Nokea
The nurse must administer in one syringe a combined dose of two different insulins from two vials. Place the steps (Roman numerals) in the correct order.
- A. Cleanse tops of vials.
- B. Inject air into vial 1.
- C. Withdraw medication from vial 1.
- D. Change needles.
- E. Withdraw medication from vial 2.
- F. Inject air into vial 2.
Correct Answer: A,B,F,C,E
Rationale: The correct order is: Cleanse vials (I), inject air into vial 1 (II), inject air into vial 2 (VI), withdraw from vial 1 (III), withdraw from vial 2 (V). Changing needles (IV) is not standard.
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An RN delegates patient assignments to an LPN and nursing assistant. Later, the RN overhears a nursing assistant arguing with a patient regarding a late breakfast tray. The nursing assistant begins to raise his voice as the disagreement continues. The best action from the RN is
- A. call the nursing assistant out of the room and speak with him about the incident.
- B. apologize to the patient and assign another nursing assistant to that room.
- C. report the nursing assistant to the nursing manager for poor patient care.
- D. write an incident report and give a copy to the nursing assistant and nurse manager.
Correct Answer: A
Rationale: Addressing the nursing assistant privately de-escalates the situation, provides coaching, and maintains professionalism without immediate escalation.
The nurse is assessing a client with suspected diverticulitis. Which of the following findings would the nurse expect?
- A. Pain in the right upper quadrant.
- B. Fever and left lower quadrant pain.
- C. Diarrhea with bright red blood.
- D. Soft, non-tender abdomen.
Correct Answer: B
Rationale: fever and left lower quadrant pain are common in diverticulitis due to inflammation in the sigmoid colon
The nurse is precepting a student nurse who is helping to care for a client with a hip fracture. The client has Buck's traction applied. Which statement by the student nurse indicates a need for further explanation by the primary nurse?
- A. The weight on Buck's traction should be between 5 and 7 pounds.
- B. Buck's traction is a type of skeletal traction that helps in bone realignment.
- C. The weights should hang freely and be checked regularly for correct positioning.
- D. Diligent pin site care is crucial to prevent infection in clients with skeletal traction.
Correct Answer: B
Rationale: Buck’s traction is skin traction, not skeletal traction, which uses pins. The other statements are correct regarding weight, positioning, and pin care (though pin care applies to skeletal traction).
If a nurse accidentally punctures a finger with a needle after withdrawing blood from a client, which of the following actions should be carried out first?
- A. Notify a supervisor.
- B. Wash the puncture area with soap and water.
- C. Apply pressure to the wound.
- D. File an incident/injury report.
Correct Answer: B
Rationale: Washing the puncture with soap and water (B) is the first step to reduce infection risk. Other actions (A, C, D) follow.
The physician has ordered 50 mEq of potassium chloride for a client with a potassium level of 2.5 mEq. The nurse should administer the medication:
- A. Slow, continuous IV push over 10 minutes
- B. Continuous infusion over 30 minutes
- C. Controlled infusion over 5 hours
- D. Continuous infusion over 24 hours
Correct Answer: C
Rationale: Potassium chloride should be administered slowly (e.g., over 5 hours for 50 mEq) to prevent cardiac complications, as rapid infusion can cause hyperkalemia.