for hypokalemia. Eating potassium-rich foods can help maintain normal potassium levels.

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