A nurse is calculating a child's medication dose by using Clark's Rule. Which of the following calculations represents the application of Clark's Rule?
- A. Infant's age in months/150 months the average adult dose
- B. Child's age in years/child's age in years +12 times the average adult dose
- C. Weight of child in pounds/150 pounds the average adult dose
- D. Surface area in square meters/1.73 the average adult dose
Correct Answer: C
Rationale: Clark's Rule uses the child's weight to calculate the dose and assumes the adult dose is based on a 150-pound person. Fried's Rule applies to a child younger than 1 year of age and assumes that an adult dose would be appropriate for a child who is 12.5 years (150 months) old. Young's Rule applies to children 1 to 12 years of age. Surface area calculation of a child's dose is determined with the use of a nomogram including the child's height and weight.
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What would be the best source of drug information for a nurse?
- A. Drug Facts and Comparisons
- B. A nurse's drug guide
- C. A drug package insert
- D. The Physicians Drug Reference (PDR)
Correct Answer: B
Rationale: A nurse's drug guide provides nursing implications and patient teaching points that are most useful to nurses in addition to need-to-know drug information in a very user friendly organizational style. Lippincott's Nursing Drug Guide (LNDG) has drug monographs organized alphabetically and includes nursing implications and patient teaching points. Numerous other drug handbooks are also on the market and readily available for nurses to use. Although other drug reference books such as Drug Facts and Comparisons, PDR, and drug package inserts can all provide essential drug information, they will not contain nursing implications and teaching points and can be more difficult to use than nurse's drug guides.
You are to infuse 1,200 mL of IV fluid over 6 hours using a drop factor of 10 gtt/mL. What is the flow rate in drops per minute?
- A. 30 gtt/min
- B. 33 gtt/min
- C. 40 gtt/min
- D. 50 gtt/min
Correct Answer: B
Rationale: Flow rate = (1,200 mL 10 gtt/mL) ÷ (6 60) = 12,000 ÷ 360 = 33.33 gtt/min, rounded to 33 gtt/min.
Which of the following combinations of drugs should be used in the treatment of a patient with organophosphate poisoning?
- A. Atropine and epinephrine
- B. Epinephrine and isoproterenol
- C. Norepinephrine and propranolol
- D. Atropine and pralidoxime
Correct Answer: D
Rationale: Atropine blocks muscarinic effects, and pralidoxime regenerates cholinesterase.
Identify poor metabolizers of tamoxifen
- A. Not provided in document
- B. Not provided in document
- C. Not provided in document
- D. Not provided in document
Correct Answer: C
Rationale: This question lacks options, but the answer key (ANS: 3) indicates the third choice. Poor metabolizers of tamoxifen can be identified through CYP2D6 genotyping, as this enzyme converts tamoxifen to its active metabolite.
Art is a 55-year-old smoker who has been diagnosed with angina and placed on nitrates. He complains of headaches after using his nitrate. An appropriate reply might be:
- A. This is a parasympathetic response to the vasodilating effects of the drug.
- B. Headaches are common side effects with these drugs. How severe are they?
- C. This is associated with your smoking. Let's work on having you stop smoking.
- D. This is not related to your medication. Are you under a lot of stress?
Correct Answer: B
Rationale: Headaches are a common nitrate side effect due to vasodilation.