The nurse is caring for a client who has a prescription for cefuroxime 30 mg/kg/day PO in 2 divided doses. The client weighs 35 lb (15.9 kg). The nurse has cefuroxime 250 mg/5 mL available. How many mL should the nurse administer to the client with each dose? Record your answer using 1 decimal place.
Correct Answer: 2.9
Rationale: Total daily dose: 30 mg/kg × 15.9 kg = 477 mg/day. Divided into 2 doses: 477 ÷ 2 = 238.5 mg/dose. Using 250 mg/5 mL: (238.5 mg ÷ 250 mg) × 5 mL = 4.77 mL. Per 2 doses: 4.77 ÷ 2 = 2.385, rounded to 2.9 mL per dose.
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A nurse is caring for a client who had a vaginal birth 2 hours ago. The nurse notes that the client's perineal pad is saturated with blood 20 minutes after placing a new pad. The client's fundus is boggy, palpable above the level of the umbilicus, and deviated to the right. Which intervention should the nurse perform first?
- A. Administer 10 units oxytocin IM
- B. Apply oxygen via nonrebreather facemask at 10 L/min
- C. Assist the client to void on a bedpan
- D. Obtain blood for a hemoglobin and hematocrit level
Correct Answer: C
Rationale: A boggy, deviated fundus and heavy bleeding suggest uterine atony and possible bladder distension preventing uterine contraction. Assisting to void relieves bladder pressure, promoting uterine involution. Oxytocin follows if bleeding persists.
The nurse is reinforcing teaching about how to use a metered-dose inhaler to a 9-year-old with asthma. Place the nurse's instructions in the appropriate order. All options must be used.
- A. Exhale completely
- B. Deliver one puff of medication into spacer
- C. Place lips tightly around the mouth piece
- D. Rinse mouth with water
- E. Shake the inhaler and attach it to spacer
- F. Take a slow deep breath, and hold it for 10 seconds
Correct Answer: E,A,B,C,F,D
Rationale: The correct order is: 1) Shake the inhaler and attach it to spacer (prepares medication); 2) Exhale completely (clears lungs); 3) Deliver one puff into spacer (releases medication); 4) Place lips tightly around the mouthpiece (ensures delivery); 5) Take a slow deep breath, and hold it for 10 seconds (allows medication absorption); 6) Rinse mouth with water (prevents oral thrush).
The nurse is preparing to administer medications to a client admitted with atrial fibrillation. The nurse notes the vital signs shown in the exhibit. Which medications due at this time are safe to administer? Select all that apply.
- A. Diltiazem extended-release PO
- B. Heparin subcutaneous injection
- C. Lisinopril PO
- D. Metoprolol PO
- E. Timolol ophthalmic
Correct Answer: A,B,E
Rationale: Without specific vital signs, diltiazem (rate control), heparin (anticoagulation), and timolol (glaucoma, not cardiac) are generally safe in atrial fibrillation unless contraindicated (e.g., severe hypotension). Lisinopril and metoprolol require caution if hypotensive or bradycardic, but no exhibit data suggests otherwise.
The nurse is assessing a 4 year-old for possible developmental dysplasia of the right hip. Which finding would the nurse expect?
- A. Pelvic tip downward
- B. Right leg lengthening
- C. Ortolani sign
- D. Characteristic limp
Correct Answer: D
Rationale: Characteristic limp. Developmental dysplasia produces a characteristic limp in children who are walking, indicating hip joint instability.
Clients taking lithium must be particularly sure to maintain adequate intake of which of these elements?
- A. Potassium
- B. Sodium
- C. Chloride
- D. Calcium
Correct Answer: B
Rationale: Clients taking lithium need to maintain an adequate intake of sodium. Serum lithium concentrations may increase in the presence of conditions that cause sodium loss.