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A nurse is caring for a child who has recurrent otitis media. The child weighs 14.9 kg (33 lb). A prescription is written for amoxicillin 40 mg/kg PO to be given in two divided doses per day. The pharmacy provides the nurse with amoxicillin 250 mg/5 mL. How many mL of the medication should the nurse plan to administer for each dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 6
Rationale: Correct Answer: 6 mL
Rationale:
1. Calculate the total daily dose of amoxicillin: 40 mg/kg * 14.9 kg = 596 mg/day
2. Since the dose is divided into two doses, each dose will be half of the total daily dose: 596 mg/2 = 298 mg
3. Determine how many mL of the 250 mg/5 mL amoxicillin solution contains 298 mg: (298 mg / 250 mg) * 5 mL = 5.96 mL
4. Round the answer to the nearest whole number, which is 6 mL.
Summary:
- Choice A: Incorrect. It lacks a calculated rationale and is not the correct answer.
- Choices B-G: Irrelevant as they are not supported by the calculations.
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A nurse is preparing to administer phenobarbital 3 mg/kg/day PO in two divided doses to a client who weighs 145 lb. The amount available is phenobarbital 100 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 1
Rationale: To determine the total daily dose, convert the client's weight from lb to kg (145 lb / 2.2 = 65.91 kg). Then calculate the total daily dose in mg (3 mg/kg/day * 65.91 kg = 197.73 mg/day). Since it is divided into two doses, the nurse should administer approximately 99 mg per dose. Since each tablet is 100 mg, the nurse should administer 1 tablet per dose. This is the correct answer, as it ensures the client receives the prescribed dose. Other choices are incorrect as they do not align with the calculated dose needed, leading to potential under or overdosing.
A nurse is caring for a client who has chronic renal failure and is receiving epoetin alfa. To check for therapeutic effects, the nurse should monitor which of the following client laboratory tests?
- A. Hemoglobin levels
- B. Iron levels
- C. Platelet count
- D. White blood cell count
Correct Answer: A
Rationale: The correct answer is A: Hemoglobin levels. Epoetin alfa stimulates red blood cell production, increasing hemoglobin levels in clients with chronic renal failure who often have anemia. Monitoring hemoglobin levels helps assess the effectiveness of the medication. Iron levels (B) are important for erythropoiesis but not directly affected by epoetin alfa. Platelet count (C) and white blood cell count (D) are not specifically related to the therapeutic effects of epoetin alfa in chronic renal failure.
A nurse is monitoring a client's response to receiving glipizide instead of guaifenesin. Which of the following actions should the nurse take?
- A. Lower the head of the client's bed.
- B. Check the client for urinary retention
- C. Offer the client a carbohydrate snack.
- D. Test the client's deep-tendon reflexes.
Correct Answer: C
Rationale: The correct answer is C: Offer the client a carbohydrate snack. Glipizide is an oral antidiabetic medication that can lower blood sugar levels by stimulating the release of insulin from the pancreas. If the client receives glipizide instead of guaifenesin (an expectorant), there is a risk of hypoglycemia due to the medication's blood sugar-lowering effects. Offering a carbohydrate snack can help prevent or treat hypoglycemia by quickly raising blood sugar levels. Lowering the head of the bed (A), checking for urinary retention (B), and testing deep-tendon reflexes (D) are not directly related to the client's response to glipizide.
A nurse in a clinic receives a telephone call from a client who has tuberculosis and was prescribed rifampin 3 days ago. The client reports, 'My saliva and tears are red. What should I do?' Which of the following responses by the nurse is appropriate?
- A. This is an expected adverse effect of the medication.'
- B. Stop taking the medication. You are having an allergic reaction.'
- C. This condition will only last a couple of days.'
- D. Taking the medication with red meat will cause this adverse effect.'
Correct Answer: A
Rationale: The correct response is A: "This is an expected adverse effect of the medication." Red discoloration of bodily fluids is a known side effect of rifampin. The medication can cause harmless discoloration of saliva, tears, sweat, and urine. It does not indicate an allergic reaction or a serious issue that requires stopping the medication. Choice B is incorrect as stopping the medication abruptly is not necessary. Choice C is incorrect as the duration of this side effect varies. Choice D is incorrect as the discoloration is not related to the consumption of red meat.
A nurse is collecting data from a client who has a new prescription for nitrofurantoin to treat a urinary tract infection. The nurse should monitor the client for which of the following adverse effects?
- A. Tinnitus
- B. Abdominal cramping
- C. Stevens-Johnson syndrome
- D. Insomnia
Correct Answer: C
Rationale: The correct answer is C: Stevens-Johnson syndrome. Nitrofurantoin can cause serious adverse effects like Stevens-Johnson syndrome, which is a severe skin reaction. This syndrome presents with flu-like symptoms, followed by a painful rash that can lead to skin peeling and blistering. It is important for the nurse to monitor the client for any signs of skin rash, especially if it is accompanied by mucous membrane involvement. Tinnitus (choice A) and abdominal cramping (choice B) are not commonly associated with nitrofurantoin. Insomnia (choice D) is also not a common adverse effect of this medication.