Nokea
A client receives a prescription for a secondary infusion of IV erythromycin 1 gram in 200 mL dextrose 5% in water (D5W) to be infused in 90 minutes. The nurse should program the infusion pump to deliver how many mL/hour? (Enter the numerical value only. If rounding is required, round to the nearest whole number.)
Correct Answer: 133
Rationale: Volume = 200 mL, Time = 90 minutes = 1.5 hours. Infusion rate = 200 mL / 1.5 hours = 133.33 mL/hr, rounded to 133 mL/hr.
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When administering zolpidem to an older client, which computer documentation indicates that the desired outcome has been achieved?
- A. Exhibits fewer emotional outbursts.
- B. Improved ability to concentrate.
- C. Decreased episodes of incontinence.
- D. Sleeps soundly through the night.
Correct Answer: D
Rationale: Zolpidem is a sedative for insomnia, and sleeping soundly through the night indicates its effectiveness. Emotional outbursts, concentration, and incontinence are not primary targets of zolpidem.
A client who is receiving pregabalin for fibromyalgia complains of tremors in the hands. Which action should the nurse implement?
- A. Notify the healthcare provider.
- B. Administer a PRN dose of an antianxiety drug.
- C. Obtain orthostatic blood pressure readings.
- D. Collect a capillary glucose level.
Correct Answer: A
Rationale: Tremors are a potential side effect of pregabalin, warranting notification of the healthcare provider for possible dose adjustment. Antianxiety drugs, blood pressure readings, or glucose levels are not directly related to addressing pregabalin-induced tremors.
A female client who is starting a new prescription for doxycycline hyclate tells the nurse that she takes birth control pills. Which action should the nurse take?
- A. Instruct the client to take the two medications at least two hours apart.
- B. Advise the client that the birth control pills will be less effective while taking doxycycline hyclate.
- C. Notify the healthcare provider of the contraindication to tetracyclines.
- D. Encourage the client to stop taking birth control pills until she has finished taking all the doxycycline hyclate.
Correct Answer: B
Rationale: Doxycycline can reduce birth control pill effectiveness, requiring additional contraception. Timing separation, contraindication notification, or stopping birth control are incorrect actions.
History and physical
The client is a 26-year-old female with acute appendicitis. She has a 12 year history of type 1 diabetes mellitus and no other significant medical history. The appendectomy was completed without issue, and the client will be admitted to the surgical floor to recover.
Nurses notes
0730
Admitted the client. She is awake and alert. She rates her pain 2 on a 0 to 10 pain scale. Her pulses are equal bilaterally. Heart rate is 76 beats/minute, normal sinus rhythm. Her oxygen saturation is 100% on room air. She has a gauze dressing over her surgical site, which is clean and dry. Her temperature is 98.5° F (37.0° C) orally. She urinated 50 mL upon arrival in the unit and is reporting she
Lab results
Blood glucose 279mg/dl
Orders
Admit to the surgical floor
• Dextrose 5% and 0.9% sodium chloride IV to infuse at 125 mL/hr
Advance diet as tolerated
• Insulin glargine 12 units SUBQ every 24 hours
. Ceftriaxone 2 gram IV piggy back (IVPB) every
24 hours for 3 days, first dose given in surgery
It is 1800, and the client has a scheduled dose of insulin glargine due. The client has a regular diet tray ordered with 60 carbohydrates. The tray has not yet arrived in the room. For each nursing action below, click to specify if the action is indicated, contraindicated or nonessential.Each row must have one option selected.
- A. Give insulin lispro 4 units: Contraindicated
- B. Verify that the client can count carbohydrates: Nonessential
- C. Mix the insulin lispro and insulin glargine in one syringe: Contraindicated
- D. Give insulin glargine 12 units: Indicated
Correct Answer:
Rationale: A: Lispro is contraindicated without meal intake to avoid hypoglycemia. B: Carb counting is nonessential for scheduled glargine. C: Mixing lispro and glargine is contraindicated. D: Glargine is indicated as scheduled.
History and physical
Client is a 66-year-old male with a history of type 2 diabetes mellitus and hypertension. He takes a metoprolol, hydrochlorothiazide, and metformin. He went to his primary healthcare provider reporting that he had been having trouble controlling his blood pressure in the last few days. He has also had a severe headache. Client was a direct admit to the hospital from the primary healthcare provider's office.
Nurses notes
1000
Admitted the client to the medical floor. He informs that he already took his metoprolol,
hydrochlorothiazide, and metformin dose. He says his morning glucose was 111 mg/dL (6.16 mmol/L). Rates his pain as 6 on a 0 to 10 pain scale. Minoxidil and ibuprofen given as prescribed.
1200
Pain rated at 1 on a 0 to 10 pain scale.
Lab results
Blood glucose 218mg/dl
Flowsheet
1000
Vital signs
. Temperature 99° F (37.2° C) orally
. Heart rate 59 beats/minute in atrial fibrillation
• Respiratory rate 20 breaths/minute
. Blood pressure 203/166 mm Hg
Oxygen saturation 97% on room air
Orders
Admit to the medical floor
Heart healthy diet
Vital signs every 2 hours and as needed (PRN)
Give minoxidil 5 mg PO now
Give 400 mg ibuprofen PO PRN for pain
Check blood glucose before meals and at sleep (HS)
Review H and P, nurse's notes, laboratory results, flow sheet, and prescriptions. Click to mark whether the assessment finding represents a therapeutic result of the minoxidil administered, a non-therapeutic side-effect, or an unrelated finding. Each row must have one option selected.
- A. Dizziness while sitting up: Non-therapeutic side effect
- B. Blood glucose 218mg/dl: Unrelated finding
- C. Mouth dryness: Non-therapeutic side effect
- D. Blood pressure 162/111mmHg: Therapeutic result
- E. Heart rate 99: Non-therapeutic side effect
- F. Pain of 1 out of 10: Unrelated finding
- G. Urine output 600ml: Unrelated finding
Correct Answer:
Rationale: A: Dizziness is a minoxidil side effect (hypotension). B: High glucose relates to diabetes. C: Dry mouth is a possible side effect. D: Lowered blood pressure is therapeutic. E: Tachycardia is a side effect. F: Pain reduction relates to ibuprofen. G: Urine output is unrelated.