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A nurse is preparing to administer 4,000 units of heparin subcutaneously to a client who has deep-vein thrombosis. Available is heparin 10,000 units/mL. How many mL of heparin should the nurse administer? (Round to the nearest tenth.)
Correct Answer: 0.4
Rationale: To calculate the mL of heparin to administer, use the formula: desired dose (4,000 units) ÷ concentration (10,000 units/mL) = X mL. 4,000 ÷ 10,000 = 0.4 mL. The correct answer is 0.4 mL because it accurately represents the calculated dose needed for the client. Other choices are incorrect as they do not align with the correct calculation.
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A nurse is providing teaching to a client about the administration of omeprazole. Which of the following should the nurse include?
- A. You cannot take this medication with an antacid.
- B. You should reduce your intake of calcium while taking this medication.
- C. You should take this medication before meals.
- D. You can take a second dose if symptoms persist up to 2 hours after the first dose.
Correct Answer: C
Rationale: Rationale: Choice C is correct because omeprazole is a proton pump inhibitor that works best when taken before meals to inhibit gastric acid secretion. This timing ensures optimal effectiveness of the medication. Choices A, B, and D are incorrect. Choice A is inaccurate because omeprazole can be taken with antacids, but it is recommended to be taken separately. Choice B is incorrect as there is no specific need to reduce calcium intake while taking omeprazole. Choice D is incorrect as taking a second dose without medical advice may lead to overdosing and adverse effects.
A nurse is teaching a client about oral contraceptive. Which of the following information should the nurse include in the teaching?
- A. Abdominal pain is an expected adverse effect of oral contraceptives
- B. It can take up to 1 year to become pregnant after stopping an oral contraceptive
- C. Some herbal supplements can decrease the effectiveness of an oral contraceptive
- D. A pelvic examination is needed prior to starting an oral contraceptive
Correct Answer: C
Rationale: The correct answer is C: Some herbal supplements can decrease the effectiveness of an oral contraceptive. The nurse should include this information in the teaching to ensure the client understands potential interactions. Herbal supplements like St. John's Wort can reduce the effectiveness of oral contraceptives by increasing their metabolism. This can lead to contraceptive failure and unintended pregnancy. Option A is incorrect because abdominal pain is not an expected adverse effect of oral contraceptives. Option B is incorrect as fertility typically returns quickly after stopping oral contraceptives, not taking up to a year. Option D is incorrect as a pelvic examination is not always necessary before starting oral contraceptives.
A nurse accidentally administers the medication metformin instead of metoprolol to a client. Which of the following actions should the nurse take?
- A. Monitor the client's thyroid function levels.
- B. Collect the client's uric acid level.
- C. Obtain the client's HDL level.
- D. Check the client's glucose level.
Correct Answer: D
Rationale: The correct answer is D: Check the client's glucose level. Metformin is a medication used to treat diabetes, so administering it instead of metoprolol could lead to hypoglycemia. Checking the client's glucose level will help determine if the client is experiencing low blood sugar levels due to the medication error. Monitoring thyroid function (A), collecting uric acid levels (B), and obtaining HDL levels (C) are not relevant in this situation and would not address the immediate concern of potential hypoglycemia.
A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering it to a client who has diabetes mellitus. Which of the following actions should the nurse take first?
- A. Withdraw the regular insulin from the vial
- B. Withdraw the NPH insulin from the vial
- C. Inject air into the NPH vial
- D. Inject air into the regular insulin vial
Correct Answer: C
Rationale: The correct answer is C: Inject air into the NPH vial. This step is crucial to prevent creating a vacuum in the vial when withdrawing the NPH insulin, ensuring accurate dosage measurement. Injecting air into the NPH vial equalizes pressure, making it easier to withdraw the correct amount of insulin without causing air bubbles.
Choice A is incorrect as withdrawing regular insulin first may lead to air being drawn into the syringe when withdrawing NPH insulin. Choice B is incorrect because withdrawing NPH insulin first without equalizing pressure may cause difficulty in drawing the correct amount of insulin. Choice D is incorrect as injecting air into the regular insulin vial before withdrawing NPH insulin is unnecessary and may introduce air bubbles into the syringe.
A home health nurse is visiting a client who has heart failure and a prescription for furosemide. The nurse identifies that the client has gained 2.5 kg (5 lb.) since the last visit 2 days ago. Which of the following actions should the nurse take first?
- A. Encourage the client to dangle the legs while sitting in a chair
- B. Teach the client about foods low in sodium
- C. Determine medication adherence by the client
- D. Notify the provider of the client's weight gain
Correct Answer: D
Rationale: The correct answer is D: Notify the provider of the client's weight gain. This is the first action the nurse should take because sudden weight gain in a client with heart failure could indicate fluid retention, which may worsen the client's condition. By notifying the provider, the nurse can ensure timely intervention to adjust the medication or treatment plan. Encouraging leg dangling (A) may help with circulation but does not address the immediate concern of weight gain. Teaching about low-sodium foods (B) is important for long-term management but not the priority at this moment. Determining medication adherence (C) is important but should come after addressing the immediate weight gain issue.