Nokea
A client has an order for Demerol 75 mg and atropine 0.4 mg IM as a preoperative medication. The Demerol vial contains 50 mg/mL, and atropine is available 0.4 mg/mL. How much medication will the nurse administer in total?
Correct Answer: 1.7
Rationale: Demerol: 75 mg ÷ 50 mg/mL = 1.5 mL. Atropine: 0.4 mg ÷ 0.4 mg/mL = 1 mL. Total = 1.5 + 1 = 2.5 mL. However, the closest answer is 1.7 mL (B), possibly due to a typo in the question or answer choices.
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A 15-year-old child is admitted to the pediatric unit with a diagnosis of thalassemia. Which of the following would be included in educating the mother and child as part of discharge planning?
- A. Give oral iron medication every day.
- B. Have the child's blood pressure monitored every week.
- C. Know the signs and symptoms of iron overload.
- D. Keep exercise at a minimum to reduce stress.
Correct Answer: C
Rationale: Oral iron supplements are contraindicated in thalassemia. Although heart failure may be an end result of this disease, this action is unnecessary. Iron overload is a potential complication of frequent blood transfusions of children with thalassemia. Children should be encouraged to pursue activities related to their exercise tolerance.
When a client is receiving vasoactive therapy IV, such as dopamine (Intropin), and extravasation occurs, the nurse should be prepared to administer which of the following medications directly into the site?
- A. Phentolamine (Regitine)
- B. Epinephrine
- C. Phenylephrine (Neo-Synephrine)
- D. Sodium bicarbonate
Correct Answer: A
Rationale: Phentolamine is given to counteract the-adrenergic effects that cause ischemia and necrosis of local tissue. Epinephrine is an endogenous catecholamine that produces vasoconstriction and increases heart rate and contractility. Phenylephrine causes constriction of arterioles of skin, mucous membranes, and viscera, which in turn can cause ischemia and necrosis. Sodium bicarbonate is an alkalinizing agent that is incompatible with dopamine.
A 5-year-old child was recently diagnosed as having acute lymphoid leukemia. She is hospitalized for additional tests and to begin a course of chemotherapy designed to induce a remission. She is scheduled to have a bone marrow aspiration tomorrow. She has had a bone marrow test previously and is apprehensive about having another. Which of the following interventions will be most effective in relieving her anxiety?
- A. Explain what will take place and what she will see, feel, and hear.
- B. Remind her that she has had this procedure before and that it is nothing to be afraid of.
- C. Tell her not to worry about it, that it will be over soon and she can join her friends in the playroom.
- D. Give her a big hug and tell her that she is a big girl now and that she will do just fine.
Correct Answer: A
Rationale: Providing a detailed explanation of the procedure helps reduce anxiety by preparing the child for what to expect, addressing her previous experience.
A client with preeclampsia is admitted with an order for magnesium sulfate. Which action by the nurse indicates an understanding of magnesium toxicity?
- A. The nurse lowers the temperature of the room.
- B. The nurse places an airway at the bedside.
- C. The nurse inserts an indwelling catheter and obtains an hourly intake and output.
- D. The nurse darkens the room to reduce environmental stimuli.
Correct Answer: B
Rationale: Magnesium sulfate toxicity can cause respiratory depression or arrest. Placing an airway at the bedside prepares for potential emergency intervention. The other actions are less specific to managing magnesium toxicity.
A client with a history of liver cirrhosis is admitted with complaints of ascites. The nurse should give priority to:
- A. Monitoring for infection
- B. Administering pain medication
- C. Monitoring blood pressure
- D. Administering diuretics
Correct Answer: A
Rationale: Ascites increases infection risk (e.g., spontaneous bacterial peritonitis) in cirrhosis, so monitoring for infection is the priority.