Nursing Elites

1. A patient is admitted to the emergency department with hypovolemia. Which IV solution should the nurse anticipate administering?

• A. 3% sodium chloride
• B. 10% dextrose in water
• C. 0.45% sodium chloride
• D. Lactated Ringer's solution

Correct answer: D

Rationale: Lactated Ringer's solution is the most suitable IV solution for a patient with hypovolemia. It is a balanced crystalloid solution containing electrolytes such as sodium, chloride, potassium, calcium, and lactate, which closely resemble the body's natural fluids. This solution helps to restore intravascular volume and electrolyte balance in hypovolemic patients. Choice A, 3% sodium chloride, is a hypertonic solution used for specific situations like severe hyponatremia or cerebral edema, not typically for hypovolemia. Choice B, 10% dextrose in water, is a hypertonic solution primarily used for providing calories and free water, not for volume expansion. Choice C, 0.45% sodium chloride, is a hypotonic solution used for conditions like hypernatremia or as maintenance fluid, not for hypovolemia.

2. A nurse is preparing to delegate bathing and turning of a newly admitted client who has end-stage cancer to an experienced assistive personnel (AP). Which of the following assessments should the nurse make before delegating care?

• A. Is the client's family present so the AP can show them how to turn the client?
• B. Has data been collected about specific client needs related to turning?
• C. Does the AP have time to change the client's central IV line dressing after turning her?
• D. Has the AP checked the client's pain level prior to turning her?

Correct answer: B

Rationale: Before delegating the task of bathing and turning a client with end-stage cancer to an experienced assistive personnel (AP), the nurse must assess specific client needs related to turning. This assessment ensures that the delegated care is tailored to the client's individual requirements, promoting safe and effective care. Option A is incorrect because the presence of the client's family is not directly related to assessing the client's specific needs for turning. Option C is incorrect as it refers to a different task (changing the central IV line dressing) and is not directly related to the turning assessment. Option D is incorrect as checking the client's pain level, although important, is not directly related to the specific needs related to turning the client.

3. In which position will you place your patient when they are demonstrating the signs and symptoms of hypovolemic shock?

• A. The Trendelenburg position
• B. The supine position
• C. The left lateral position
• D. The right lateral position

Correct answer: A

Rationale: The correct answer is A, the Trendelenburg position. This position involves placing the patient with their legs elevated higher than their head. It is used to increase blood flow to the upper body, including the brain and heart, in cases of hypovolemic shock. This helps improve perfusion to vital organs. Choices B, C, and D are incorrect as they do not facilitate the desired redistribution of blood flow needed in hypovolemic shock. The supine position is lying flat on the back, the left lateral position is lying on the left side, and the right lateral position is lying on the right side.

4. A nurse manager observes an assistive personnel (AP) incorrectly transferring a client to the bedside commode. Which of the following should the nurse take first?

• A. Refer the AP to the facility procedure manual
• B. Demonstrate the proper client transfer technique for the AP
• C. Instruct the AP to request assistance when unsure about a task
• D. Help the AP assist the client with the transfer

Correct answer: D

Rationale: The correct first action for the nurse is to ensure the safety of the client by immediately intervening to help the AP with the transfer. This hands-on assistance can prevent any potential harm to the client. Referring the AP to the facility procedure manual (Choice A) might take time and delay the necessary immediate action. Demonstrating the proper technique (Choice B) can be done after ensuring the client's safety. Instructing the AP to request assistance (Choice C) is not the most urgent step when a client's safety is at risk.

5. During which stage of anesthesia is a patient most likely to experience involuntary motor activity?

• A. Stage I
• B. Stage II
• C. Stage III
• D. Stage VI

Correct answer: B

Rationale: The correct answer is Stage II. During Stage II of anesthesia, a patient is most likely to experience involuntary motor activity. This stage is known as the excitement stage, where the patient may exhibit purposeful or involuntary movements. Choice A (Stage I) is incorrect because Stage I is the induction phase where the patient is transitioning from consciousness to unconsciousness, and involuntary motor activity is less likely to occur. Choice C (Stage III) is incorrect as it is the stage of surgical anesthesia characterized by muscle relaxation, and involuntary motor activity is less common during this stage. Choice D (Stage VI) is incorrect as there is no Stage VI in the standard stages of anesthesia. Therefore, the most appropriate stage where involuntary motor activity is likely to occur is Stage II.

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