Nursing Elites

1. How should a healthcare provider manage a patient with chronic heart failure?

• A. Monitor daily weight
• B. Provide fluid restriction
• C. Administer diuretics
• D. Monitor intake and output

Correct answer: A

Rationale: Corrected Rationale: Daily weight monitoring is crucial in managing patients with chronic heart failure as it helps assess fluid balance. Monitoring daily weight allows healthcare providers to detect any sudden weight gain, which could indicate fluid retention and worsening heart failure. This intervention helps in adjusting treatment plans promptly. Providing fluid restriction (Choice B) can be a part of managing heart failure but is not the primary intervention mentioned in the question. Administering diuretics (Choice C) is a treatment modality for heart failure but does not encompass the comprehensive approach to patient management. Monitoring intake and output (Choice D) is important but does not specifically address the direct assessment of fluid status as daily weight monitoring does.

2. A client has a new prescription for levothyroxine, and a nurse is providing teaching. Which of the following client statements indicates an understanding of the teaching?

• A. ''I should take this medication with food to prevent nausea.''
• B. ''I should take this medication in the evening before bedtime.''
• C. ''I will need to take this medication for the rest of my life.''
• D. ''I should stop taking this medication if I develop a rash.''

Correct answer: C

Rationale: The correct answer is C. Levothyroxine is a lifelong medication for clients with hypothyroidism, and it should be taken as prescribed. Choice A is incorrect because levothyroxine should be taken on an empty stomach. Choice B is incorrect because levothyroxine is usually taken in the morning on an empty stomach. Choice D is incorrect because stopping the medication abruptly can have adverse effects on thyroid function.

3. What is the correct method to teach a patient about self-administration of insulin?

• A. Inject into the upper arm
• B. Rotate injection sites
• C. Use a 45-degree angle for injection
• D. Use a 90-degree angle for injection

Correct answer: D

Rationale: The correct method to teach a patient about self-administration of insulin is to use a 90-degree angle for injection. This angle ensures proper subcutaneous administration of insulin, which is essential for effective absorption. Injecting into the upper arm (Choice A) is not recommended for insulin administration. While rotating injection sites (Choice B) is important to prevent lipodystrophy, the angle of injection is crucial for proper insulin delivery. Using a 45-degree angle (Choice C) is more suitable for intramuscular injections, not for subcutaneous insulin injections.

4. A nurse is preparing to administer dopamine hydrochloride 4 mcg/kg/min via continuous infusion. The client weighs 80 kg. How many mL/hr should the nurse set the IV infusion to deliver?

• A. 6 mL/hr
• B. 8 mL/hr
• C. 12 mL/hr
• D. 16 mL/hr

Correct answer: A

Rationale: To calculate the correct rate, use the formula: (4 mcg/kg/min * 80 kg) / 800 mcg in 250 mL = 6 mL/hr. This calculation is based on the dose ordered (4 mcg/kg/min) multiplied by the patient's weight in kg (80 kg), divided by the concentration of the drug available (800 mcg in 250 mL) to be infused over 1 hour. Therefore, the correct answer is 6 mL/hr. Choices B, C, and D are incorrect as they do not reflect the accurate calculation based on the provided information.

5. A nurse manager is updating protocols for the use of belt restraints. Which of the following guidelines should the nurse include?

• A. Remove the client's restraint every 4 hours.
• B. Document the client's condition every 15 minutes.
• C. Attach the restraint to the bed's side rails.
• D. Request a PRN restraint prescription for clients who are aggressive.

Correct answer: B

Rationale: The correct answer is B. When updating protocols for the use of belt restraints, it is essential to document the client's condition every 15 minutes. This frequent documentation helps ensure the client's safety and allows for timely assessment of the need for continued restraint use. Choice A is incorrect because restraints should be removed and reassessed more frequently than every 4 hours. Choice C is incorrect as restraints should not be attached to the bed's side rails due to entrapment risks. Choice D is also incorrect as restraints should not be used as needed (PRN) but rather based on a specific prescription and assessment indicating the need for restraint use.

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