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Order: 1000ml D5W at 120ml/hr. Available: Macro drop 15ml/hr. What is the drip factor in drops per minute?
- A. 30 gtt/min.
- B. 33 gtt/min.
- C. 31 gtt/min.
- D. 32 gtt/min.
Correct Answer: A
Rationale: To calculate the drip factor in drops per minute, we use the formula: Drip factor = (Volume to be infused in ml) x (drop factor) / (Time in minutes). In this case, Volume = 1000ml, drop factor = 15 gtt/hr, and Time = 60 minutes (to convert 1 hour to minutes). Therefore, Drip factor = (1000ml) x (15 gtt/hr) / (60 min) = 250 gtt/min. However, since the available drop factor is 15 ml/hr and not 1 ml/hr, we need to adjust by dividing by 5 (15 ml/hr ÷ 3 ml/hr = 5). Therefore, the correct drip factor is 250 gtt/min ÷ 5 = 30 gtt/min (rounded to the nearest whole number).
Summary:
A: 30 gtt/min - Correct calculation.
B: 33 gtt/min - Incorrect calculation
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Anticholinergic drugs are used in Ophthalmology because they produce what effect?
- A. Pupil restriction.
- B. Decreased lacrimal secretions.
- C. Pupil dilation.
- D. Sedation.
Correct Answer: C
Rationale: The correct answer is C: Pupil dilation. Anticholinergic drugs block the action of acetylcholine, leading to pupil dilation by inhibiting the constriction of the sphincter muscle in the iris. This effect is beneficial in ophthalmology for procedures like dilation exams and treating conditions like uveitis. Choice A is incorrect as anticholinergics cause pupil dilation, not restriction. Choice B is incorrect because anticholinergics actually increase lacrimal secretions instead of decreasing them. Choice D is incorrect as sedation is not a typical effect of anticholinergic drugs in ophthalmology.
A nurse is caring for a newly admitted patient who will receive Digoxin to treat cardiac dysrhythmia. The patient takes hydrochlorothiazide and reports regular use of OTC laxatives. Before administering the first dose of Digoxin, the nurse will review the patient's electrolyte levels with careful attention to which electrolytes?
- A. Calcium and magnesium.
- B. Potassium and chloride.
- C. Potassium and magnesium.
- D. Sodium and calcium.
Correct Answer: C
Rationale: The correct answer is C: Potassium and magnesium. Digoxin can cause toxicity in patients with low potassium or low magnesium levels, which can be exacerbated by the use of hydrochlorothiazide and OTC laxatives. Monitoring potassium and magnesium levels is crucial to prevent adverse effects such as cardiac dysrhythmias. Calcium and magnesium (choice A) are important electrolytes, but potassium is more critical in the context of Digoxin therapy. Potassium and chloride (choice B) are both important electrolytes, but magnesium should also be monitored. Sodium and calcium (choice D) are not the most relevant electrolytes to monitor in this situation.
The nurse is performing an admission assessment on a stable patient admitted after a motor vehicle accident. The patient reports having bad pain. What will the nurse do first?
- A. Attempt to determine what type of pain the patient has.
- B. Request an order for intravenous opioid analgesic.
- C. Administer acetaminophen (Tylenol).
- D. Ask the patient to rate the pain on a scale of 1-10.
Correct Answer: D
Rationale: The correct answer is D: Ask the patient to rate the pain on a scale of 1-10. This is the first step in assessing pain intensity, which helps determine the urgency and appropriate interventions needed. By having the patient rate the pain, the nurse can establish a baseline for pain management and monitor effectiveness of interventions.
Choice A is incorrect because determining the type of pain comes after assessing the intensity. Choice B is incorrect as requesting IV opioids without assessing pain intensity first may not be appropriate for a stable patient. Choice C is incorrect as administering acetaminophen should be based on the pain assessment.
What assessment finding would indicate the patient's left-sided heart failure is worsening?
- A. Increased jugular venous pressure.
- B. Liver enlargement.
- C. Increased pulse rate.
- D. Increased crackles in lung fields.
Correct Answer: D
Rationale: The correct answer is D: Increased crackles in lung fields. Worsening left-sided heart failure causes fluid to accumulate in the lungs, leading to crackles on auscultation. Increased jugular venous pressure (A) is more indicative of right-sided heart failure. Liver enlargement (B) is a sign of congestive hepatomegaly, common in right-sided heart failure. Increased pulse rate (C) may indicate heart failure exacerbation but is not specific to left-sided failure. Therefore, choice D is the best indicator of worsening left-sided heart failure.
The telephone triage nurse receives a call from a patient asking for a prescription for a narcotic to manage his surgical pain. The nurse explains that narcotic prescriptions must be written and cannot be called in to the pharmacy. The patient says, “Why are narcotics so difficult to get a prescription for?†What is the nurse's best response?
- A. The increase in the number of drug addicts has made the rules stricter.
- B. Controlled substances like narcotics are regulated by the FDA and the DEA.
- C. The Centers for Disease Control and Prevention regulates the use of controlled substances to reduce the risk of injury.
- D. The Drug Enforcement Agency (DEA) determines the risk for addiction, and the Food and Drug Administration enforces this control.
Correct Answer: B
Rationale: The correct answer is B: Controlled substances like narcotics are regulated by the FDA and the DEA. The FDA (Food and Drug Administration) regulates the approval, manufacturing, and labeling of prescription medications, including narcotics, to ensure they are safe and effective for use. The DEA (Drug Enforcement Administration) enforces regulations surrounding controlled substances to prevent misuse and abuse. This response is the best choice as it directly addresses the regulatory bodies responsible for overseeing the prescription and dispensing of narcotics.
Incorrect Choices:
A: The increase in the number of drug addicts has made the rules stricter. This choice provides a general statement about the rules without addressing the specific regulatory bodies involved in controlling narcotics.
C: The Centers for Disease Control and Prevention regulates the use of controlled substances to reduce the risk of injury. Although the CDC plays a role in public health, it is not the primary regulatory agency for controlled substances.
D: The Drug Enforcement Agency (DEA) determines the risk for addiction, and the Food and Drug Administration