Nokea
A nurse is preparing to administer 1 L of IV fluid over 6 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 167 mL/hr
Rationale: To calculate mL/hr for IV fluid administration, divide the total volume (1 L = 1000 mL) by the total time in hours (6 hr). Therefore, 1000 mL / 6 hr = 166.67 mL/hr, rounded to 167 mL/hr. This rate ensures the patient receives the correct volume over the specified time. Other choices are incorrect because they do not follow the correct calculation method or may not deliver the required volume within the specified time frame.
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A nurse is reinforcing teaching with a client who has diabetes mellitus and takes insulin glargine and insulin aspart. Which of the following actions indicates that the client understands the instructions?
- A. The client administers insulin glargine at the same time every day.
- B. The client mixes insulin aspart and insulin glargine in the same syringe.
- C. The client administers insulin aspart 30 min before breakfast.
- D. The client stores open vials of insulin glargine at room temperature for 60 days.
Correct Answer: A
Rationale: The correct answer is A. Administering insulin glargine at the same time every day helps maintain consistent blood sugar levels due to its long-acting nature. Mixing insulin aspart and glargine is incorrect as they have different onset and duration of action. Administering insulin aspart 30 min before breakfast may not align with the client's meal timing. Storing open vials of insulin glargine at room temperature for 60 days exceeds the recommended storage duration, risking potency and efficacy.
A nurse is preparing to administer gentamicin to a child who weighs 44 lb. The provider prescribes 6 mg/kg/day IV to be administered in three equal doses. Available is gentamicin 40 mg/mL. How many mL should the nurse administer with 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: 1 mL
Rationale: The correct answer is 1 mL. To calculate the dose for each administration, first convert the child's weight from pounds to kilograms (44 lb = 20 kg). The total daily dose is 6 mg/kg/day, so for a 20 kg child, the total daily dose is 120 mg (6 mg/kg/day x 20 kg). Since it is to be given in three equal doses, each dose would be 40 mg (120 mg total dose ÷ 3 doses). Since the available concentration is 40 mg/mL, the nurse would administer 1 mL for each dose (40 mg ÷ 40 mg/mL = 1 mL). Therefore, the correct answer is 1 mL.
Incorrect answers:
- Choice B: This is incorrect as it does not follow the correct calculation method.
- Choice C: This is incorrect as it does not consider the weight of the child and the total daily dose required.
- Choice D: This is incorrect as it does not
Vital Signs Day 1: Temperature 37.5° C (99.5° F), Heart rate 98/min, Respiratory rate 20/min, Blood pressure 180/86 mm Hg, Oxygen saturation 95% on room air, Weight 90 kg (198 lb); 2 months later: Temperature 37.5° C (99.5° F), Heart rate 48/min, Respiratory rate 20/min, Blood pressure 140/76 mm Hg, Oxygen saturation 97% on room air, Weight 91 kg (200 lb)
The nurse is evaluating the client's response to the medication. The client's ___________ and ____________ indicate the client's condition is improving.
- A. HDL Level
- B. Heart rate
- C. Potassium level
- D. Weight
- E. blood Pressure
Correct Answer: B, E
Rationale: The correct answer is B, Heart rate and E, Blood Pressure. Monitoring heart rate and blood pressure are vital signs that reflect the overall cardiovascular function and response to medication. An improvement in heart rate and blood pressure indicates better circulation and cardiac output, suggesting the client's condition is improving. The other choices (A, C, D) do not directly reflect the client's cardiovascular status and are not appropriate indicators of medication response. Weight (D) can fluctuate for various reasons, and HDL level (A) and Potassium level (C) are important but specific to different aspects of health. Thus, heart rate and blood pressure are the most relevant indicators in this context.
A nurse is preparing to administer regular insulin 4 units and NPH insulin 10 units subcutaneously to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse take first?
- A. Inject 10 units of air into the NPH insulin vial.
- B. Draw up 10 units from the NPH insulin vial.
- C. Inject 4 units of air into the regular insulin vial.
- D. Draw up 4 units from the regular insulin vial.
Correct Answer: C
Rationale: The correct answer is C: Inject 4 units of air into the regular insulin vial. This action is done to prevent negative pressure in the vial, making it easier to withdraw the correct dose of insulin. By injecting air first, the nurse ensures that the exact amount of insulin can be withdrawn accurately without causing any damage to the vial or affecting the dose.
Choice A is incorrect as injecting air into the NPH insulin vial is not necessary before drawing up the insulin. Choice B is incorrect as drawing up the NPH insulin before preparing the regular insulin would be out of sequence. Choice D is incorrect as drawing up the regular insulin before injecting air into the vial could lead to difficulty in withdrawing the correct dose.
A nurse is preparing to administer an IM injection to a client who has gonorrhea. Which of the following actions should the nurse take?
- A. Inject the medication at least 5 cm (2 in) from the umbilicus.
- B. Administer the medication with a 27-gauge /0.5 inch needle.
- C. Use the Z-track technique to administer the medication.
- D. Give the medication without aspirating prior to injection.
Correct Answer: C
Rationale: The correct answer is C: Use the Z-track technique to administer the medication. The Z-track technique involves pulling the skin laterally before injecting the medication to prevent leakage and irritation. This is crucial when administering IM injections to prevent the medication from leaking into the subcutaneous tissue. Option A is incorrect because the injection site for IM injections should be at least 2.5 cm (1 inch) away from the umbilicus. Option B is incorrect because a larger needle gauge (e.g., 22-25 gauge) is typically used for IM injections to reduce discomfort and prevent medication leakage. Option D is incorrect because aspirating prior to injection is not necessary for IM injections and may cause tissue damage.