Nursing Elites

1. When ambulating a frail, older adult client, the nurse should:

• A. Use the transfer belt if the client is unsteady
• B. Walk beside the client without support
• C. Encourage the client to use a walker
• D. Hold the client's arm for support

Correct answer: A

Rationale: Using a transfer belt if the client is unsteady is essential to provide added safety and support during ambulation. This device helps the nurse assist the client in maintaining balance and prevents falls. Walking beside the client without support (choice B) may not offer enough assistance for a frail, older adult who is unsteady. Encouraging the client to use a walker (choice C) could be helpful in some cases, but if the client is unsteady during ambulation, additional support like a transfer belt is more appropriate. Holding the client's arm for support (choice D) may not provide enough stability and safety compared to using a transfer belt.

2. A client is to receive cimetidine (Tagamet) 300 mg q6h IVP. The preparation arrives from the pharmacy diluted in 50 ml of 0.9% NaCl. The LPN plans to administer the IVPB dose over 20 minutes. For how many ml/hr should the infusion pump be set to deliver the secondary infusion?

• A. 150
• B. 50
• C. 100
• D. 75

Correct answer: A

Rationale: Setting the infusion pump to 150 ml/hr ensures the correct administration rate of the IVPB dose over 20 minutes. To calculate the infusion rate, consider that the total volume to be infused is 50 ml over 20 minutes. To convert this to ml/hr, the calculation is (50 ml / 20 minutes) x 60 minutes/hr = 150 ml/hr. Choices B, C, and D are incorrect as they do not reflect the correct calculation for the infusion rate needed to deliver the secondary infusion over the specified time.

3. Prior to a client being transported for a chest x-ray, what should a healthcare professional do first?

• A. Identify the client using two identifiers
• B. Confirm the client's fasting status
• C. Check the client's allergies to contrast media
• D. Explain the procedure to the client

Correct answer: A

Rationale: Identifying the client using two identifiers is the crucial first step to ensure correct patient identification before any procedure. This process helps prevent errors and ensures that the right procedure is performed on the right patient. Confirming the client's identity is the top priority before addressing other aspects such as fasting status, allergies, or explaining the procedure. While confirming fasting status and checking for allergies are important, they are secondary to confirming the client's identity. Explaining the procedure to the client is also essential but should occur after ensuring proper identification.

4. A patient uses an in-the-canal hearing aid. Which assessment is a priority?

• A. Eyeglass usage
• B. Cerumen buildup
• C. Type of physical exercise
• D. Excessive moisture problems

Correct answer: B

Rationale: When a patient uses an in-the-canal hearing aid, cerumen buildup is a critical issue that needs to be regularly assessed. Cerumen can easily block the sound passage and affect the functionality of the hearing aid. Assessing and managing cerumen buildup is a priority to ensure the proper functioning of the hearing aid. Eyeglass usage, type of physical exercise, and excessive moisture problems are not directly related to the specific issue of cerumen buildup in in-the-canal hearing aids, making them lower priority assessments in this context.

5. A healthcare professional is preparing to administer 750 mL of 0.9% sodium chloride IV to infuse over 7 hr. The professional should set the infusion pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

• A. 107 mL/hr
• B. 120 mL/hr
• C. 95 mL/hr
• D. 100 mL/hr

Correct answer: A

Rationale: To calculate the infusion rate, divide the total volume (750 mL) by the total time (7 hr). 750 ÷ 7 ≈ 107 mL/hr. Choice A is correct because it accurately calculates the infusion rate based on the total volume and time. Choices B, C, and D are incorrect as they do not reflect the correct calculation for the infusion rate in this scenario.

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