Nursing Elites

1. A healthcare provider is caring for four clients. Which of the following tasks can the healthcare provider delegate to an assistive personnel?

• A. Perform chest compressions during cardiac resuscitation
• B. Perform a dressing change for a new amputee
• C. Assess the effectiveness of antiemetic medication
• D. Provide discharge instructions

Correct answer: A

Rationale: Performing chest compressions during cardiac resuscitation is a critical life-saving intervention that can be delegated to an assistive personnel during an emergency. This task requires immediate action and basic training, making it appropriate for delegation. Performing a dressing change for a new amputee involves specialized knowledge and skills, typically performed by licensed healthcare providers. Assessing the effectiveness of medication requires critical thinking and decision-making skills that are within the scope of a licensed healthcare provider. Providing discharge instructions involves educating the patient on post-discharge care and follow-up, which is typically done by a healthcare provider to ensure clear communication and understanding.

2. A healthcare professional is reviewing the results of an ABG performed on a client with chronic emphysema. Which of the following results suggests the need for further treatment?

• A. PaO2 level of 89 mm Hg
• B. PaCO2 level of 55 mm Hg
• C. HCO3 level of 25 mEq/L
• D. pH level of 7.37

Correct answer: B

Rationale: A PaCO2 level of 55 mm Hg indicates hypercapnia, which is common in clients with emphysema but may require further treatment if it leads to respiratory acidosis or distress. Elevated PaCO2 levels can indicate inadequate ventilation and impaired gas exchange, potentially leading to respiratory acidosis. The other results fall within normal ranges or compensated values for a client with chronic emphysema and do not necessarily indicate the need for immediate intervention.

3. A client is found on the floor of their room experiencing a seizure. Which of the following actions is the priority for the nurse?

• A. Place the client on their side with their head forward
• B. Call for help
• C. Protect the client's head
• D. Restrain the client

Correct answer: A

Rationale: During a seizure, the priority action for the nurse is to place the client on their side with their head forward. This position helps maintain an open airway and prevents aspiration, which is crucial in managing the client's safety during a seizure. Calling for help is important but ensuring the client's immediate safety by positioning them correctly takes precedence. Protecting the client's head can be done concurrently while positioning the client. Restraint is not appropriate during a seizure as it can lead to injuries and complications.

4. A nurse is preparing to administer a dose of furosemide. Which of the following should the nurse do before administration?

• A. Check potassium levels
• B. Assess blood glucose levels
• C. Monitor respiratory rate
• D. Administer with food

Correct answer: A

Rationale: The correct answer is to check potassium levels before administering furosemide. Furosemide is a diuretic that can cause hypokalemia (low potassium levels) as a side effect. Monitoring potassium levels is crucial to prevent potential complications related to electrolyte imbalance. Assessing blood glucose levels (choice B) is not directly related to furosemide administration. Monitoring respiratory rate (choice C) is important in certain situations, but it is not the priority before administering furosemide. Administering furosemide with food (choice D) is not a requirement as it can be administered regardless of meals.

5. A nurse is preparing to administer furosemide 4 mg/kg/day PO divided into 2 equal doses daily to a toddler who weighs 22 lb. How many mg should the nurse administer per dose?

• A. 10 mg
• B. 20 mg
• C. 30 mg
• D. 40 mg

Correct answer: B

Rationale: To calculate the correct dose, first, convert the toddler's weight from pounds to kilograms: 22 lb / 2.2 lb/kg = 10 kg. Next, multiply the weight in kilograms by the dosage: 4 mg/kg x 10 kg = 40 mg/day. Since the total daily dose is divided into 2 equal doses, each dose would be 20 mg. Therefore, the correct answer is 20 mg. Choice A (10 mg) is incorrect because it does not account for the correct weight-based dosage. Choice C (30 mg) and Choice D (40 mg) are incorrect as they do not correctly calculate the dose based on the weight of the toddler and the prescribed dosage per kg.

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