Nokea
A nurse is ordered to infuse 1,500 mL of IV fluid over 12 hours using a drop factor of 15 gtt/mL. What is the flow rate in drops per minute?
- A. 31.25 gtt/min
- B. 33.33 gtt/min
- C. 41.67 gtt/min
- D. 62.5 gtt/min
Correct Answer: A
Rationale: Flow rate = (1,500 mL 15 gtt/mL) ÷ (12 60) = 22,500 ÷ 720 = 31.25 gtt/min, exactly matching option A.
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While administering a medication that the nurse has researched and found to have limited effectiveness, the patient tells the nurse, I have read all about this drug and it is such a wonder drug. I'm so lucky my doctor prescribed it because I just know it will treat my problem. The nurse suspects this drug will be more effective than usual for this patient because of what effect?
- A. Cumulative effect
- B. First-pass effect
- C. Placebo effect
- D. Cross-tolerance effect
Correct Answer: C
Rationale: A drug is more likely to be effective if the patient thinks it will work than if the patient believes it will not work. This is called the placebo effect. If a drug is taken in successive doses at intervals that are shorter than recommended, or if the body is unable to eliminate a drug properly, the drug can accumulate in the body, leading to toxic levels and adverse effects. This is a cumulative effect. First-pass effect addresses the reduction of available drug when taken orally due to metabolism in the liver before the drug reaches the bloodstream. Cross-tolerance is resistance to drugs within the same class.
Choose the correct statement about ondansetron:
- A. It is a dopamine D2 receptor antagonist
- B. It suppresses postoperative nausea and vomiting
- C. It is the most effective antiemetic for motion sickness
- D. It is not effective by oral route
Correct Answer: B
Rationale: Ondansetron, a 5-HT3 receptor antagonist, effectively suppresses postoperative nausea and vomiting; it's less effective for motion sickness and is effective orally.
In teaching about the use of sublingual nitroglycerine, the patient should be instructed:
- A. To swallow the tablet with a full glass of water
- B. To place one tablet under the tongue if chest pain occurs and allow it to dissolve
- C. To take one tablet every 5 minutes until the chest pain goes away
- D. That it should 'burn' when placed under the tongue or it is no longer effective
Correct Answer: B
Rationale: Sublingual nitroglycerin is placed under the tongue for rapid absorption.
The nurse is preparing to administer an intravenous polymyxin antibiotic. The patient reports dizziness along with numbness and tingling of the hands and feet. The nurse will perform which action?
- A. Administer the drug since these are harmless side effects
- B. Hold the drug and notify the provider of these adverse reactions
- C. Obtain an order for an oral form of this medication
- D. Request an order for serum electrolytes
Correct Answer: B
Rationale: Polymyxin neurotoxicity (dizziness, numbness) warrants holding and reporting; these aren't harmless , and it's not oral . Polymyxins can cause nephrotoxicity and neurotoxicity.
A nurse is teaching a female client who has tobacco use disorder about Nicotine replacement therapy. Which of the following statements by the client indicates understanding of the teaching?
- A. I should avoid eating right before I chew a piece of nicotine gum.
- B. I will need to stop using the nicotine gum after 1 year.
- C. I know that nicotine gum is a safe alternative to resulting if I become pregnant.
- D. I must chew the nicotine gum quickly for about 15 minutes.
Correct Answer: A
Rationale: Avoiding food before chewing enhances nicotine absorption; gum isn't safe in pregnancy, and chewing is slow.