Nursing Elites

1. A premature infant weighing 1,200 grams at birth receives a prescription for beractant (Survanta) 120 mg endotracheal now and q6 hr for 24 hr. The recommended dose for beractant is 100 mg/kg birth weight per dose. Single-use vials of Survanta are labeled 100 mg/4 ml. What action should the nurse take?

• A. Give 4.8 ml q6 hr
• B. Notify the healthcare provider that the dose is too high
• C. Notify the healthcare provider that the dose is too low
• D. Give 1.2 ml q6 hr

Correct answer: A

Rationale: The correct answer is to give 4.8 ml q6 hr. To calculate the dose, you divide the prescribed dose of 120 mg by the concentration of Survanta, which is 100 mg per 4 ml. This results in 4.8 ml per dose, as 120 mg ÷ 100 mg/4 ml = 4.8 ml. Option B suggesting to notify the healthcare provider that the dose is too high is incorrect because the calculated dose of 4.8 ml is based on the recommended dose of 100 mg/kg birth weight. Option C suggesting to notify the healthcare provider that the dose is too low is incorrect as the calculated dose is based on the correct dosage calculation. Option D suggesting to give 1.2 ml q6 hr is incorrect because it doesn't align with the correct calculation.

2. A client with diabetic peripheral neuropathy has been taking pregabalin for 4 days. Which finding indicates to the nurse that the medication is effective?

• A. Granulating tissue in foot ulcer
• B. Full volume of pedal pulse
• C. Reduced level of pain
• D. Improved visual activity

Correct answer: C

Rationale: The correct answer is C: 'Reduced level of pain.' Pregabalin is used to manage neuropathic pain, so a reduction in pain indicates the medication's effectiveness in this case. Granulating tissue in a foot ulcer and the full volume of a pedal pulse are not direct indicators of pregabalin's effectiveness in managing neuropathic pain. Improved visual activity is not related to the effects of pregabalin in diabetic peripheral neuropathy.

3. An older male resident of a long-term care facility has been scratching his legs for the past 2 days. Which intervention should the nurse implement?

• A. Explain the importance of bathing or showering daily
• B. Encourage fluid intake of at least 2,000 ml daily
• C. Keep the legs covered as much as possible
• D. Apply emollient to the affected area at least twice daily

Correct answer: D

Rationale: The correct intervention for the nurse to implement in this scenario is to apply emollient to the affected area at least twice daily. This is because applying emollients helps address dry skin, which is a common cause of itching in older adults. Explaining the importance of bathing or showering daily (Choice A) may be helpful for general hygiene but may not specifically address the itching. Encouraging fluid intake (Choice B) and keeping the legs covered (Choice C) are not directly related to addressing the itching caused by dry skin.

4. Which action should the school nurse take first when conducting a screening for scoliosis?

• A. Compare dorsal trunk measurements
• B. Have the individual extend arms over the head for visualization
• C. Inspect for symmetrical shoulder height
• D. Observe weight-bearing on each leg

Correct answer: C

Rationale: Inspecting for symmetrical shoulder height is a crucial initial step in screening for scoliosis. Asymmetry in shoulder height can indicate the presence of spinal curvature, which is a key indicator of scoliosis. This assessment is prioritized as it provides a visual clue to potential spinal abnormalities. Choices A, B, and D are not the first steps in scoliosis screening. Choice A involves a more detailed measurement that is not the primary visual indicator for scoliosis; choice B is not a primary indicator of scoliosis but can be used for further examination, and choice D is not directly related to identifying spinal curvature.

5. The nurse provides discharge teaching to a client who was recently diagnosed with diabetes mellitus (DM). After receiving the instructions, the client expresses understanding about when, how, and why to take his prescribed medications at home. Which intervention is most important for the nurse to implement?

• A. Review the purpose of medications prescribed for the client to take home with him
• B. Provide the client with a printed list of medications and a schedule for administration
• C. Send a list of medications taken while hospitalized to the client’s healthcare provider
• D. Offer to consult with the pharmacist about resources for reduced-price medications

Correct answer: B

Rationale: Providing the client with a printed list of medications and a schedule for administration is crucial to ensure adherence and understanding of the medication regimen at home. This intervention helps the client follow the prescribed treatment plan accurately. Choice A is not as essential since the client already understands when, how, and why to take the medications. Choice C is not a priority at this point as the client needs information for home medication management. Choice D, while helpful, is not the most important intervention compared to providing a clear list and schedule for medication administration.

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