Nursing Elites

1. The doctor has ordered 20 cc per hour of normal saline intravenously for your pediatric patient. You will be using pediatric intravenous tubing that delivers 60 cc per drop. How many drops per minute will you administer using this pediatric intravenous set?

• A. 30 drops per minute
• B. 25 drops per minute
• C. 20 drops per minute
• D. 22 drops per minute

Correct answer: C

Rationale: To calculate the drops per minute, first convert the ordered amount to drops per minute. 20 cc per hour equals 20 drops per hour with 60 cc per drop tubing, which is equivalent to 20 drops per hour * 60 cc per drop = 1200 drops per hour. To find drops per minute, divide 1200 by 60 (minutes in an hour), which equals 20 drops per minute. Therefore, the correct answer is 20 drops per minute. Choices A, B, and D are incorrect as they do not reflect the correct calculation based on the provided information.

2. A nurse in the emergency department is preparing to care for a client who arrived via ambulance. The client is disoriented and has a cardiac arrhythmia. Which of the following actions should the nurse take?

• A. Proceed with treatment without obtaining written consent
• B. Contact the client's next of kin to obtain consent for treatment
• C. Have the client sign a consent for treatment
• D. Notify risk management before initiating treatment

Correct answer: A

Rationale: In emergency situations where a client is disoriented and has a cardiac arrhythmia, obtaining written consent may not be possible due to the urgency of the situation. The priority is to provide immediate treatment to ensure patient safety. Contacting the next of kin or having the client sign a consent form would cause unnecessary delays in providing critical care. Notifying risk management before initiating treatment is not the most appropriate action when dealing with a time-sensitive situation like a cardiac arrhythmia.

3. Which of the following is the best way for a nurse to improve quality of care?

• A. Recognize that physicians are among the health-care professionals interested in improving quality of care.
• B. Work with patients and families to improve healthcare.
• C. Collaborate with other health-care professionals, patients, and their families.
• D. Recognize that physicians are among the numerous professionals in health care.

Correct answer: C

Rationale: The best way for a nurse to improve the quality of care is by collaborating with other health-care professionals, patients, and their families. By working together with the healthcare team, patients, and families, nurses can ensure a holistic approach to care delivery, leading to better outcomes. Choices A and D are incorrect as they focus solely on physicians, while choice B, though important, does not fully encompass the collaborative aspect necessary for comprehensive care.

4. A client with DM has an above-knee amputation because of severe peripheral vascular disease. Two days following surgery, when preparing the client for dinner, what is the nurse's primary responsibility?

• A. Check the client's serum glucose level
• B. Assist the client out of bed to the chair
• C. Place the client in a high-Fowler's position
• D. Ensure that the client's residual limb is elevated

Correct answer: A

Rationale: The correct answer is to check the client's serum glucose level. In a client with diabetes who just had surgery, monitoring the serum glucose level is crucial to ensure proper management of the condition. This helps in preventing complications related to blood sugar fluctuations. Assisting the client out of bed may be important but not the primary responsibility at this time. Placing the client in a high-Fowler's position or ensuring the residual limb is elevated are important interventions for comfort and circulation but are not the primary concern in this scenario.

5. A nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which of the following clinical manifestations would the nurse expect to note in the client?

• A. Twitching
• B. Positive Trousseau's sign
• C. Hyperactive bowel sounds
• D. Hyperactive deep tendon reflexes

Correct answer: A

Rationale: The correct answer is A: Twitching. Hypocalcemia often presents with neuromuscular irritability, leading to manifestations such as twitching. Trousseau's sign is actually a positive indicator of hypocalcemia, not negative, making choice B incorrect. Hypoactive bowel sounds are not typically associated with hypocalcemia, making choice C incorrect. Similarly, hypoactive deep tendon reflexes are not a common finding in hypocalcemia, making choice D incorrect.

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