Nokea
A nurse is caring for a client who has a prescription for total parenteral nutrition (TPN). Which of the following routes of administration should the nurse use?
- A. Subcutaneous
- B. Intravenous
- C. Central venous access device
- D. Midline catheter
Correct Answer: C
Rationale: The correct answer is C: Central venous access device. TPN is a highly concentrated solution that provides all the nutrients a person needs intravenously. A central venous access device allows for the infusion of TPN into a large central vein, such as the superior vena cava, ensuring immediate access to the bloodstream for rapid absorption. Using other routes like subcutaneous (A), intravenous (B), or midline catheter (D) may not be suitable due to the high osmolarity of TPN, which can cause irritation and damage to smaller veins. Therefore, a central venous access device is the most appropriate and safe route for administering TPN.
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A nurse is providing teaching to a client about the administration of omeprazole. Which of the following should the nurse include?
- A. You cannot take this medication with an antacid.
- B. You should reduce your intake of calcium while taking this medication.
- C. You should take this medication before meals.
- D. You can take a second dose if symptoms persist up to 2 hours after the first dose.
Correct Answer: C
Rationale: Rationale: Choice C is correct because omeprazole is a proton pump inhibitor that works best when taken before meals to inhibit gastric acid secretion. This timing ensures optimal effectiveness of the medication. Choices A, B, and D are incorrect. Choice A is inaccurate because omeprazole can be taken with antacids, but it is recommended to be taken separately. Choice B is incorrect as there is no specific need to reduce calcium intake while taking omeprazole. Choice D is incorrect as taking a second dose without medical advice may lead to overdosing and adverse effects.
A nurse is caring for a client who is 12 hr postpartum and has a third-degree perineal laceration. The client reports not having a bowel movement
for 4 days. Which of the following medications should the nurse administer?
- A. Bisacodyl 10 mg per rectum
- B. Magnesium hydroxide 30 mL PO
- C. Famotidine 20 mg PO
- D. Loperamide 4 mg PO
Correct Answer: A
Rationale: The correct answer is A: Bisacodyl 10 mg per rectum. Bisacodyl is a stimulant laxative that helps stimulate bowel movements. Given the client's situation of not having a bowel movement for 4 days postpartum with a third-degree perineal laceration, prompt relief is needed to prevent complications such as constipation or increased pressure on the perineal area. Administering Bisacodyl per rectum will provide a faster onset of action compared to oral medications, ensuring timely relief for the client.
Choice B: Magnesium hydroxide is a laxative used for constipation but may not provide immediate relief for the client in this urgent situation.
Choice C: Famotidine is a histamine-2 blocker used for managing stomach acid but is not indicated for addressing constipation.
Choice D: Loperamide is an antidiarrheal medication and is contraindicated in this scenario as it can worsen constipation.
A nurse is assessing a client who has hypermagnesemia. Which of the following medications should the nurse prepare to administer?
- A. Protamine sulfate
- B. Acetylcysteine
- C. Calcium gluconate
- D. Flumazenil
Correct Answer: C
Rationale: The correct answer is C: Calcium gluconate. In hypermagnesemia, there is an excess of magnesium in the blood, leading to muscle weakness, cardiac arrhythmias, and respiratory depression. Calcium gluconate is the antidote for hypermagnesemia as it works by antagonizing the effects of magnesium. By administering calcium gluconate, the nurse can help reverse the symptoms associated with hypermagnesemia and restore normal calcium levels in the body. Protamine sulfate (Choice A) is used to reverse the effects of heparin, acetylcysteine (Choice B) is used as an antidote for acetaminophen overdose, and flumazenil (Choice D) is used to reverse the effects of benzodiazepines. These medications are not indicated for hypermagnesemia.
A nurse is preparing to initiate IV therapy for a client. Which of the following sites should the nurse use to place the peripheral IV catheter?
- A. Nondominant dorsal venous arch
- B. Dominant distal dorsal vein
- C. Nondominant forearm basilic vein
- D. Dominant antecubital vein
Correct Answer: A
Rationale: The correct answer is A: Nondominant dorsal venous arch. This site is preferred for peripheral IV catheter placement due to the larger vein diameter, ease of access, and reduced risk of complications like nerve damage or infiltration. The nondominant side is chosen to prevent disruption of daily activities. The dorsal venous arch is a superficial vein that is easily visible and palpable, making it suitable for successful cannulation. It also allows for optimal flow rate and minimizes the risk of phlebitis. Choices B, C, and D are not ideal for various reasons such as smaller vein size, increased risk of nerve damage, and difficulty in accessing or securing the catheter.
A nurse is preparing to administer Igrasm 5mcg/kg/day subcutaneous to a client who weighs 143 lb. How many mcg should the nurse administer per day?
Correct Answer: 325 mcg
Rationale: The correct answer is 325 mcg. First, convert the client's weight from lb to kg: 143 lb ÷ 2.2 = 65 kg. Next, calculate the daily dose: 5 mcg/kg/day x 65 kg = 325 mcg/day. Therefore, the nurse should administer 325 mcg per day.
Other choices are incorrect because they do not follow the correct conversion of weight to kg and do not calculate the dose accurately based on the weight and prescribed dosage.