Nursing Elites

1. Seconal 0.1 gram PRN at bedtime is prescribed to a client for rest. The scored tablets are labeled 1.5 grains per tablet. How many tablets should the LPN/LVN plan to administer?

• A. 0.5 tablet
• B. 1 tablet
• C. 1.5 tablets
• D. 2 tablets

Correct answer: B

Rationale: To calculate the number of tablets needed, convert the prescribed dose of Seconal from grams to grains. Since 1 gram is equal to approximately 15.43 grains, 0.1 gram is roughly 1.543 grains. Given that each tablet contains 1.5 grains, administering 1 tablet (which is slightly more than the 1.543 grains needed) provides the correct dose of Seconal. Therefore, the LPN/LVN should plan to administer 1 tablet. Choice A (0.5 tablet) is incorrect as it would provide less than the required dose. Choice C (1.5 tablets) and Choice D (2 tablets) are incorrect as they would exceed the necessary dosage.

2. A nurse manager is assigning care of a client who is being admitted from the PACU following thoracic surgery. The nurse manager should assign the client to which of the following staff members?

• A. Charge nurse
• B. Registered nurse (RN)
• C. Practical nurse (PN)
• D. Assistive personnel (AP)

Correct answer: B

Rationale: In this scenario, a client who has undergone thoracic surgery and is being admitted from the PACU requires a high level of nursing care. Registered nurses (RNs) have the education and training necessary to provide the complex care and monitoring needed for a post-thoracic surgery client. Charge nurses may oversee units but may not always be directly involved in providing bedside care. Practical nurses (PNs) have a different scope of practice compared to RNs and may not have the advanced skills needed for post-thoracic surgery care. Assistive personnel (AP) provide valuable support but do not have the qualifications to manage the care of a client following thoracic surgery.

3. A healthcare provider is monitoring a client for adverse effects following the administration of an opioid. Which of the following effects should the provider identify as an adverse effect of opioids?

• A. Urinary incontinence
• B. Diarrhea
• C. Bradypnea
• D. Orthostatic hypotension

Correct answer: D

Rationale: The correct answer is D: Orthostatic hypotension. Opioids can cause orthostatic hypotension, leading to a sudden drop in blood pressure when changing positions. This effect is due to the vasodilatory properties of opioids, which can result in decreased blood flow to the brain upon standing up. Choices A, B, and C are incorrect. Urinary incontinence and diarrhea are not typical adverse effects of opioids. Bradypnea, or slow breathing, is a potential side effect of opioid overdose or respiratory depression, but it is not a common adverse effect following normal opioid administration.

4. What action should be taken to maintain the patency of a peripherally inserted central catheter (PICC)?

• A. Flush the catheter with heparin solution daily.
• B. Change the dressing at the insertion site daily.
• C. Use sterile technique when changing the dressing.
• D. Keep the insertion site dry at all times.

Correct answer: C

Rationale: The correct answer is to use sterile technique when changing the dressing. This practice is essential for preventing infections that can compromise the patency of the PICC line. While flushing the catheter with heparin solution helps prevent clot formation, it does not directly maintain patency. Changing the dressing daily is important for hygiene but does not have a direct impact on catheter patency. Keeping the insertion site dry is crucial to prevent infections but does not specifically address patency maintenance.

5. A nurse receives a report about a client who has 0.9% sodium chloride infusing IV at 125 mL/hr. When the nurse performs the initial assessment, they note that the client has received only 80 mL over the last 2 hrs. Which of the following actions should the nurse take first?

• A. Check the IV tubing for obstruction
• B. Increase the infusion rate
• C. Administer a bolus of fluid
• D. Replace the IV catheter

Correct answer: A

Rationale: The correct first action for the nurse to take in this situation is to check the IV tubing for obstruction. By doing this, the nurse can assess if there is any blockage or kink in the tubing that is impeding the flow of the IV solution. This step is crucial as it helps in identifying the reason for the inadequate infusion rate. Increasing the infusion rate (Choice B) without first checking for obstructions can lead to potential complications if there is a blockage. Administering a bolus of fluid (Choice C) may not be appropriate without addressing the cause of the decreased infusion rate. Similarly, replacing the IV catheter (Choice D) is not the initial priority unless obstruction is ruled out and other troubleshooting measures have been taken.

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