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How many drops per minute should the nurse set for the infusion? The patient has been prescribed 1 liter of 0.9% sodium chloride, USP to be administered intravenously (IV) over a period of 4 hours. The IV administration set delivers 10 drops/mL.
- A. 40 gtt/min
- B. 42 gtt/min
- C. 44 gtt/min
- D. 46 gtt/min
Correct Answer: B
Rationale: Calculating 1000 mL ÷ 240 min × 10 gtt/mL yields 41.7 gtt/min, rounded to 42 gtt/min.
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A client with a seizure disorder is seen at the clinic for a follow-up visit and a prescription renewal for phenytoin. Which assessment finding warrants immediate intervention by the nurse?
- A. Chronic insomnia.
- B. Puffy, bleeding gums.
- C. Double vision.
- D. Blood pressure 100/78 mm Hg.
Correct Answer: C
Rationale: Double vision, or diplopia, can indicate phenytoin toxicity, which is a serious condition that may lead to impaired vision and increased risk of falls or injuries. This side effect suggests that the patient may be experiencing adverse reactions to the medication, necessitating prompt evaluation and intervention, such as checking serum phenytoin levels and possibly adjusting the medication regimen.
The nurse is teaching a patient with chronic obstructive pulmonary disease (COPD) about huff coughing to clear secretions. During the patient's return demonstration, the patient exhales using pursed lips. What should the nurse do next?
- A. Advise the patient that the procedure is being performed correctly.
- B. Tell the patient to take several shallow breaths before the next exhalation.
- C. Instruct the patient to inhale deeply and then quickly and forcefully exhale 2 to 3 times.
- D. Position the patient in the semi-Fowler's position and apply oxygen.
Correct Answer: C
Rationale: Instructing the patient to inhale deeply and exhale forcefully corrects the improper pursed-lip technique, ensuring effective huff coughing to clear mucus.
Which group of foods should the nurse recommend for patients with a strong family history of colon and rectal cancers?
- A. Lean beef, salads, and baked potatoes.
- B. Potatoes, low-fat breads, and applesauce.
- C. Oatmeal, raisins, and fruit with skin.
- D. Chicken, rice, and wheat products.
Correct Answer: C
Rationale: Oatmeal, raisins, and fruit with skin are high in fiber, which supports gut health and reduces the risk of colorectal cancer.
A client with right hydronephrosis and a history of renal calculi is preparing for discharge following a retrograde pyelogram. Which instruction should the nurse include in the client's discharge instructions?
- A. Use an incentive spirometer.
- B. Monitor the urinary stream for decreased output.
- C. Restrict physical activities.
- D. Report when hematuria becomes pink-tinged.
Correct Answer: B
Rationale: Monitoring urinary output detects complications like obstruction in hydronephrosis or renal calculi.
The healthcare provider prescribes diagnostic tests for a patient whose chest x-ray indicates pneumonia. Which diagnostic test should the nurse prepare the patient for?
- A. Computerized tomography (CT) of the chest.
- B. Arterial blood gases (ABG).
- C. Sputum culture and sensitivity.
- D. Blood cultures.
Correct Answer: C
Rationale: A sputum culture and sensitivity test identifies the causative organism of pneumonia, guiding appropriate antibiotic therapy.