Nokea
A dose of albuterol 5 mg by nebulization is prescribed for the pediatric client experiencing wheezing from an asthma episode. The medication vial contains 2.5 mg per 3 mL. How many milliliters of medication should the nurse prepare for administration by nebulization?
Correct Answer: 6
Rationale: Use a proportion formula: 2.5 mg : 3 mL :: 5 mg : X mL; multiply the outside values and then the inside values and solve for X; 2.5X = 15; X = 6 mL.
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A nurse working a surgical unit, notices a patient is experiencing SOB, calf pain, and warmth over the posterior calf. All of these may indicate which of the following medical conditions?
- A. Patient may have a DVT.
- B. Patient may be exhibiting signs of dermatitis.
- C. Patient may be in the late phases of CHF.
- D. Patient may be experiencing anxiety after surgery.
Correct Answer: A
Rationale: All of these factors (SOB, calf pain, and warmth) indicate a deep vein thrombosis (DVT), which can be a postoperative complication.
A client with stress incontinence should be advised:
- A. to purchase absorbent undergarments.
- B. that Kegel exercises might help.
- C. that effective surgical treatments are nonexistent.
- D. that behavioral therapy is ineffective.
Correct Answer: B
Rationale: Kegel exercises, tightening and releasing the pelvic floor muscles, might improve stress incontinence. Choice A is not an appropriate treatment for stress incontinence. Several effective surgical treatments exist. Lifestyle and dietary modifications can also be helpful.
A 20-year-old obese female client is preparing to have gastric bypass surgery for weight loss. She says to the nurse, 'I need this surgery because nothing else I have done has helped me to lose weight.' Which response by the nurse is most appropriate?
- A. If you eat less, you can save some money.'
- B. Exercise is a healthier way to lose weight.'
- C. You should try the Atkins diet first.'
- D. I respect your decision to choose surgery.'
Correct Answer: D
Rationale: This statement is most appropriate, as it shows respect and empathy. The other statements are both insensitive and unprofessional.
A woman is in the active phase of labor. An external monitor has been applied, and a fetal heart deceleration of uniform shape is observed, beginning just as the contraction is under way and returning to the baseline at the end of the contraction. Which of the following nursing actions is most appropriate?
- A. Administer O2.
- B. Turn the client on her left side.
- C. Notify the physician.
- D. No action is necessary.
Correct Answer: D
Rationale: It is an early deceleration as a result of head compression, and at this time no action is necessary. Close observation of the mother and baby is needed.
Which of the following is an inappropriate item to include in planning care for a severely neutropenic client?
- A. Transfuse netrophils (granulocytes) to prevent infection.
- B. Exclude raw vegetables from the diet.
- C. Avoid administering rectal suppositories.
- D. Prohibit vases of fresh flowers and plants in the client's room.
Correct Answer: A
Rationale: Granulocyte transfusion is not indicated to prevent infection. Produced in the bone marrow, granulocytes normally comprise 70% of all WBCs. They are subdivided into three types based on staining properties: neutrophils, eosinophils, and basophils. They can be beneficial in a selected population of infected, severely granulocytopenic clients (less than 500/mm3) who do not respond to antibiotic therapy and who are expected to experience prolonged suppression of granulocyte production.