Nursing Elites

1. The healthcare provider prescribes an IV infusion of isoproterenol in D5W at 300 mcg/hour. How many ml/hour should the nurse set the pump to?

• A. 100 ml/hour
• B. 75 ml/hour
• C. 60 ml/hour
• D. 125 ml/hour

Correct answer: B

Rationale: To calculate the correct infusion rate, convert 300 mcg/hour to mg/hour (300 mcg = 0.3 mg). Since the IV solution is 1 mg in 250 ml, the rate is calculated as 0.3 mg/hour = 75 ml/hour. Therefore, the nurse should set the pump to 75 ml/hour. Choice A (100 ml/hour) is incorrect as it does not reflect the accurate calculation. Choice C (60 ml/hour) is incorrect as it is lower than the correct rate. Choice D (125 ml/hour) is incorrect as it is higher than the correct rate.

2. A client with chronic kidney disease is prescribed erythropoietin. What lab value should the nurse monitor to evaluate the effectiveness of the therapy?

• A. White blood cell count.
• B. Hemoglobin level.
• C. Serum creatinine level.
• D. Platelet count.

Correct answer: B

Rationale: Erythropoietin therapy stimulates red blood cell production in clients with chronic kidney disease. Hemoglobin levels should be monitored to assess the effectiveness of the therapy and ensure the client is not developing anemia. Increased hemoglobin levels indicate successful treatment, whereas very high levels may suggest erythropoietin is overcorrecting the anemia. Monitoring the white blood cell count is not directly related to erythropoietin therapy for anemia. Serum creatinine level is used to assess kidney function rather than the effectiveness of erythropoietin therapy. Platelet count is not typically affected by erythropoietin therapy and is not a key indicator of its effectiveness.

3. The charge nurse is planning assignments on a medical unit. Which client should be assigned to the PN?

• A. Test a stool specimen for occult blood
• B. Assist with the ambulation of a client with a chest tube
• C. Irrigate and redress a leg wound
• D. Admit a client from the emergency room

Correct answer: C

Rationale: Irrigating and redressing a leg wound is a common task within the PN's scope of practice, making this assignment appropriate. Tasks like testing stool specimens for occult blood and assisting with ambulation of a client with a chest tube may require a higher level of training and assessment, typically performed by RNs. Admitting a client from the emergency room involves a comprehensive assessment and decision-making process, which is usually within the RN's responsibility.

4. A client with diabetes mellitus reports tingling in their feet. What is the nurse's best intervention?

• A. Advise the client to avoid wearing tight shoes.
• B. Refer the client to a podiatrist for foot care.
• C. Teach the client about blood sugar control and foot care.
• D. Administer insulin as prescribed.

Correct answer: C

Rationale: The correct intervention for a client with diabetes mellitus experiencing tingling in their feet is to teach the client about blood sugar control and foot care. This is essential because tingling in the feet can be a sign of neuropathy, a common complication of diabetes. Educating the client on maintaining proper blood sugar levels and foot care practices can help manage neuropathy symptoms and prevent complications like ulcers or infections. Advising the client to avoid tight shoes (Choice A) may help with comfort but does not address the underlying issue. Referring the client to a podiatrist (Choice B) is important for foot care but does not directly address blood sugar control. Administering insulin (Choice D) is not the priority for managing tingling in the feet related to neuropathy.

5. A client with a chest tube following a pneumothorax is complaining of increased shortness of breath. What is the nurse's first action?

• A. Check for kinks in the chest tube tubing.
• B. Assess the client's lung sounds.
• C. Elevate the head of the bed to 30 degrees.
• D. Prepare for chest tube replacement.

Correct answer: C

Rationale: The correct first action for a client with a chest tube experiencing increased shortness of breath is to elevate the head of the bed to 30 degrees. This position promotes lung expansion, improves oxygenation, and can help relieve shortness of breath. Checking for kinks in the chest tube tubing would be important but not the first action in this situation. Assessing the client's lung sounds is also important but not the initial priority. Preparing for chest tube replacement is not indicated based solely on the client's complaint of increased shortness of breath.

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