Nursing Elites

1. What is the most important nursing action when administering IV potassium?

• A. Monitor for decreased urine output
• B. Administer via IV push
• C. Administer slowly and dilute in IV fluids
• D. Ensure the client drinks 500 mL of water before administration

Correct answer: C

Rationale: The most important nursing action when administering IV potassium is to administer it slowly and dilute it in IV fluids. This approach helps prevent irritation and hyperkalemia. Monitoring for decreased urine output (Choice A) is important but not as critical as ensuring the safe administration of IV potassium. Administering potassium via IV push (Choice B) is unsafe and can lead to adverse effects. Ensuring the client drinks water before administration (Choice D) is not directly related to the safe administration of IV potassium.

2. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following interventions should the nurse include in the plan of care?

• A. Monitor the client's temperature every 4 hours
• B. Monitor blood glucose levels every 6 hours
• C. Administer insulin as prescribed
• D. Monitor daily fluid intake

Correct answer: B

Rationale: Corrected Rationale: Monitoring blood glucose levels is crucial in clients receiving TPN because the solution has a high glucose content. This monitoring helps prevent hyperglycemia and allows for timely adjustments in the TPN formulation if needed. Monitoring the client's temperature (Choice A) is not directly related to TPN administration. Administering insulin (Choice C) should be based on blood glucose levels and the healthcare provider's orders; it is not a standard intervention for all clients on TPN. Monitoring daily fluid intake (Choice D) is important for overall fluid balance but is not as critical as monitoring blood glucose levels specifically for clients on TPN.

3. What are the nursing interventions for a patient with hypokalemia?

• A. Administer potassium supplements and monitor ECG
• B. Provide a high-sodium diet and monitor for hypertension
• C. Monitor for muscle weakness and provide dietary education
• D. Administer diuretics and provide oral fluids

Correct answer: A

Rationale: The correct intervention for a patient with hypokalemia is to administer potassium supplements and monitor the ECG. Potassium supplements help correct the low potassium levels in the body, while ECG monitoring is essential to detect any cardiac arrhythmias associated with hypokalemia. Choice B is incorrect because a high-sodium diet would worsen hypokalemia by further depleting potassium levels. Choice C is incorrect as it only focuses on monitoring symptoms and providing dietary education, but does not address the immediate need to correct potassium levels. Choice D is also incorrect as administering diuretics would exacerbate hypokalemia by increasing potassium loss.

4. A nurse is performing postmortem care for a client prior to the arrival of the client's family for viewing of the body. Which of the following actions should the nurse take?

• A. Apply moisturizing lotion to the skin
• B. Turn off the lights
• C. Remove all jewelry
• D. Gently close the client's eyelids

Correct answer: D

Rationale: The correct action the nurse should take is to gently close the client's eyelids. This is a respectful and common practice in postmortem care before allowing the family to view the body. Applying moisturizing lotion to the skin is unnecessary and may not be appropriate at this time. Turning off the lights might not be necessary and could impact the viewing environment for the family. While removing all jewelry is generally a good practice, it is not as crucial as gently closing the client's eyelids for postmortem care.

5. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following actions should the nurse take?

• A. Administer the TPN through a peripheral IV catheter.
• B. Check the client's capillary blood glucose level every 4 hours.
• C. Heat the TPN solution to room temperature before administering.
• D. Weigh the client every 3 days.

Correct answer: B

Rationale: The correct answer is to check the client's capillary blood glucose level every 4 hours. Clients receiving TPN are at risk for hyperglycemia, so regular monitoring of blood glucose levels is essential to detect and manage hyperglycemia promptly. Administering TPN through a peripheral IV catheter (Choice A) is incorrect as TPN should be given through a central venous catheter to prevent complications. Heating the TPN solution to room temperature (Choice C) is unnecessary and not a standard practice. Weighing the client every 3 days (Choice D) is important for monitoring fluid status but is not the priority action when caring for a client receiving TPN.

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