Nursing Elites

1. The healthcare professional calculates the IV flow rate for a patient receiving an antibiotic. The patient is to receive 100mL of the antibiotic over 30 minutes. The IV infusion set has a drop factor of 10 drops per milliliter. How many drops per minute should the healthcare professional set the IV to deliver?

• A. 11
• B. 19
• C. 26
• D. 33

Correct answer: D

Rationale: To determine the drops per minute for the IV flow rate, you can use the formula: Drops Per Minute = (Milliliters to be infused x Drop Factor) / Time in Minutes. Substituting the given values, you get 100 mL x 10 drops/mL / 30 minutes = 33 drops per minute. Therefore, the correct answer is 33, as the healthcare professional should set the IV to deliver 33 drops per minute to infuse the antibiotic correctly. Choices A, B, and C are incorrect as they do not match the calculated drops per minute based on the provided values.

2. A 20-year-old female attending college is found unconscious in her dorm room. She has a fever and a noticeable rash. She has just been admitted to the hospital. Which of the following tests is most likely to be performed first?

• A. Blood sugar check
• B. CT scan
• C. Blood cultures
• D. Arterial blood gases

Correct answer: C

Rationale: The most likely test to be performed first in this scenario is blood cultures. Blood cultures are crucial to investigate the fever and rash symptoms in an unconscious patient. This test is used to detect foreign invaders like bacteria, yeast, and other microorganisms in the blood, which could indicate a blood infection (bacteremia). A positive blood culture result confirms the presence of bacteria in the blood. A blood sugar check (choice A) may be important but is less likely to be the first test in this context. A CT scan (choice B) and arterial blood gases (choice D) are generally not the initial tests performed to investigate a fever and rash with altered mental status.

3. The client is seven (7) days post total hip replacement. Which statement by the client requires the nurse's immediate attention?

• A. I have bad muscle spasms in my lower leg of the affected extremity.
• B. I just can't 'catch my breath' over the past few minutes and I think I am in grave danger.
• C. I have to use the bedpan to pass my water at least every 1 to 2 hours.
• D. It seems that the pain medication is not working as well today.

Correct answer: B

Rationale: While all statements by the client require attention, the most critical one that demands immediate action is option B. Clients who have undergone hip or knee surgery are at an increased risk of postoperative pulmonary embolism. Sudden dyspnea and tachycardia are hallmark signs of this condition. Without appropriate prophylaxis such as anticoagulant therapy, deep vein thrombosis (DVT) can develop within 7 to 14 days after surgery, potentially leading to pulmonary embolism. It is crucial for the nurse to recognize signs of DVT, which include pain, tenderness, skin discoloration, swelling, or tightness in the affected leg. Signs of pulmonary embolism include sudden onset dyspnea, tachycardia, confusion, and pleuritic chest pain. Option B indicates a potentially life-threatening situation that requires immediate intervention to prevent serious complications.

4. Which clinical manifestations are recognized in nephrotic syndrome?

• A. Hematuria, bacteriuria, weight gain
• B. Gross hematuria, albuminuria, fever
• C. Hypertension, weight loss, proteinuria
• D. Massive proteinuria, hypoalbuminemia, edema

Correct answer: D

Rationale: Nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia, and edema. In this syndrome, there is loss of proteins, particularly albumin, in the urine leading to hypoalbuminemia, fluid retention, and subsequent edema. This results in elevated lipid levels like hypercholesterolemia, but not hypertension. Therefore, choices A, B, and C are incorrect. Hematuria, bacteriuria, fever, and weight loss are not typically associated with nephrotic syndrome, distinguishing it from other kidney disorders.

5. Which food should the assistive personnel be instructed to remove from the child's food tray based on the prescribed treatment for nephrotic syndrome?

• A. Pickle
• B. Wheat toast
• C. Baked chicken
• D. Steamed vegetables

Correct answer: A

Rationale: In nephrotic syndrome, a no-added-salt diet is recommended to manage the condition. High-sodium foods like pickles should be avoided as they can exacerbate fluid retention and swelling. Wheat toast, baked chicken, and steamed vegetables are generally suitable for individuals with nephrotic syndrome as they are low in sodium and protein, which are important considerations for this condition. Therefore, the correct choice is to remove the pickles from the child's food tray.

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