Nursing Elites

1. The nurse plans to closely monitor for which clinical manifestation after administering furosemide (Lasix)?

• A. Decrease pulse
• B. Decrease temperature
• C. Decrease BP
• D. Decrease respiratory rate.

Correct answer: C

Rationale: High-ceiling diuretics, such as furosemide, are the most effective diuretic agents. They produce more loss of fluid and electrolytes than any others. A sudden loss of fluid can result in decreased BP. When BP drops, the pulse will probably increase rather than decrease.

2. The patient with bipolar disorder is being treated with lithium and has a new prescription for captopril for hypertension. The combination of these two drugs makes which assessment particularly important?

• A. Potassium level
• B. Lithium level
• C. Creatinine level
• D. Blood pressure

Correct answer: B

Rationale: When captopril, an ACE inhibitor, is combined with lithium, it can lead to lithium accumulation. Therefore, monitoring lithium levels is crucial to prevent toxicity. While ACE inhibitors like captopril can cause hyperkalemia, renal insufficiency, and hypotension, the risk of these effects is not increased by the combination of lithium and captopril.

3. A child is being cared for following a head injury. Which of the following findings should indicate to the healthcare provider that the child is developing diabetes insipidus?

• A. Urine specific gravity of 1.045
• B. Sodium level of 155
• C. Blood glucose level of 45
• D. Urine output of 35 ml per hour

Correct answer: B

Rationale: In a child with a head injury, the development of diabetes insipidus can occur due to pituitary hypofunction, leading to a deficiency of antidiuretic hormone. An elevated sodium level (hypernatremia) is a key finding in diabetes insipidus due to the excessive loss of free water in the urine, resulting in increased sodium concentration in the blood.

4. The patient taking warfarin for prevention of deep vein thrombosis has an INR of 1.2. Which action by the nurse is most appropriate?

• A. Administer IV push protamine sulfate
• B. Continue with the current prescription.
• C. Prepare to administer Vitamin K
• D. Call healthcare provider to increase the dose

Correct answer: D

Rationale: An INR level of 1.2 is below the therapeutic range (2-3) for warfarin therapy. Therefore, the nurse should contact the healthcare provider to discuss the need for an increased dose to achieve the desired therapeutic range and prevent deep vein thrombosis effectively. Administering IV push protamine sulfate is used to reverse the effects of heparin, not warfarin. Continuing with the current prescription without addressing the subtherapeutic INR level may not effectively prevent deep vein thrombosis. Administering Vitamin K is indicated for warfarin overdose leading to excessive anticoagulation, not for a subtherapeutic INR level that is below the target range.

5. For a 6-year-old child with hypokalemia, which menu choice should the nurse encourage?

• A. Pizza with a fruit plate
• B. Chicken strips with chips
• C. Fajita with rice
• D. Hamburger with French fries

Correct answer: A

Rationale: Pizza with a fruit plate is the most suitable choice for a 6-year-old child with hypokalemia due to its potassium content. Potassium-rich foods like fruits can help replenish potassium levels in the body, aiding in the treatment of hypokalemia.

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