Nursing Elites

1. A nurse is preparing to administer iron dextran IV to a client. Which of the following actions should the nurse plan to take?

• A. Administer a small test dose before giving the full dose
• B. Infuse the medication over 30 seconds
• C. Monitor client closely for hypertension
• D. Administer cyanocobalamin as an antidote if toxicity occurs

Correct answer: A

Rationale: The correct action the nurse should plan to take when preparing to administer iron dextran IV is to administer a small test dose before giving the full dose. This is done to assess for any allergic reactions that the client may have to the medication. Choice B is incorrect because iron dextran should be infused slowly over a longer period, typically over 1-2 hours to reduce the risk of adverse reactions. Choice C is incorrect because iron dextran administration is more commonly associated with hypotension rather than hypertension. Choice D is incorrect because cyanocobalamin is not used as an antidote for iron dextran toxicity; instead, treatment for iron toxicity may involve supportive care, chelation therapy, or in severe cases, iron antidotes like deferoxamine.

2. 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? (Round the answer to the nearest whole number)

• A. 20 mg
• B. 15 mg
• C. 10 mg
• D. 30 mg

Correct answer: A

Rationale: To calculate the dosage per dose, first, convert the toddler's weight from pounds to kilograms: 22 lb / 2.2 = 10 kg. Then, multiply the weight by the dosage: 4 mg × 10 kg = 40 mg/day. Since this total daily dose is divided into 2 equal doses, the nurse should administer 20 mg per dose. Therefore, the correct answer is 20 mg. Choice B (15 mg) is incorrect because it does not account for the correct weight conversion and dosage calculation. Choice C (10 mg) is incorrect as it only considers the weight conversion but doesn't multiply it by the dosage. Choice D (30 mg) is incorrect as it miscalculates the dosage by not dividing the total daily dose into 2 equal parts.

3. A client with chronic kidney failure and an AV fistula for hemodialysis is prescribed epoetin alfa. Which of the following therapeutic effects should the nurse include in the teaching?

• A. Reduces blood pressure
• B. Inhibits clotting of fistula
• C. Promotes RBC production
• D. Stimulates growth of neutrophils

Correct answer: C

Rationale: The correct answer is C: Promotes RBC production. Epoetin alfa stimulates erythropoiesis (red blood cell production) to treat anemia associated with chronic kidney failure. This helps in increasing the hemoglobin levels and improving oxygen-carrying capacity. Choices A, B, and D are incorrect as epoetin alfa does not have direct effects on reducing blood pressure, inhibiting clotting of the fistula, or stimulating the growth of neutrophils.

4. A nurse is administering insulin glulisine 10 units subcutaneously at 0730 to an adolescent client who has type 1 diabetes mellitus. The nurse should anticipate the onset of action of the insulin at which of the following times?

• A. 0745
• B. 0700
• C. 0645
• D. 0457

Correct answer: A

Rationale: Insulin glulisine has a rapid onset of action, typically around 15 minutes. Therefore, the nurse should expect the onset around 0745. Choice A is correct as it aligns with the expected onset time. Choices B, C, and D are incorrect as they do not match the typical onset time of insulin glulisine.

5. A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication?

• A. Hearing examination
• B. Glucose tolerance test
• C. Electrocardiogram
• D. Pulmonary function tests

Correct answer: C

Rationale: The correct answer is C: Electrocardiogram. Amitriptyline can cause cardiac arrhythmias, so an electrocardiogram is necessary before starting treatment. A hearing examination (choice A) is not required before initiating amitriptyline. A glucose tolerance test (choice B) is not indicated for starting this medication. Pulmonary function tests (choice D) are not necessary before initiating amitriptyline for depression.

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