Nokea
A 1000-mL dose of D5W 1/2 normal saline is to be infused in 8 hours. The drop factor for the tubing is 60 gtt/min. How many drops per minute should the nurse administer?
- A. 75 gtt/min
- B. 100 gtt/min
- C. 125 gtt/min
- D. 150 gtt/min
Correct Answer: C
Rationale: 125 gtt/min.
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The client is admitted with a diagnosis of placenta accreta. Which complication is most likely to occur?
- A. Maternal hemorrhage
- B. Fetal distress
- C. Preterm labor
- D. All of the above
Correct Answer: D
Rationale: Placenta accreta where the placenta abnormally adheres to the uterine wall increases the risk of maternal hemorrhage (during delivery) fetal distress (from placental dysfunction) and preterm labor (from interventions). All are potential complications.
Clients receiving antipsychotic drug therapy will often exhibit extrapyramidal side effects that are reversible with which of the following agents ordered by the physician?
- A. Phenothiazines
- B. Anticholinergics
- C. Anti-Parkinsonian drugs
- D. Tricyclic agents
Correct Answer: B
Rationale: This answer is incorrect. Phenothiazines are antipsychotic drugs and produce the symptoms. This answer is correct. Anticholinergic agents are often used prophylactically for extrapyramidal symptoms. They balance cholinergic activity in the basal ganglia of the brain. This answer is incorrect. Anti-Parkinsonian drugs would increase the symptoms. This answer is incorrect. Tricyclic agents are used for symptoms of depression.
The client has elected to have epidural anesthesia to relieve labor pain. If the client experiences hypotension,the nurse should:
- A. Place her in Trendelenburg position
- B. Decrease the rate of the IV infusion
- C. Administer oxygen via nasal cannula
- D. Increase the rate of the IV infusion
Correct Answer: D
Rationale: Hypotension from epidural anesthesia results from vasodilation. Increasing the IV infusion rate (e.g. with saline) restores blood volume and pressure. Trendelenburg may worsen spinal anesthesia spread and oxygen is secondary unless hypoxia occurs.
Which guidelines would hamper staff learning and compliance?
- A. Provide scientific information regarding nosocomial infections.
- B. Clarify information with staff during each session.
- C. Acknowledge resistance of staff to changes in policies.
- D. Utilize diagrams to provide information.
- E. Provide all information needed to the staff on the first session.
- F. Tell the staff that changes were mandated by hospital policy.
- G. Send a memo regarding errors in IV site care procedure.
Correct Answer: E, F, G
Rationale: Providing all information in one session (E) can overwhelm staff, reducing retention. Stating changes are mandated (F) may foster resentment, decreasing compliance. Sending a memo about errors (G) may seem punitive, discouraging engagement. In contrast, scientific information (A), clarification (B), acknowledging resistance (C), and diagrams (D) promote understanding and acceptance.
The orthopedic nurse should be particularly alert for a fat embolus in which of the following clients having the greatest risk for this complication after a fracture?
- A. A 50-year-old with a fractured fibula
- B. A 20-year-old female with a wrist fracture
- C. A 21-year-old male with a fractured femur
- D. An 8-year-old with a fractured arm
Correct Answer: C
Rationale: Fat embolus is most common in long bone fractures, especially the femur, and in young adults. A 21-year-old with a femur fracture (C) is at highest risk. Fibula (A), wrist (B), and arm (D) fractures have lower risk.