Nursing Elites

1. A nurse is preparing to insert an IV catheter for an adult client. Which of the following actions should the nurse take?

• A. Choose the most distal site on the selected extremity
• B. Apply a cool compress to the selected extremity before insertion of the IV catheter
• C. Stroke the selected extremity before insertion of the IV catheter
• D. Place the tourniquet above the proposed insertion site

Correct answer: C

Rationale: When preparing to insert an IV catheter, stroking the extremity before insertion helps to visualize veins, making it easier to locate a suitable vein for catheter insertion. Choosing the most distal site on the extremity is correct because veins more distal are preferred for IV catheter insertion. Applying a cool compress to the extremity before insertion is unnecessary and not a standard practice. Placing the tourniquet below the proposed insertion site is incorrect; the tourniquet should be placed above the proposed insertion site to help engorge the veins for easier visualization and access.

2. A healthcare professional is preparing to administer metoprolol 200 mg PO daily. The medication available is metoprolol 100 mg/tablet. How many tablets should the healthcare professional administer? (Round the answer to the nearest whole number. Do not use a trailing zero.)

• A. 1 tablet
• B. 2 tablets
• C. 0.5 tablet
• D. 4 tablets

Correct answer: B

Rationale: To administer 200 mg of metoprolol using 100 mg tablets, the healthcare professional should give 2 tablets. Each tablet contains 100 mg of metoprolol, so 2 tablets will provide the required 200 mg dose. Choice A is incorrect because 1 tablet would only provide 100 mg, which is insufficient. Choice C is incorrect as fractions of tablets are usually not used in practice to ensure accurate dosing. Choice D is incorrect as it would result in an overdose, providing 400 mg instead of the prescribed 200 mg.

3. The healthcare provider prescribes 1,000 ml of Ringer's Lactate with 30 Units of Pitocin to run over 4 hours for a client who has just delivered a 10-pound infant by cesarean section. The tubing has been changed to a 20 gtt/ml administration set. The LPN/LVN plans to set the flow rate at how many gtt/min?

• A. 42 gtt/min
• B. 83 gtt/min
• C. 125 gtt/min
• D. 250 gtt/min

Correct answer: B

Rationale: To calculate the flow rate in drops per minute (gtt/min), the formula is Total volume (mL) ÷ Time (min) ÷ Drop factor (gtt/mL). In this case, 1000 mL ÷ 240 min ÷ 20 gtt/mL = 83 gtt/min. Therefore, setting the flow rate to 83 gtt/min ensures the correct administration of the IV fluids and medication. Choices A, C, and D are incorrect as they do not align with the correct calculation based on the provided information.

4. When evaluating a client's use of a cane, which action should the nurse identify as an indication of correct use?

• A. The client's stronger side holds the cane
• B. The top of the cane is parallel to the client's waist
• C. The client holds the cane on the stronger side of their body
• D. The client moves the cane 46 cm (18 in) forward

Correct answer: C

Rationale: The correct way to use a cane is to hold it on the stronger side of the body. This helps to provide support and maintain alignment. Option A is incorrect because the cane should be held on the stronger side, not the weaker side. Option B is incorrect as the top of the cane should be at the level of the greater trochanter, not the waist. Option D is incorrect because the client should move the weaker limb forward with the cane for stability.

5. A middle-aged adult in a clinical setting mentions being at average risk for colon cancer and asks about routine screening. What should the nurse recommend?

• A. Performing a blood sample for a screening test.
• B. Scheduling a colonoscopy starting at age 60.
• C. Undergoing a fecal occult blood test annually.
• D. Having a sigmoidoscopy every 10 years.

Correct answer: C

Rationale: The correct answer is C. Colorectal cancer screening for individuals at average risk typically begins at age 50. One of the recommended options for routine screening is a fecal occult blood test done annually. Choice A is incorrect as blood samples are not used for routine colorectal cancer screening. Choice B is incorrect because colonoscopies usually start at age 50, not 60. Choice D is incorrect as sigmoidoscopies are recommended every 5 years, not every 10 years, for individuals at average risk for colon cancer.

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