A patient requires 40 units of NPH insulin and 10 units of regular insulin daily subcutaneously. What is the correct sequence when mixing insulins?
a. Inject air into the regular insulin vial and withdraw 10 units; then, using the same syringe, inject air into the NPH vial and withdraw 40 units of NPH insulin.
b. Inject air into the NPH insulin vial, being careful not to allow the solution to touch the needle; next, inject air into the regular insulin vial and withdraw 10 units; then, withdraw 40 units of NPH insulin.
c. Inject air into the regular insulin vial, being careful not to allow the solution to touch the needle; next, inject air into the NPH insulin vial and withdraw 40 units; then, withdraw 10 units of regular insulin.
d. Inject air into the NPH insulin vial and withdraw 40 units; then, using the same syringe, inject air into the regular insulin vial and withdraw 10 units of regular insulin.
1. A nurse is monitoring a patient who is receiving an IV infusion of normal saline. The patient is apprehensive and presents with a pounding headache, rapid pulse rate, chills, and dyspnea. What would be the nurse's priority intervention related to these symptoms?
a. Discontinue the infusion immediately, monitor vital signs, and report findings to primary care provider immediately.
b. Slow the rate of infusion, notify the primary care provider immediately and monitor vital signs.
c. Pinch off the catheter or secure the system to prevent entry of air, place the patient in the Trendelenburg position, and call for assistance.
d. Discontinue the infusion immediately, apply warm compresses to the site, and restart the IV at another site.
1. A nurse is administering a blood transfusion for a patient following surgery. During the transfusion, the patient displays signs of dyspnea, dry cough, and pulmonary edema. What would be the nurse's priority actions related to these symptoms?
a. Slow or stop the infusion; monitor vital signs, notify the health care provider, place the patient in upright position with feet dependent.
b. Stop the transfusion immediately and keep the vein open with normal saline, notify the health care provider stat, administer antihistamine parenterally as needed.
c. Stop the transfusion immediately and keep the vein open with normal saline, notify the health care provider, and treat symptoms.
d. Stop the infusion immediately, obtain a culture of the patient's blood, monitor vital signs, notify the health care provider, administer antibiotics stat.
A nurse is finished with patient care. How would the nurse remove PPE when leaving the room?
a. Remove gown, goggles, mask, gloves, and exit the room
b. Remove gloves, perform hand hygiene, then remove gown, mask, and goggles
c. Untie gown waist strings, remove gloves, goggles, gown, mask; perform hand hygiene
d. Remove goggles, mask, gloves, and gown, and perform hand hygiene
Read the following patient scenario and identify the step of the nursing process represented by each numbered and boldfaced nursing activity.
Annie seeks the help of the nurse in the student health clinic because she suspects that her roommate, Angela, suffered date rape. She is concerned because Angela chose not to report the rape and does not seem to be coping well. (1) After talking with Annie, the nurse learns that although Angela blurted out that she had been raped when she first came home, since then she has refused verbalization about the rape ("I don't want to think or talk about it"), has stopped attending all college social activities (a marked change in behavior), and seems to be having nightmares. After analyzing the data, the nurse believes that Angela might be experiencing (2) rape-trauma syndrome: silent reaction. Fortunately, Angela trusts Annie and is willing to come to the student health center for help. A conversation with Angela confirms the nurse's suspicions, and problem identification begins. The nurse talks further with Angela (3) to develop some treatment goals and formulate outcomes. The nurse also begins to think about the types of nursing interventions most likely to yield the desired outcomes. In the initial meeting with Angela, (4) the nurse encourages her expression of feelings and helps her to identify personal coping strategies and strengths. The nurse and Angela decide to meet in 1 week (5) to assess her progress toward achieving targeted outcomes. If she is not making progress, the care plan might need to be modified.
A nurse uses critical thinking skills to focus on the care plan of an older adult who has dementia and needs placement in a long-term care facility. Which statements describe characteristics of this type of critical thinking applied to clinical reasoning? Select all that apply.
a. It functions independently of nursing standards, ethics, and state practice acts.
b. It is based on the principles of the nursing process, problem solving, and the scientific method.
c. It is driven by patient, family, and community needs as well as nurses' needs to give competent, efficient care.
d. It is not designed to compensate for problems created by human nature, such as medication errors.
e. It is constantly re-evaluating, self-correcting, and striving for improvement.
f. It focuses on the big picture rather than identifying the key problems, issues, and risks involved with patient care.
A nurse is scheduling tests for a patient who has been experiencing epigastric pain. The health care provider ordered the following tests: (a) barium enema, (b) fecal occult blood test, (c) endoscopic studies, and (d) upper gastrointestinal series. Which is the correct order in which the tests would normally be performed?
a. c, b, d, a
b. d, c, a, b
c. a, b, d, c
d. b, a, d, c