Nokea
A client who weighs 187 lb has an order to receive enoxaparin (Lovenox) 1 mg/kg. This drug is available in a concentration of 30 mg/0.3 mL. What dose would the nurse administer in milliliters?
- A. 0.85 mL
- B. 0.9 mL
- C. 0.95 mL
- D. 1.0 mL
Correct Answer: A
Rationale: Calculation: 187 lb ÷ 2.2 = 85 kg. Dose = 85 kg × 1 mg/kg = 85 mg. Concentration = 30 mg/0.3 mL = 100 mg/mL. Volume = 85 mg ÷ 100 mg/mL = 0.85 mL. Thus, the nurse administers 0.85 mL.
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The nurse is providing discharge teaching for a client post-inguinal herniorrhaphy. Which statement by the client indicates a need for further teaching?
- A. I'll avoid heavy lifting for about 6 weeks.
- B. I can take a shower tomorrow.
- C. I'll call the doctor if I have a fever.
- D. I can resume sexual activity next week.
Correct Answer: D
Rationale: Resuming sexual activity within a week post-inguinal herniorrhaphy may strain the surgical site, indicating a need for further teaching to delay such activities for 4–6 weeks. The other statements align with appropriate postoperative care. CN: Health promotion and maintenance; CL: Evaluate
When suctioning a tracheostomy or laryngectomy tube, the nurse should follow which of the following procedures?
- A. Use a sterile catheter each time the client is suctioned.
- B. Clean the catheter in sterile water after each use and reuse for no longer than 8 hours.
- C. Protect the catheter in sterile packaging between suctioning episodes.
- D. Use a clean catheter with each suctioning, and disinfect it in hydrogen peroxide between uses.
Correct Answer: A
Rationale: Using a sterile catheter each time minimizes infection risk in the airway. Reusing catheters, even if cleaned, increases infection risk.
The nurse learns that a client who is scheduled for a tonsillectomy has been taking 40 mg of oral prednisone daily for the last week for poison ivy on his leg. What is the nurse's best action?
- A. Document the prednisone with current medications.
- B. Notify the surgeon of the poison ivy.
- C. Notify the anesthesiologist of the prednisone administration.
- D. Send the client to surgery.
Correct Answer: C
Rationale: Prednisone use affects adrenal function and stress response, increasing risks during anesthesia. Notifying the anesthesiologist ensures proper perioperative management, such as stress-dose steroids.
A client uses timolol maleate (Timoptic) eyedrops. The expected outcome of this beta-adrenergic blocker is to control glaucoma by:
- A. Constricting the pupils.
- B. Dilating the canals of Schlemm.
- C. Reducing aqueous humor formation.
- D. Improving the ability of the ciliary muscle to contract.
Correct Answer: C
Rationale: Timolol maleate, a beta-adrenergic blocker, reduces intraocular pressure by decreasing the production of aqueous humor in the eye.
A client with acute chest pain is receiving I.V. morphine sulfate. Which of the following results are intended effects of morphine in this client? Select all that apply.
- A. Reduces myocardial oxygen consumption.
- B. Promotes reduction in respiratory rate.
- C. Prevents ventricular remodeling.
- D. Reduces blood pressure and heart rate.
- E. Reduces anxiety and fear.
Correct Answer: A,D,E
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