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The client in a code is now in ventricular bigeminy. The HCP orders a lidocaine drip at three (3) mg/min. The lidocaine comes prepackaged with two (2) grams of lidocaine in 500 mL of D5W. At which rate will the nurse set the infusion pump?
Correct Answer: 45
Rationale: Lidocaine concentration: 2 g = 2000 mg in 500 mL = 4 mg/mL. Dose: 3 mg/min. Rate = (3 mg/min) / (4 mg/mL) = 0.75 mL/min = 45 mL/hour (0.75 * 60). Pump set to 45 mL/hour.
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A student reports to the school nurse with complaints of stinging and burning from a wasp sting. Which intervention should the nurse implement?
- A. Grasp the stinger and pull it out.
- B. Apply a warm, moist soak to the area.
- C. Cleanse the site with alcohol.
- D. Apply an ice pack to the site.
Correct Answer: D
Rationale: An ice pack reduces pain and swelling from a wasp sting. Removing the stinger is unnecessary (wasps don’t leave stingers), warm soaks increase swelling, and alcohol is ineffective.
The client is diagnosed with neurogenic shock. Which signs/symptoms should the nurse assess in this client?
- A. Cool, moist skin.
- B. Bradycardia.
- C. Wheezing.
- D. Decreased bowel sounds.
Correct Answer: B
Rationale: Neurogenic shock causes bradycardia due to loss of sympathetic tone. Cool, moist skin is typical of hypovolemic shock, wheezing suggests anaphylaxis, and decreased bowel sounds are non-specific.
The ED nurse is caring for a male client admitted with carbon monoxide poisoning. Which intervention requires the nurse to notify the rapid response team?
- A. The client has expectorated black sputum.
- B. The client reports trying to kill himself.
- C. The client’s pulse oximeter reading is 94%.
- D. The client has stridor and reports dizziness.
Correct Answer: D
Rationale: Stridor indicates airway obstruction, and dizziness suggests worsening CO toxicity, requiring rapid response. Black sputum, suicidal intent, and 94% SpO2 are less acute.
The nurse is teaching a class on disaster preparedness. Which are components of an emergency operations plan (EOP)? Select all that apply.
- A. A plan for practice drills.
- B. A deactivation response.
- C. A plan for internal communication only.
- D. A preincident response.
- E. A security plan.
Correct Answer: A,B,D,E
Rationale: An EOP includes practice drills, deactivation, preincident planning, and security. Communication plans include external stakeholders, not just internal.
Which health-care team member referral should be made by the nurse when a code is being conducted on a client in a community hospital?
- A. The hospital chaplain.
- B. The social worker.
- C. The respiratory therapist.
- D. The director of nurses.
Correct Answer: C
Rationale: The respiratory therapist manages airway and ventilation during a code, critical for resuscitation. Chaplain, social worker, and director are supportive, not acute.