Nokea
Four clients are scheduled to receive IV infusions, but there are only three intravenous (IV) pumps available. Which prescribed infusion can most safely be administered without an IV infusion pump?
- A. Heparin in Normal Saline prescribed for deep vein thrombosis.
- B. Regular Insulin in Normal Saline prescribed for ketoacidosis.
- C. Magnesium in Normal Saline prescribed for hypomagnesemia.
- D. Ceftriaxone in 5% Dextrose in Water prescribed for pneumonia.
Correct Answer: D
Rationale: Ceftriaxone can be safely administered via gravity drip over 30 minutes, unlike high-alert medications like heparin, insulin, or magnesium.
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A 5-year-old boy with mumps is being transferred to the pediatric unit. Which nursing intervention is most important for the nurse to implement?
- A. Place an isolation cart outside of the room to initiate droplet precautions.
- B. Schedule bedside play time with the occupational therapist.
- C. Instruct the child's parents about the need for transmission precautions.
- D. Assign the child to a room close to the nurse's station.
Correct Answer: A
Rationale: Initiating droplet precautions with an isolation cart prevents mumps transmission, a priority for infection control.
The charge nurse is assigning care to clients who are all receiving continuous intravenous medication infusions. The client receiving which medication infusion is best to assign to the licensed practical nurse (PN), rather than an RN?
- A. Nitroprusside sodium, an antihypertensive.
- B. Methotrexate, an antimetabolite chemotherapeutic agent.
- C. Octreotide acetate, an antidiarrheal agent.
- D. Amiodarone hydrochloride, an antiarrhythmic agent.
Correct Answer: C
Rationale: Octreotide infusion is stable and within the PN's scope, unlike high-risk medications requiring RN oversight.
A male client is admitted with difficulty breathing related to a recent diagnosis of metastatic lung cancer. He tells the nurse that he does not want to be 'hooked up to any machines'. His vital signs are heart rate 120 beats/minute, blood pressure 98/50 mm Hg, respirations 30 breaths/minute, and oxygen saturation rate is 88%. Which action should the nurse take?
- A. Obtain the client's legal records for power of attorney.
- B. Ask the palliative care team to speak with the client.
- C. Give analgesic medications as needed (PRN).
- D. Discontinue the intravenous infusion.
Correct Answer: B
Rationale: Consulting palliative care aligns with the client's wishes, focusing on symptom relief and quality of life.
It is most important for the charge nurse to schedule a multi-disciplinary team meeting to discuss which client?
- A. A business executive admitted with Guillain-Barre syndrome who has residual bilateral numbness in the lower extremities.
- B. A woman who is pregnant with twins and whose due date is one week away.
- C. An elderly client admitted through the emergency department with a broken hip whose blood glucose is 400 mg/dL (22 mmol/L).
- D. A 2-year-old who contracted Hepatitis A while at a local daycare center.
Correct Answer: C
Rationale: The elderly client with a broken hip and uncontrolled diabetes requires urgent, coordinated care to manage multiple acute conditions.
A newly hired unlicensed assistive personnel (UAP) expresses fear to the charge nurse about collecting a sputum specimen from a client who is HIV positive. Which action should the charge nurse take first?
- A. Provide the UAP with the infection control policy.
- B. Offer to assist the UAP with the collection of the specimen.
- C. Determine the UAP's knowledge about HIV transmission.
- D. Demonstrate the proper use of personal protective equipment.
Correct Answer: C
Rationale: Determining the UAP's knowledge about HIV transmission is the first action to address their fear, identify misconceptions, and provide targeted education.