The nurse is preparing to start an IV on a newly admitted patient. Which action by the nurse places the patient at risk for infection?

The nurse applies a tourniquet to assess a vein.

The nurse dons gloves before starting the IV.

The nurse blows on the area cleansed with alcohol to dry it quickly

The nurse cleans the area with an alcohol pad

Answer and Explanation

The Correct Answer is C

A. The nurse applies a tourniquet to assess a vein: Applying a tourniquet is standard practice and does not increase infection risk if proper technique is used.

B. The nurse dons gloves before starting the IV: Wearing gloves minimizes the risk of infection for both the patient and the nurse.

C. The nurse blows on the area cleansed with alcohol to dry it quickly: Blowing on the site introduces bacteria from the nurse's breath to the cleansed area, increasing the risk of infection.

D. The nurse cleans the area with an alcohol pad: Cleaning the site with alcohol reduces the risk of infection and is standard practice.

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Correct Answer is ["50"]

Explanation

Flowrate(gtt/min) = Volume /Time× Dropfactor(gtt/mL)

Rate= 400ml /8hr ×60min/hr×60 gtt/mL

=400ml /480 × 60 gtt/mL

=50 gtt/min

A. Have the laboratory draw a blood sample for an erythrocyte sedimentation rate. B. Restrict fluid intake. C. Obtain a 12-lead ECG. D. Administer potassium gluconate 40 mEq orally.

Correct Answer is C

Explanation

A. Have the laboratory draw a blood sample for an erythrocyte sedimentation rate (ESR): ESR measures inflammation and is unrelated to hyperkalemia.

B. Restrict fluid intake: Fluid restriction is not appropriate for hyperkalemia unless specifically related to fluid overload or renal failure.

C. Obtain a 12-lead ECG: Hyperkalemia can cause life-threatening cardiac dysrhythmias such as peaked T waves, widened QRS complexes, or asystole. ECG monitoring is essential.

D. Administer potassium gluconate 40 mEq orally: This would worsen hyperkalemia and is contraindicated.

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The nurse is preparing to start an IV on a newly admitted patient. Which action by the nurse places the patient at risk for infection?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["50"]

Explanation

A nurse is reviewing the laboratory values for a client who takes spironolactone and notes that the client's serum potassium level is 6.8 mEq/L (3.5 -5 mEq/L). The nurse notifies the provider and anticipates that the provider will provide which of the following instructions?

Correct Answer is C

Explanation

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