Nursing Elites

1. A nurse is preparing to administer ampicillin 500 mg IV bolus every 6 hours. Available is ampicillin 500 mg in 50 mL dextrose 5% in water (D5W) to infuse over 20 minutes. The nurse should set the IV pump to deliver how many mL/hr?

• A. 100 mL/hr
• B. 150 mL/hr
• C. 200 mL/hr
• D. 250 mL/hr

Correct answer: B

Rationale: To infuse 50 mL over 20 minutes, the pump should be set to 150 mL/hr. This calculation ensures the correct rate for the infusion of the medication. Choices A, C, and D are incorrect as they do not align with the correct calculation based on the given information.

2. A healthcare provider notices a discrepancy in the narcotics log. What is the appropriate response?

• A. Correct the narcotics log and move on.
• B. Report the discrepancy to the supervisor.
• C. Confront the provider responsible for the discrepancy.
• D. Dispose of the medication and ignore the discrepancy.

Correct answer: B

Rationale: When a healthcare provider notices a discrepancy in the narcotics log, the appropriate response is to report the issue to the supervisor. Reporting discrepancies is crucial to maintain accountability and prevent potential misuse. Choice A is incorrect because simply correcting the log without addressing the underlying issue does not ensure accountability. Choice C is inappropriate as confronting the provider directly may not be the best approach and could lead to a confrontational situation. Choice D is highly inappropriate as ignoring the discrepancy and disposing of medication without proper documentation can lead to serious consequences.

3. A nurse is caring for a client who is requesting to leave the facility against medical advice (AMA). The client states, 'I am ready to go immediately.' Which of the following actions should the nurse take first?

• A. Teach the client about the potential health risks of leaving early
• B. Ask the client to sign a document stating they are leaving AMA
• C. Document the client's statement in direct quotes in the medical record
• D. Complete an incident report detailing the client scenario

Correct answer: A

Rationale: The correct action for the nurse to take first is to educate the client about the potential health risks of leaving against medical advice (AMA). By providing this information, the nurse can help the client make an informed decision regarding their healthcare. Choice B, asking the client to sign a document, can be done after the client has been informed about the risks. Choice C, documenting the client's statement, is important but should not take precedence over educating the client. Choice D, completing an incident report, is not the priority when a client is requesting to leave AMA.

4. The nurse is evaluating the effectiveness of guided imagery for pain management in a patient with second- and third-degree burns requiring extensive dressing changes. Which finding best indicates the effectiveness of guided imagery?

• A. The patient's need for analgesic medication decreases during the dressing changes.
• B. The patient rates pain during the dressing change as a 6 on a scale of 0 to 10.
• C. The patient asks for pain medication during the dressing changes only once throughout the procedure.
• D. The patient's facial expressions remain stoic during the procedure.

Correct answer: A

Rationale: The correct answer is A. A reduction in the need for analgesic medication indicates that guided imagery is effective in managing the patient's pain. Choices B, C, and D do not directly measure the effectiveness of guided imagery. A patient rating pain as 6 on a scale of 0 to 10, asking for pain medication once, or having stoic facial expressions may not necessarily reflect the impact of guided imagery on pain management.

5. A patient reports nausea and vomiting after chemotherapy. What is the nurse's priority action?

• A. Administer an antiemetic as prescribed.
• B. Encourage the patient to eat small, frequent meals.
• C. Provide the patient with anti-nausea wristbands.
• D. Encourage the patient to rest after eating.

Correct answer: A

Rationale: The correct answer is to administer an antiemetic as prescribed. Chemotherapy-induced nausea and vomiting can be distressing for patients. Administering an antiemetic helps alleviate these symptoms effectively. Choice B, encouraging the patient to eat small, frequent meals, may be helpful for other gastrointestinal issues but is not the priority when the patient is experiencing nausea and vomiting. Choice C, providing anti-nausea wristbands, may offer some relief but is not as direct and immediate as administering an antiemetic. Choice D, encouraging the patient to rest after eating, is not the priority in this situation where the focus should be on managing the nausea and vomiting.

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