Nursing Elites

1. The healthcare provider prescribes ceftazidime (Fortaz) 35 mg every 8 hours IM for an infant. The 500 mg vial is labeled with the instruction to add 5.3 ml diluent to provide a concentration of 100 mg/ml. How many ml should the nurse administer for each dose?

• A. 0.35 ml
• B. 0.40 ml
• C. 0.50 ml
• D. 0.45 ml

Correct answer: B

Rationale: To calculate the volume to be administered for 35 mg of ceftazidime, divide the prescribed dose by the concentration: 35 mg / 100 mg/ml = 0.35 ml. Rounding off, the nurse should administer 0.4 ml for each dose. Choice A is incorrect as it doesn't consider rounding off. Choice C is incorrect because it's not the correct calculation. Choice D is incorrect as it doesn't reflect the accurate volume needed.

2. An adult male who lives alone is brought to the Emergency Department by his daughter who found him unresponsive. Initial assessment indicated that the client has minimal respiratory effort, and his pupils are fixed and dilated. At the daughter's request, the client is intubated and ventilated. Which nursing intervention has the highest priority?

• A. Notify the client's minister of his condition.
• B. Determine if the client has an executed living will.
• C. Provide the family with information about palliative care.
• D. Discuss the possibility of organ donation with the family.

Correct answer: B

Rationale: Verifying whether the client has an executed living will is crucial to ensuring that his treatment preferences are followed. In this critical situation, knowing the client's wishes regarding medical interventions is paramount. Options A, C, and D are not the highest priority as they do not directly address the immediate need to determine the client's treatment preferences.

3. A woman with an anxiety disorder calls her obstetrician's office and tells the nurse of increased anxiety since the normal vaginal delivery of her son three weeks ago. Since she is breastfeeding, she stopped taking her antianxiety medications, but thinks she may need to start taking them again because of her increased anxiety. What response is best for the nurse to provide this woman?

• A. Describe the transmission of drugs to the infant through breast milk
• B. Encourage her to use stress-relieving alternatives, such as deep breathing exercises
• C. Inform her that some antianxiety medications are safe to take while breastfeeding
• D. Explain that anxiety is a normal response for the mother of a 3-week-old.

Correct answer: C

Rationale: There are several antianxiety medications that are not contraindicated for breastfeeding mothers, so it is important to inform her of this option.

4. The nurse is assessing a client with left-sided heart failure. Which finding requires immediate intervention?

• A. Shortness of breath
• B. Jugular venous distention
• C. Crackles in the lungs
• D. Peripheral edema

Correct answer: C

Rationale: Crackles in the lungs indicate pulmonary congestion in a client with left-sided heart failure and require immediate intervention to prevent respiratory failure. Crackles suggest fluid accumulation in the lungs, leading to impaired gas exchange and potentially respiratory distress. Shortness of breath, jugular venous distention, and peripheral edema are common manifestations of heart failure but do not directly indicate acute respiratory compromise like crackles in the lungs do.

5. A client with a history of chronic heart failure is admitted with shortness of breath. Which assessment finding is most concerning?

• A. Crackles in the lungs
• B. Shortness of breath
• C. Elevated liver enzymes
• D. Heart rate of 100 beats per minute

Correct answer: C

Rationale: Elevated liver enzymes are concerning in a client with chronic heart failure as they may indicate liver congestion or worsening heart failure, requiring immediate intervention. While crackles in the lungs and shortness of breath are common in heart failure, elevated liver enzymes specifically point towards possible liver involvement due to heart failure. A heart rate of 100 beats per minute can be expected in a client with heart failure due to compensatory mechanisms, but elevated liver enzymes signal a more severe condition.

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