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A nurse administers subcutaneous NPH insulin at 0700 to a child who has diabetes. At which of the following times should the nurse observe for hypoglycemia caused by the onset of the medication?
- A. 715
- B. 800
- C. 900
- D. 1000
Correct Answer: D
Rationale: The correct answer is D: 1000. NPH insulin typically starts working within 1 to 2 hours after administration, peaks in 4 to 12 hours, and lasts up to 24 hours. Since the nurse administered the insulin at 0700, the onset of hypoglycemia should be observed around 0900 to 1100. Choice A (715) is too soon for onset. Choice B (800) falls within the expected onset time, but it may be too early for hypoglycemia. Choice C (900) is also within the expected onset time frame, but waiting until 1000 (Choice D) allows for a more accurate observation of hypoglycemia as the peak effect of NPH insulin is approaching.
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A nurse is preparing to administer cefixime to a patient. The dose is 200 mg PO. Available is cefixime oral suspension 100 mg/mL. How many milliliters should the nurse administer?
- A. 1.9 mL.
- B. 2 mL.
- C. 2.1 mL.
- D. 2.2 mL.
Correct Answer: B
Rationale: The correct answer is B: 2 mL. To calculate the amount of cefixime oral suspension needed, divide the prescribed dose by the concentration of the suspension. In this case, 200 mg ÷ 100 mg/mL = 2 mL. Choice A is incorrect as it underestimates the amount needed. Choices C and D overestimate the amount.
A nurse is preparing to administer amoxicillin 250 mg PO. Available is amoxicillin oral suspension 125 mg/5 mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.).
- A. 2 mL.
- B. 5 mL.
- C. 8 mL.
- D. 10 mL.
Correct Answer: D
Rationale: To determine the correct amount of oral suspension to administer, we first need to calculate the total mL needed for 250 mg of amoxicillin. Given that the concentration is 125 mg/5 mL, we can set up a proportion: 125 mg is to 5 mL as 250 mg is to x mL. Cross multiply to find x: 125x = 250*5. Solving for x, we get x = 250*5/125 = 10 mL. Therefore, the nurse should administer 10 mL of amoxicillin oral suspension.
Choice A (2 mL) is incorrect because it is only half of the calculated amount. Choice B (5 mL) is incorrect because it does not account for the higher dosage required. Choice C (8 mL) is incorrect as it is too low based on the calculation.
A nurse is preparing to administer dextrose 3.5% in water (D3.5W) 1200 mL to infuse over 24 hours. The drop factor of the manual IV infusion is 15 gtt/mL. How many gtt/min should the nurse set the infusion to deliver? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.).
- A. 25 gtt/min.
- B. 13 gtt/min.
- C. 42 gtt/min.
- D. 15 gtt/min.
Correct Answer: B
Rationale: The correct answer is B: 13 gtt/min. To calculate the infusion rate in gtts/min, first find the total gtts needed per 24 hours: 1200 mL x 15 gtts/mL = 18000 gtts. Then, divide by 24 hours to get gtts/min: 18000 gtts / 1440 min = 12.5 gtts/min, which rounds to 13 gtts/min. This ensures the correct administration rate for the D3.5W infusion. Choice A (25 gtt/min) is incorrect as it does not accurately calculate the infusion rate. Choices C and D (42 gtt/min and 15 gtt/min) are incorrect as they do not follow the correct calculation method.
A nurse is teaching the parents of a child who has diabetes mellitus about the manifestations of hypoglycemia. Which of the following manifestations should the nurse include in the teaching?
- A. Dry mucous membranes.
- B. Polyuria.
- C. Poria.
- D. Bradycardia.
Correct Answer: D
Rationale: The correct answer is D: Bradycardia. Hypoglycemia can lead to decreased heart rate due to inadequate glucose supply to the heart. This can result in bradycardia. Dry mucous membranes (A) are more indicative of dehydration. Polyuria (B) is excessive urination, which is not a common manifestation of hypoglycemia. "Poria" (C) is not a recognized medical term. Therefore, the correct manifestation to include in teaching about hypoglycemia in a child with diabetes mellitus is bradycardia.
A nurse is reinforcing teaching for a client who has angina pectoris and a new prescription to apply a nitroglycerin transdermal patch daily. Which of the following instructions should the nurse give the client?
- A. Remove the used patch with medication areas to the inside and discard it in a closed receptacle.
- B. Keep the current nitroglycerin patch in place for 24 hours per day.
- C. Cleanse the excess hair from the skin before applying a nitroglycerin patch.
- D. Apply a second patch in place if angina pain occurs.
Correct Answer: A
Rationale: The correct answer is A: Remove the used patch with medication areas to the inside and discard it in a closed receptacle. This instruction is crucial as it ensures proper disposal to prevent accidental exposure to others. Removing the patch with the medication area inside reduces the risk of skin irritation. Keeping the patch in a closed receptacle prevents animals or children from coming into contact with the medication.
Choice B is incorrect because the patch should be applied for a specific duration, typically around 12-14 hours, not 24 hours. Choice C is unnecessary as excess hair does not affect the patch's efficacy. Choice D is dangerous as applying a second patch without medical guidance can lead to overdose.