Nokea
A nurse is preparing to administer clindamycin palmitate 225 mg PO every 8 hours to a client. The amount available is clindamycin palmitate oral suspension 75 mg/5 mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 15
Rationale: Correct Answer: 15 mL
Rationale: To calculate the mL to administer, first determine the total daily dose (675 mg). Divide this by the concentration of the oral suspension (75 mg/5 mL) to get the total mL per day (45 mL). Divide this by the number of doses per day (3) to get the mL per dose (15 mL).
Summary:
A: Incorrect, as it does not align with the correct calculation.
B-G: Irrelevant since the correct calculation method indicates 15 mL is the appropriate answer.
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A nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of the following statements by the client indicates an understanding of the teaching?
- A. I’ll be sure to eat more foods with vitamin K.
- B. I’ll take aspirin for my headaches.
- C. I’ll use my electric razor for shaving.
- D. It’s okay to have a couple of glasses of wine with dinner each evening.
Correct Answer: C
Rationale: The correct answer is C: "I’ll use my electric razor for shaving." This statement indicates an understanding of the teaching because warfarin is a blood thinner, increasing the risk of bleeding. Using an electric razor reduces the risk of nicks and cuts, which could lead to excessive bleeding.
Incorrect choices:
A: "I’ll be sure to eat more foods with vitamin K." - Eating more vitamin K-rich foods can interfere with the effectiveness of warfarin.
B: "I’ll take aspirin for my headaches." - Aspirin is a blood thinner and should not be taken along with warfarin.
D: "It’s okay to have a couple of glasses of wine with dinner each evening." - Alcohol can interact with warfarin and increase the risk of bleeding.
Choosing option C demonstrates the client's understanding of the importance of minimizing the risk of bleeding while on warfarin therapy.
A nurse and an assistive personnel (AP) are providing care for four clients who were admitted to the medical-surgical unit on the previous shift. The nurse should delegate meal assistance for which of the following clients to the AP?
- A. A client who has Guillain-Barré syndrome
- B. A client who has systemic sclerosis
- C. A client who has amyotrophic lateral sclerosis (ALS)
- D. A client who has a lumbosacral spinal tumor
Correct Answer: D
Rationale: The correct answer is D: a client who has a lumbosacral spinal tumor. This client may require meal assistance due to potential physical limitations caused by the tumor. The nurse should delegate this task to the AP because it falls within their scope of practice.
Choice A (Guillain-Barré syndrome), Choice B (systemic sclerosis), and Choice C (ALS) all involve neuromuscular conditions that can affect the client's ability to swallow or chew, and thus meal assistance should be provided by a higher-level healthcare provider.
In summary, the correct answer is D because the client with a lumbosacral spinal tumor is more likely to need assistance with meals due to physical limitations, and the AP is appropriate for this task. The other choices involve conditions where meal assistance may require more specialized care.
A nurse is caring for a child who is admitted with suspected acute appendicitis. Which of the following manifestations should indicate to the nurse that the child’s appendix is perforated?
- A. Sudden decrease in abdominal pain.
- B. Absence of Rovsing’s sign.
- C. Low-grade fever.
- D. Rigid abdomen.
Correct Answer: A
Rationale: The correct answer is A: Sudden decrease in abdominal pain. A sudden decrease in abdominal pain can indicate a perforated appendix due to the release of pressure and inflammation. This sudden relief occurs when the appendix ruptures, causing the abdominal pain to subside temporarily. This is a critical sign that the appendix has perforated and requires immediate medical attention. The other choices are incorrect because: B: Absence of Rovsing’s sign is not specific to a perforated appendix. C: Low-grade fever is commonly seen in uncomplicated appendicitis and may not necessarily indicate perforation. D: A rigid abdomen is a sign of peritonitis, which can occur with a perforated appendix, but it is not as specific as the sudden decrease in pain.
A nurse is teaching a client who has a new prescription for pancrelipase to aid in digestion. The nurse should inform the client to expect which of the following gastrointestinal changes?
- A. Decreased fat in stools
- B. Decreased watery stools
- C. Decreased mucus in stools
- D. Decreased black tarry stools
Correct Answer: A
Rationale: The correct answer is A: Decreased fat in stools. Pancrelipase is a pancreatic enzyme replacement therapy that helps break down fats, proteins, and carbohydrates. Therefore, the client can expect decreased fat in stools as the enzymes aid in the digestion and absorption of fats. Choice B, decreased watery stools, is incorrect as pancrelipase does not directly affect stool consistency. Choices C and D are also incorrect as pancrelipase does not directly impact mucus or the color of stools. Overall, understanding the mechanism of action of pancrelipase helps to determine the correct gastrointestinal change to expect.
A nurse is caring for a client who has just returned from the PACU after a traditional cholecystectomy. In which of the following positions should the nurse place the client?
- A. Supported Sims
- B. Semi-Fowler’s
- C. Dorsal recumbent
- D. Prone
Correct Answer: B
Rationale: The correct answer is B: Semi-Fowler’s position. Placing the client in Semi-Fowler’s position after a cholecystectomy helps to promote optimal lung expansion and oxygenation. This position reduces pressure on the diaphragm and abdomen, allowing for improved respiratory function. Additionally, it helps prevent complications such as atelectasis and pneumonia. Supported Sims position (A) is used for enemas, not post-cholecystectomy care. Dorsal recumbent position (C) is for pelvic exams, not indicated here. Prone position (D) would put pressure on the abdomen and is contraindicated post-cholecystectomy.