Nursing Elites

1. The healthcare provider prescribes an IV solution of isoproterenol (Isuprel) 1 mg in 250 ml of D5W at 300 mcg/hour. The nurse should program the infusion pump to deliver how many ml/hour?

• A. 50 ml/hour
• B. 25 ml/hour
• C. 75 ml/hour
• D. 100 ml/hour

Correct answer: C

Rationale: To calculate the infusion rate, convert 1 mg to 1,000 mcg (1 mg = 1,000 mcg) and then use the formula D/H x Q, where D is the desired dose, H is the dose on hand, and Q is the quantity of solution. In this case, it would be 300 mcg/hour / 1,000 mcg x 250 ml = 75 ml/hour. Therefore, the nurse should program the infusion pump to deliver 75 ml/hour. Choice A (50 ml/hour), Choice B (25 ml/hour), and Choice D (100 ml/hour) are incorrect as they do not correspond to the calculated rate of 75 ml/hour.

2. Following routine diagnostic tests, a client who is symptom-free is diagnosed with Paget's disease. Client teaching should be directed toward what important goal for this client?

• A. Maintain adequate cardiac output.
• B. Promote adequate tissue perfusion.
• C. Promote rest and sleep.
• D. Reduce the risk for injury.

Correct answer: D

Rationale: In Paget's disease, bone remodeling is affected, leading to increased risk for fractures. Therefore, the primary goal of client teaching should focus on reducing the risk for injury. Choices A and B are not directly related to the primary concern of Paget's disease, which is bone fractures. Choice C, promoting rest and sleep, is important for overall health but is not the priority when considering the specific risks associated with Paget's disease.

3. The nurse is caring for a client with a tracheostomy who has thick, tenacious secretions. Which assessment finding requires immediate intervention?

• A. Crepitus around the tracheostomy site
• B. Dry and cracked tracheostomy site
• C. Mucous plugging of the tracheostomy tube
• D. Yellowing of the skin around the tracheostomy site

Correct answer: C

Rationale: Mucous plugging of the tracheostomy tube is the most concerning assessment finding in a client with a tracheostomy. It can lead to airway obstruction, which requires immediate intervention to ensure the client's airway remains patent. Crepitus around the tracheostomy site may indicate subcutaneous emphysema but is not as urgent as a blocked airway. A dry and cracked tracheostomy site may indicate poor skin integrity but does not pose an immediate threat to the client's airway. Yellowing of the skin around the tracheostomy site could suggest a localized infection, but it is not as critical as a potential airway obstruction caused by mucous plugging.

4. After checking the fingerstick glucose at 1630, what action should be implemented?

• A. Notify the healthcare provider.
• B. Administer 8 units of insulin aspart SubQ.
• C. Give an IV bolus of Dextrose 50% 50 ml.
• D. Perform quality control on the glucometer.

Correct answer: B

Rationale: Administering insulin aspart (rapid-acting insulin) is the appropriate action to manage the elevated glucose level of 1630. Choice A, notifying the healthcare provider, is not the immediate action needed for this glucose level. Choice C, giving an IV bolus of Dextrose 50%, would exacerbate hyperglycemia instead of treating it. Choice D, performing quality control on the glucometer, is not relevant to the management of the patient's glucose level at this time.

5. The nurse is teaching a male client with multiple sclerosis how to empty his bladder using the Crede Method. When performing a return demonstration, the client applies pressure to the umbilical areas of his abdomen. What instruction should the nurse provide?

• A. Stroke the inner thigh below the perineum to initiate urinary flow
• B. Contract, hold, and then relax the pubococcygeal muscle
• C. Pour warm water over the external sphincter at the distal glans
• D. Apply downward manual pressure at the suprapubic regions

Correct answer: D

Rationale: The client is applying pressure in the wrong region (umbilical area) and should be instructed to apply pressure at the suprapubic area. Applying downward manual pressure at the suprapubic region helps in emptying the bladder effectively by assisting in pushing the urine out through the urethra. Choices A, B, and C are incorrect because they do not address the specific issue of applying pressure to help empty the bladder using the Crede Method.

Similar Questions