Question

A nurse is preparing to administer fluconazole 500 mg via intravenous (IV) infusion over 45 minutes. Available is fluconazole 500 mg in 100 mL 0.9% sodium chloride (NaCl). At what rate will the nurse set the infusion? (If needed, round the answer to the nearest whole number.)

Answer 1

Correct Answers:

133

Rationale :

🧮To calculate IV rate: 100 mL ÷ 45 min × 60 min gives 133.3 mL/hr, rounded to 133 mL/hr.

🕒The volume to be infused is 100 mL and the time is 45 minutes, requiring a conversion to hourly rate.

📏This calculation ensures safe and accurate delivery of the prescribed medication over the intended time frame.

💊Correct rate setting helps prevent toxicity and maintains therapeutic effect.

📌Core Message

The correct IV infusion rate is 133 mL/hr, derived by converting 100 mL over 45 minutes into an hourly rate.

Answer 2

Correct Answers:

Bring the bladder scanner into the client's room.
Routinely assist the client to the bathroom.
Measure and record the client's urine output.

Rationale :

🧰UAPs can assist with non-invasive tasks, like bringing equipment such as a bladder scanner.

🚽They can routinely assist with toileting, supporting the client’s voiding needs.

📋Measuring and recording output is within the scope of a UAP and crucial for monitoring urinary status.

🚫Inserting catheters and administering medications are nursing responsibilities and require license.

📌Core Message

UAPs may assist with routine care like toileting, measuring output, and setting up equipment, but not with invasive procedures or medications.

Answer 3

Correct Answers:

Inform the primary healthcare provider (PCP)

Rationale :

⚠️Metformin with contrast dye increases the risk for lactic acidosis, especially if renal function is compromised.

👩‍⚕️The PCP must be informed to determine whether to proceed, delay, or provide renal protection.

🛑The nurse should not proceed with the test without clearance from the provider.

💉Starting D5W or checking sugar does not address the primary risk associated with metformin and contrast.

📌Core Message

If a client has taken metformin before a contrast study, the nurse must notify the provider to prevent lactic acidosis risk.

Answer 4

Correct Answers:

"Do you experience pain during urination?"

Rationale :

🚽Dysuria (painful urination) is a hallmark sign of urinary tract infection (UTI).

🧪This symptom reflects inflammation or infection of the urinary tract lining.

💁‍♂️Vaginal discharge points to gynecologic issues, not specifically UTIs.

🥗Dietary changes or kidney stones are not direct indicators of a current UTI.

📌Core Message

The best question to identify UTI is asking about pain with urination, a primary clinical indicator.

Answer 5

Correct Answers:

Epoetin alfa

Rationale :

📉A hemoglobin of 7.5 g/dL indicates anemia, commonly seen in chronic renal failure due to low erythropoietin.

💉Epoetin alfa stimulates the bone marrow to produce more red blood cells.

🧪Other options manage potassium (sodium polystyrene), phosphate (sevelamer), and vitamin D levels (cholecalciferol), but not anemia.

🧠This is the standard treatment for anemia of chronic disease, especially renal-related.

📌Core Message

Epoetin alfa is indicated to treat anemia in chronic kidney disease by replacing deficient erythropoietin.

Answer 6

Correct Answers:

Palpitations
Temperature
Exophthalmos

Rationale :

❤️Palpitations and elevated heart rate suggest thyroid storm or hyperthyroidism, requiring urgent follow-up.

🌡️High temperature and hot skin are signs of thyroid overactivity and metabolic stress.

👁️Exophthalmos indicates Graves’ disease, which is a serious autoimmune condition.

💁‍♂️Loose stools and hunger are expected in hyperthyroidism and do not require immediate action.

📌Core Message

The nurse should immediately follow up on palpitations, fever, and exophthalmos as they indicate acute hyperthyroid crisis.

Answer 7

Correct Answers:

Cardiovascular system

Rationale :

❤️Tachycardia (144 bpm) and chest discomfort are cardiac symptoms often seen in thyroid crisis or hypermetabolism.

🧬Though hyperthyroidism affects many systems, cardiac output and arrhythmias pose the most immediate danger.

🧍‍♀️Integumentary, GI, and neurologic changes are present but not as life-threatening as CV instability.

🧘‍♂️Prioritization follows ABC and risk of cardiac decompensation.

📌Core Message

The nurse should prioritize the cardiovascular system because tachycardia and chest symptoms signal hemodynamic risk.

Answer 8

Correct Answers

Blank 1 Correct Option: hyperthyroidism
Blank 2 Correct Option: thyroxine level
Blank 3 Correct Option: thyroid stimulating hormone level

Rationale :

🔥Symptoms like heat intolerance, weight loss, palpitations, and exophthalmos are classic of hyperthyroidism.

🧪To confirm, labs should assess thyroxine (T4) and thyroid-stimulating hormone (TSH).

📉A low TSH and high T4 confirm primary hyperthyroidism.

📋Cushing syndrome and parathyroid disorders don’t fit the current clinical presentation.

📌Core Message

The client is showing signs of hyperthyroidism, and appropriate labs include thyroxine and TSH levels for diagnosis.

Answer 9

Correct Answers

Obtain a 12-lead electrocardiogram (ECG) [ Indicated ]
Palpate the thyroid gland to assess for tumors [ Contraindicated ]
Administer prescribed propranolol [ Indicated ]
Teach the client to increase fiber intake [ Indicated ]
Place client on a diet high in iodine [ Contraindicated ]
Request a prescription for methimazole [ Indicated ]
Maintain a cool and quiet environment [ Indicated ]

Rationale :

📈ECG is necessary to evaluate tachycardia/arrhythmias.

🖐️Avoid palpating thyroid in suspected hyperthyroidism to prevent thyroid storm.

💊Propranolol helps reduce HR and symptoms of adrenergic excess.

🥗Fiber helps with diarrhea; avoid iodine-rich foods which worsen hyperthyroidism.

🧴Methimazole is first-line antithyroid medication.

🧊Cool/quiet environment helps prevent stimulating the hyperactive system.

📌Core Message

Care should include ECG, propranolol, methimazole, low-stimulation environment, and avoidance of palpation or iodine intake.

Answer 10

Correct Answers

Blank 1 Correct Option: decrease
Blank 2 Correct Option: thyroxine
Blank 3 Correct Option: hyperthyroidism

Rationale :

🔥The client’s tachycardia, weight loss, heat intolerance, and anxiety indicate excessive metabolic activity, consistent with hyperthyroidism.

🧪Elevated thyroxine (T4) levels reflect excessive thyroid hormone replacement, most likely from levothyroxine overdose.

💊The appropriate provider response is to decrease the levothyroxine dosage to reduce hormone levels and stabilize metabolism.

⚕️These manifestations are not due to hypothyroidism or parathyroid dysfunction, confirming overreplacement as the cause.

📌Core Message

The provider should decrease levothyroxine because the client’s thyroxine is elevated, producing signs of hyperthyroidism.

Action	Indicated	Contraindicated
Obtain a 12-lead electrocardiogram (ECG)
Palpate the thyroid gland to assess for tumors
Administer prescribed propranolol
Teach the client to increase fiber intake
Place client on a diet high in iodine
Request a prescription for methimazole
Maintain a cool and quiet environment

1 :
A nurse is preparing to administer fluconazole 500 mg via intravenous (IV) infusion over 45 minutes. Available is fluconazole 500 mg in 100 mL 0.9% sodium chloride (NaCl). At what rate will the nurse set the infusion? (If needed, round the answer to the nearest whole number.)

2 :
The nurse plans care for a client with urinary retention. What task(s) should the nurse plan to delegate to the unlicensed assistive personnel (UAP)? Select all that apply.

3 :
A nurse working in the radiology department is preparing a client who has diabetes mellitus for a procedure that requires the use of contrast dye. During the intake assessment, the client tells the nurse that they took their morning dose of metformin. What action should the nurse take?

4 :
The nurse cares for a client admitted to the emergency room. What question should the nurse ask the client to assess for signs of a urinary tract infection?

5 :
A nurse planning care for a client with chronic renal failure and a hemoglobin of 7.5 g/dL. The nurse anticipates receiving a prescription for which medication?

6 :
Review the electronic health record.

Answer Options

7 :
A nurse is caring for a client.

Answer Options

8 :
A nurse is caring for a 34 years old female client.

Correct Answers

9 :
A nurse is caring for a client in the emergency department.

Correct Answers

10 :
A nurse is caring for a client.

Correct Answers

1 : A nurse is preparing to administer fluconazole 500 mg via intravenous (IV) infusion over 45 minutes. Available is fluconazole 500 mg in 100 mL 0.9% sodium chloride (NaCl). At what rate will the nurse set the infusion? (If needed, round the answer to the nearest whole number.)

2 : The nurse plans care for a client with urinary retention. What task(s) should the nurse plan to delegate to the unlicensed assistive personnel (UAP)? Select all that apply.

3 : A nurse working in the radiology department is preparing a client who has diabetes mellitus for a procedure that requires the use of contrast dye. During the intake assessment, the client tells the nurse that they took their morning dose of metformin. What action should the nurse take?

4 : The nurse cares for a client admitted to the emergency room. What question should the nurse ask the client to assess for signs of a urinary tract infection?

5 : A nurse planning care for a client with chronic renal failure and a hemoglobin of 7.5 g/dL. The nurse anticipates receiving a prescription for which medication?

6 : Review the electronic health record.

Answer Options

7 : A nurse is caring for a client.

Answer Options

8 : A nurse is caring for a 34 years old female client.

Correct Answers

9 : A nurse is caring for a client in the emergency department.

Correct Answers

10 : A nurse is caring for a client.

Correct Answers

1 :
A nurse is preparing to administer fluconazole 500 mg via intravenous (IV) infusion over 45 minutes. Available is fluconazole 500 mg in 100 mL 0.9% sodium chloride (NaCl). At what rate will the nurse set the infusion? (If needed, round the answer to the nearest whole number.)

2 :
The nurse plans care for a client with urinary retention. What task(s) should the nurse plan to delegate to the unlicensed assistive personnel (UAP)? Select all that apply.

3 :
A nurse working in the radiology department is preparing a client who has diabetes mellitus for a procedure that requires the use of contrast dye. During the intake assessment, the client tells the nurse that they took their morning dose of metformin. What action should the nurse take?

4 :
The nurse cares for a client admitted to the emergency room. What question should the nurse ask the client to assess for signs of a urinary tract infection?

5 :
A nurse planning care for a client with chronic renal failure and a hemoglobin of 7.5 g/dL. The nurse anticipates receiving a prescription for which medication?

6 :
Review the electronic health record.

7 :
A nurse is caring for a client.

8 :
A nurse is caring for a 34 years old female client.

9 :
A nurse is caring for a client in the emergency department.

10 :
A nurse is caring for a client.