Question

A nurse is preparing to administer fluconazole 400 mg by intermittent IV bolus daily. Available is fluconazole 400 mg in 0.9% sodium chloride (NaCl) 200 mL to infuse over 2 hours. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Answer 1

Correct Answers:

100

Rationale :

🔷 Divide 200 mL by 2 hours to determine the IV pump rate.

🔷 200 ÷ 2 = 100 mL/hr.

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Answer 2

Correct Answers:

Apply bilateral wrist restraints.

Rationale :

♦️ Wrist restraints prevent the toddler from injuring the surgical site.

♦️ Cleft palate repair is delicate, and preventing finger or object insertion is critical.

♦️ Restraints should be checked hourly for skin integrity and circulation.

♦️ Soft diets and straws are contraindicated postoperatively to avoid suction pressure.

♦️ Pain should be managed, but restraint placement is immediate priority for safety.

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Answer 3

Correct Answers:

Administer the abdominal thrust maneuver.

Rationale :

✅ Abdominal thrusts (Heimlich) are used in conscious adults with airway obstruction.

✅ This method generates positive pressure to dislodge the object.

✅ Blind sweeps are contraindicated due to risk of further obstruction.

✅ Turning the client or inserting an oral airway won’t resolve the blockage.

✅ Airway patency is always the first priority in life-threatening events.

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Answer 4

Correct Answers:

Hyperkalemia

Rationale :

✳️ Prerenal AKI leads to decreased filtration, causing potassium accumulation.

✳️ Elevated potassium can lead to life-threatening dysrhythmias.

✳️ Monitor ECG changes and serum K+ levels.

✳️ Hypernatremia is less common; calcium and phosphate changes vary by stage.

✳️ Treatment includes correcting underlying perfusion issues and managing electrolytes.

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Answer 5

Correct Answers:

Lethargy

Rationale :

🟣 Hypothyroidism slows metabolic function, leading to fatigue and lethargy.

🟣 Clients may also experience weight gain, bradycardia, and cold intolerance.

🟣 Symptoms are opposite of hyperthyroidism, which includes exophthalmos and photophobia.

🟣 Monitor for myxedema coma in severe cases.

🟣 Treatment includes levothyroxine replacement therapy.

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Answer 6

Correct Answers:

Suppress respiratory effort.

Rationale :

🔹 Pancuronium is a neuromuscular blocker used to paralyze muscles, including the diaphragm.

🔹 It facilitates mechanical ventilation by suppressing spontaneous breathing.

🔹 It does not sedate or relieve pain, so analgesics and sedatives must be given concurrently.

🔹 Monitor for respiratory depression and ensure the ventilator is functioning properly.

🔹 Always assess the need for sedation prior to administration.

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Answer 7

Correct Answers:

Decrease the infusion rate on the IV.

Rationale :

🔸 Red neck syndrome is a rate-related reaction to vancomycin.

🔸 Slowing the rate typically resolves flushing and tachycardia.

🔸 It is not an allergy or anaphylaxis unless accompanied by hypotension or rash.

🔸 Monitor closely for progression to true hypersensitivity.

🔸 No need to change the site unless infiltration or phlebitis is present.

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Answer 8

Correct Answers:

Nonmaleficence

Rationale :

🔶 Nonmaleficence means “do no harm”—stopping a harmful treatment supports this principle.

🔶 The decision shows an effort to avoid further kidney damage.

🔶 It prioritizes the client’s well-being over research continuation.

🔶 Ethical principles in research include risk vs. benefit balance.

🔶 Veracity (truth-telling) and fidelity (faithfulness) are also important but not directly applicable.

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Answer 9

Correct Answers:

Notify the Centers for Disease Control and Prevention (CDC) when more than three cases are confirmed.
Botulism can produce paralysis within 12 to 72 hours following exposure.

Rationale :

🔵 Botulism causes paralysis within 12 to 72 hours post-exposure (C).

🔵 It is a reportable disease, especially if multiple cases occur (B).

🔵 It is not spread by direct contact, but usually via foodborne or inhaled toxin.

🔵 GI symptoms like diarrhea are not prominent; paralysis dominates.

🔵 Castor beans are related to ricin, not botulism.

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Answer 10

Correct Answers:

Knuckle deformity

Rationale :

🟡 Rheumatoid arthritis (RA) causes joint deformities, especially in the fingers and hands.

🟡 Swan neck and boutonnière deformities may occur as disease progresses.

🟡 Systemic symptoms include fever, weight loss, anorexia.

🟡 Inflammation is bilateral and symmetrical.

🟡 Monitor disease activity and support joint function.

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RN Capstone Exam 1

No.

2 :
A nurse is caring for a toddler who is 24 hours postoperative following a cleft palate repair. Which of the following actions should the nurse take?

3 :
A nurse is caring for a client who develops an airway obstruction from a foreign body but remains conscious. Which of the following actions should the nurse take first?

4 :
A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?

5 :
A nurse is assessing a client who has hypothyroidism. Which of the following findings should the nurse expect?

6 :
A nurse is caring for a client who has acute respiratory distress syndrome (ARDS) and requires mechanical ventilation. The client receives a prescription for pancuronium. The nurse recognizes that this medication is for which of the following purposes?

7 :
A nurse is assessing a client who is receiving vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take?

9 :
A nurse is preparing a response protocol for botulism as a bioterrorism agent. The nurse should prepare the protocol based on which of the following information? (Select all that apply.)

10 :
A nurse in a provider’s office is assessing a client who has rheumatoid arthritis

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RN Capstone Exam 1

No.

2 : A nurse is caring for a toddler who is 24 hours postoperative following a cleft palate repair. Which of the following actions should the nurse take?

3 : A nurse is caring for a client who develops an airway obstruction from a foreign body but remains conscious. Which of the following actions should the nurse take first?

4 : A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?

5 : A nurse is assessing a client who has hypothyroidism. Which of the following findings should the nurse expect?

6 : A nurse is caring for a client who has acute respiratory distress syndrome (ARDS) and requires mechanical ventilation. The client receives a prescription for pancuronium. The nurse recognizes that this medication is for which of the following purposes?

7 : A nurse is assessing a client who is receiving vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take?

9 : A nurse is preparing a response protocol for botulism as a bioterrorism agent. The nurse should prepare the protocol based on which of the following information? (Select all that apply.)

10 : A nurse in a provider’s office is assessing a client who has rheumatoid arthritis

2 :
A nurse is caring for a toddler who is 24 hours postoperative following a cleft palate repair. Which of the following actions should the nurse take?

3 :
A nurse is caring for a client who develops an airway obstruction from a foreign body but remains conscious. Which of the following actions should the nurse take first?

4 :
A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?

5 :
A nurse is assessing a client who has hypothyroidism. Which of the following findings should the nurse expect?

6 :
A nurse is caring for a client who has acute respiratory distress syndrome (ARDS) and requires mechanical ventilation. The client receives a prescription for pancuronium. The nurse recognizes that this medication is for which of the following purposes?

7 :
A nurse is assessing a client who is receiving vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take?

9 :
A nurse is preparing a response protocol for botulism as a bioterrorism agent. The nurse should prepare the protocol based on which of the following information? (Select all that apply.)

10 :
A nurse in a provider’s office is assessing a client who has rheumatoid arthritis