43) ANSWER

D) A 62-year-old male with chronic renal failure

Explanation

Renal failure interferes with excretion of electrolytes, including magnesium. All of the conditions listed in the incorrect options increase the risk of hypomagnesemia by interfering with magnesium absorption in the small intestine. Critical words are hypermagnesemia and risk. Eliminate options 1 and 2, since intake of magnesium is reduced in these conditions. Recall that magnesium is absorbed in the small intestine, and eliminate option 3.

42) ANSWER

B. 800 mg

RATIONALE

•First convert the weight in lbs into kg, then multiply the patient’s weight by 10 mg per dose, 4 doses per day.

44 lb/2.2 = 20 kg
20 kg x 10 mg per dose = 200 mg
200 mg x 4 doses per day = 800 mg

41) ANSWER

A. Check for fetal heart tones

EXPLANATION

•Finding the fetal heart tones is the easiest way to check status of the pregnancy in this situation.

•If no fetal heart tones are noted, A sonogram is ordered to confirm fetal status.

•There will be no fetal activity if the fetus dies in utero.

•An x-ray of the abdomen should not be done in pregnancy and will not assess whether the fetus is alive or not.

40) ANSWER

B) Replace the bag of fluid with the fluid that was ordered.

Explanation

The nurse should replace the fluid with the correct fluid immediately, to prevent the detrimental effects of receiving the wrong intravenous fluid. Once the bag of fluid has been replaced, the nurse should write an incident report and notify the physician of the error. The charge nurse and nurse manager should be alerted to the incident, but the first action is to replace the bag of intravenous fluid. Use nursing knowledge and strategies for prioritization to make the correct selection.

39) ANSWER

D) Fidelity

Explanation

Fidelity means being faithful to agreements and promises. This nurse is acting on the client s behalf to obtain needed information and report it back to the client. Nonmaleficence is duty to do no harm. Veracity refers to telling the truth for example, not lying to a client about a serious prognosis. Beneficence means doing good, such as by implementing actions (e.g., keeping a salt shaker out of sight) that benefit a client (heart condition requiring sodium-restricted diet). Use the process of elimination. The correct answer is the one that matches the description in the stem; that is, the nurse made a promise to a client and kept it, which constitutes fidelity.

38) ANSWER

B) Furosemide (Lasix)

Explanation

Treatment for hypermagnesemia is to promote urinary excretion of magnesium to decrease serum levels, so a diuretic might be indicated. Laxatives and antacids often contain magnesium, which could worsen the imbalance. Fluid restriction would be contraindicated, because it would prevent flushing of excess magnesium from the body. First, determine that the magnesium level is elevated. Eliminate option 1, since it is a source of magnesium. Eliminate option 4, since it would inhibit magnesium excretion, and option 3, because it is not useful.

37) ANSWER

C. Monophasic

RATIONALE 

•Ethinyl estradiol 30-drospirenone 3, trade name Yasmin, is a monophasic oral contraceptive.

•Monophasic contraceptives contain the same dose of estrogen and progesterone for the entire dosing schedule. The patient receives 21 days of the active drug, which is then followed by a 7 day period of a placebo to allow withdrawal bleeding.

•Multiphasic contraceptives contain both estrogen and progesterone at different dosages throughout the cycle.