Nursing Elites

1. Low birth weight is defined as a newborn's weight of:

• A. 2500 grams or less at birth, regardless of gestational age.
• B. 1500 grams or less at birth, regardless of gestational age.
• C. 2500 grams or less at birth, according to gestational age.
• D. 1500 grams or less at birth, according to gestational age.

Correct answer: A

Rationale: Low birth weight is defined as 2500 grams or less at birth, regardless of gestational age. This means that any newborn weighing 2500 grams or less is considered to have a low birth weight, irrespective of how many weeks they were in the womb. Choices B, C, and D are incorrect because they specify a weight of 1500 grams or less, which is not the standard definition of low birth weight. The correct definition is 2500 grams or less, not influenced by gestational age.

2. Which statement about adjuvant medications is true and accurate?

• A. Licensed practical nurses can administer adjuvant medications.
• B. Adjuvant medications are schedule 2 narcotics.
• C. Adjuvant medications are schedule 1 narcotics.
• D. Adjuvant medications can be purchased over the counter.

Correct answer: D

Rationale: The correct answer is D because adjuvant medications are often available over the counter without a prescription. Choices A, B, and C are incorrect. Choice A is incorrect because licensed practical nurses can administer adjuvant medications depending on their scope of practice. Choices B and C are incorrect because adjuvant medications are not classified as schedule 1 or schedule 2 narcotics.

3. Jansen is receiving metformin (Glucophage). What will be the best plan of the nurse with regard to patient education with this drug? Select one that does not apply.

• A. It stimulates the pancreas to produce more insulin.
• B. It must be taken after meals.
• C. It decreases sugar production in the liver.
• D. It inhibits absorption of carbohydrates.

Correct answer: A

Rationale: The correct choice that does not apply is A. Metformin does not stimulate the pancreas to produce more insulin; instead, it works by decreasing sugar production in the liver, inhibiting carbohydrate absorption, and reducing insulin resistance. It is recommended to take metformin with meals to reduce gastrointestinal side effects. Option B is incorrect as metformin is usually taken with meals. Option D is also incorrect as metformin does not inhibit the absorption of carbohydrates.

4. You are caring for a patient who has no cognitive functioning but only basic human functions such as opening the eyes and the sleep-wake cycle. What level of consciousness does this patient have?

• A. Obtunded
• B. A persistent vegetative state
• C. Locked-in syndrome
• D. Brain death

Correct answer: B

Rationale: A persistent vegetative state is characterized by the absence of cognitive functioning while basic human functions like the sleep-wake cycle are retained. In this state, the patient shows reflex movements and basic responses to stimuli but lacks awareness or higher mental functions. Choices A, C, and D are incorrect because: A) Obtunded refers to a decreased level of consciousness, not the absence of cognitive functioning. C) Locked-in syndrome is a condition where the patient is aware and awake but cannot move or communicate due to complete paralysis of nearly all voluntary muscles except for vertical eye movements and blinking. D) Brain death is the irreversible cessation of all brain activity, including the brainstem, leading to the loss of all functions of the brain.

5. 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.

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