A 34-week primigravida woman with preeclampsia is receiving Lactated Ringer's 500ml with magnesium sulfate 20 grams at the rate of 3g/hr. How many ml/hr should the nurse program the infusion pump?
- A. 75ml/hr
- B. 100ml/hr
- C. 50ml/hr
- D. 25ml/hr
Correct Answer: A
Rationale: To calculate the infusion rate, divide the total quantity to be infused (500ml) by the total time (1 hour) which equals 500ml/hr. Since the magnesium sulfate is being given at 3g/hr, and 1g of magnesium sulfate is in 5ml of solution, the rate will be 3g/hr x 5ml/g = 15ml/hr. Therefore, the total infusion rate should be 500ml/hr + 15ml/hr = 515ml/hr. Hence, the nurse should program the infusion pump to deliver 75ml/hr (515ml/hr total - 500ml/hr Lactated Ringer's rate).
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The healthcare provider is preparing to suture a 10-year-old with a lacerated forehead. Both parents and the 12-year-old sibling are at the child's bedside. Which instruction best supports the family?
- A. While waiting for the healthcare provider, only one family member may stay with the child.
- B. All family members should leave while the healthcare provider sutures the child's forehead.
- C. It is best if the sibling goes to the waiting room until the suturing is completed.
- D. Please decide among yourselves who will stay when the healthcare provider begins suturing.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client at 32-weeks gestation comes to the prenatal clinic with complaints of pedal edema, dyspnea, fatigue, and a moist cough. Which question is most important for the LPN/LVN to ask this client?
- A. Which symptom did you experience first?
- B. Are you eating large amounts of salty foods?
- C. Have you visited a foreign country recently?
- D. Do you have a history of rheumatic fever?
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
When can a woman who thinks she may be pregnant use a home pregnancy test to diagnose pregnancy?
- A. A home pregnancy test can be used right after your first missed period.
- B. These tests are most accurate after you have missed your second period.
- C. Home pregnancy tests often give false positives and should not be trusted.
- D. The test can provide accurate information when used right after ovulation.
Correct Answer: A
Rationale: The correct answer is A. Home pregnancy tests detect hCG, a hormone produced during pregnancy, and are most accurate after the first missed period when hCG levels are higher. Testing too early may result in a false negative. Waiting until after the first missed period increases the reliability of the test results.
The healthcare provider is preparing to administer magnesium sulfate to a laboring client whose blood pressure has increased from 110/60 mmHg to 140/90 mmHg. Which action is the highest priority?
- A. Provide a quiet environment with subdued lighting.
- B. Have calcium gluconate immediately available.
- C. Assess deep tendon reflexes (DTRs) every 4 hours.
- D. Insert a Foley catheter with a urimeter to monitor hourly output.
Correct Answer: B
Rationale: Having calcium gluconate readily available is crucial when administering magnesium sulfate, as it serves as the antidote in case of magnesium toxicity. Magnesium sulfate can lead to respiratory depression and cardiac arrest in cases of overdose or toxicity, making the prompt availability of calcium gluconate essential for immediate administration to counteract these effects.
A new mother calls the nurse stating that she wants to start feeding her 6-month-old child something besides breast milk, but is concerned that the infant is too young to start eating solid foods. How should the nurse respond?
- A. Advise the mother to wait at least another month before starting any solid foods.
- B. Instruct the mother to offer a few spoons of 2 or 3 pureed fruits at each meal.
- C. Reassure the mother that the infant is old enough to eat iron-fortified cereal.
- D. Encourage the mother to schedule a developmental assessment of the infant.
Correct Answer: C
Rationale: At 6 months, infants are generally ready to start eating iron-fortified cereals as their iron stores begin to deplete. Introducing iron-fortified cereals at this age helps meet the infant's nutritional needs, particularly for iron, which becomes deficient as the infant's iron reserves diminish. It is a safe and appropriate first food to introduce to infants around 6 months of age, along with continued breastfeeding or formula feeding.
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