Prior to hanging an IV containing potassium, the nurse will confirm that there is:

blood pressure of at least 60 mm Hg diastolic

pulse of at least 50 beats/min.

urine output of at least 30 mL/hr.

filter on the IV line.

Answer and Explanation

The Correct Answer is C

A. blood pressure of at least 60 mm Hg diastolic: Diastolic BP of 60 mm Hg is not the usual specific prerequisite cited for IV potassium.
B. pulse of at least 50 beats/min: Pulse criteria are not the standard prerequisite for giving IV potassium.
C. urine output of at least 30 mL/hr: Adequate urine output (commonly ≥30 mL/hr or ~0.5 mL/kg/hr) is required before IV potassium to ensure the kidneys can excrete potassium and to reduce risk of hyperkalemia/retention.
D. filter on the IV line: A filter is not a universal prerequisite for routine IV potassium administration (specific infusion sets vary by facility).

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Correct Answer is C

Explanation

A. Serum sodium 140 mEq/L: Normal serum sodium (≈135–145 mEq/L); not an expected adverse effect of spironolactone.
B. Serum calcium 10.5 mg/dL: Mildly high calcium is not a characteristic adverse effect of spironolactone.
C. Serum potassium 5.2: Spironolactone is a potassium-sparing diuretic and commonly causes hyperkalemia (monitor K+ closely).
D. Serum chloride 99 mEq/L: Chloride ~99 mEq/L is within normal limits (≈98–106) and not specific to spironolactone toxicity.

A. If two different insulins are ordered, they need to be given in separate injections. B. When mixing insulins, the cloudy (such as NPH) insulin is drawn up into the syringe first C. Patients need to use the injection site that is the most accessible. D. When mixing insulins, the clear (such as regular) insulin is drawn up into the syringe first.

Correct Answer is D

Explanation

A. If two different insulins are ordered, they need to be given in separate injections: Some insulins (e.g., regular with NPH) can be mixed in one syringe if they are compatible; they do not automatically require separate injections.
B. When mixing insulins, the cloudy (such as NPH) insulin is drawn up into the syringe first: Drawing cloudy first risks contaminating the clear insulin vial; the cloudy (NPH) is drawn after the clear.
C. Patients need to use the injection site that is the most accessible: Patients should rotate injection sites (abdomen, thigh, upper arm) to prevent lipodystrophy and ensure consistent absorption -not always use the most accessible site.
D. When mixing insulins, the clear (such as regular) insulin is drawn up into the syringe first: Standard safe technique is “clear before cloudy”: draw up the clear (regular) insulin first, then the cloudy (NPH), to avoid contaminating the short-acting insulin vial.

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Prior to hanging an IV containing potassium, the nurse will confirm that there is:

Nursing Test Bank

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