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Order: Vancomycin HCl 1 g in 250 mL DW IVPB, infuse in 90 min. Calculate the flow rate in drops per minute. The drop factor is 20 gtt/mL.
- A. 56 gtt/min
- B. 67 gtt/min
- C. 30 gtt/min
- D. 31 gtt/min
Correct Answer: A
Rationale: 250 mL ÷ 90 min = 2.777 mL/min. 2.777 mL/min × 20 gtt/mL = 55.56 gtt/min, rounded to 56 gtt/min. Other options are incorrect.
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A postoperative client is to be discharged today. She will need to change her dressing daily. Which statement she makes indicates that she understands the process?
- A. I will wash my hands before and after I change the dressing.'
- B. I can touch the dressings with my hands if I only touch the edges.'
- C. I should clean the area around the incision by moving the swab toward it.'
- D. I can put the old dressings directly in the waste basket.'
Correct Answer: A
Rationale: Hand washing before and after dressing changes prevents infection, reflecting proper understanding. Touching dressings, cleaning toward the incision, or improper disposal increase infection risk.
The nurse is assessing a client with suspected rheumatoid arthritis. Which of the following findings would support this diagnosis?
- A. Morning stiffness lasting over 30 minutes.
- B. Heberden’s nodes on the fingers.
- C. Pain in a single joint after exercise.
- D. Fever and weight loss without joint pain.
Correct Answer: A
Rationale: Morning stiffness lasting over 30 minutes is a hallmark of rheumatoid arthritis due to synovial inflammation. Heberden’s nodes (B) indicate osteoarthritis, single-joint pain (C) suggests injury, and fever/weight loss (D) are nonspecific without joint involvement.
The nurse prepares a 25-year-old woman for a cesarean section. The patient says she had major surgery several years ago and asks if she will receive a similar 'shot' before surgery. The nurse's response should be based on an understanding that the preoperative medication given before a cesarean section
- A. contains a lower overall dosage of medication than is given before general surgery.
- B. contains reduced amounts of sedatives and hypnotics than are given before general surgery.
- C. contains reduced amounts of narcotics than are given before general surgery.
- D. contains medications similar in type and dosages to those given before general surgery.
Correct Answer: C
Rationale: Preoperative medications for cesarean sections typically include reduced amounts of narcotics to minimize the risk of respiratory depression in the newborn, as narcotics cross the placental barrier. Sedatives and hypnotics are used in similar doses as in general surgery, and the overall dosage is not necessarily lower.
A young boy is recently diagnosed with a seizure disorder. Which of the following statements by the boy's mother indicates a need for further teaching by the nurse?
- A. I should make sure he gets plenty of rest.'
- B. I should get him a medic alert bracelet.'
- C. I should lay him on his back during a seizure.'
- D. I should loosen his clothing during a seizure.'
Correct Answer: C
Rationale: Laying a seizing child on their back risks aspiration; the correct position is on the side. The other statements reflect appropriate seizure management. Reduction of Risk Potential
The nurse is caring for a client with a history of chronic kidney disease who is receiving hemodialysis. Which of the following findings would require immediate intervention?
- A. Blood pressure of 140/90 mmHg.
- B. Weight gain of 1 kg since last dialysis.
- C. Bright red blood in the dialysis tubing.
- D. Potassium level of 4.5 mEq/L.
Correct Answer: C
Rationale: Bright red blood in the dialysis tubing indicates a potential access site bleed or tubing disconnection, requiring immediate intervention to prevent blood loss. Mild hypertension (A) and weight gain (B) are common, and a normal potassium level (D) is unremarkable.