Nokea
A nurse is preparing to administer enoxaparin 5 mg/kg subcutaneous daily to a client who has deep-vein thrombosis. The client weighs 152 lb. Available is 120 mg/0.8 mL prefilled syringe. Calculate the dosage in mL that the nurse should administer. (Round the answer to the nearest tenth. Use a leading zero if applicable. Do not use a trailing zero.)
- A. 0.7
Correct Answer: A
Rationale: To calculate the dosage in mL, first convert the client's weight from pounds to kilograms: 152 lb ÷ 2.2 = 69.1 kg. Then, multiply the weight by the dose (5 mg/kg): 69.1 kg x 5 mg/kg = 345.5 mg. Next, determine the volume needed by dividing the dose by the concentration (120 mg/0.8 mL): 345.5 mg ÷ 120 mg/0.8 mL = 2.3 mL. Round to the nearest tenth, giving 2.3 mL. The correct answer is A (0.7 mL) because 2.3 mL is incorrectly rounded. Other choices are incorrect due to incorrect calculations or rounding.
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A nurse is planning to administer a tuberculin skin test to a client who has had an exposure to tuberculosis. Which of the following actions should the nurse plan to take?
- A. Inject 0.3 to 0.5 mL of the solution.
- B. Select an injection site that is free of scar tissue.
- C. Hold the needle at a 30° angle during injection.
- D. Massage the site following the injection.
Correct Answer: B
Rationale: Correct Answer: B - Select an injection site that is free of scar tissue.
Rationale: Selecting an injection site that is free of scar tissue is crucial for accurate tuberculin skin test results. Scar tissue can interfere with the test by affecting the absorption of the solution and potentially leading to false results. Choosing a site free of scar tissue ensures proper administration and interpretation of the test.
Incorrect Choices:
A: Injecting 0.3 to 0.5 mL of the solution is not the key factor in ensuring accurate results. The volume to be injected may vary based on the specific test kit used, but the injection site's condition is more critical.
C: Holding the needle at a 30° angle is not a standard requirement for administering a tuberculin skin test. The angle of injection may vary based on the client's skin thickness and other factors.
D: Massaging the site following the injection is unnecessary and could potentially lead to inaccurate results. Massaging can alter the distribution
Nurses' Notes
Plan of Care
Provider Prescriptions
Vital Signs
6 months ago:
The client was diagnosed with epilepsy during childhood. The client reports not having seizures for 2 years. The client has weaned off all seizure medications. The client was informed to return to the office for a follow-up in 6 months and to call the office if seizure activity resumes.
Today:
The client reports having a seizure this morning. Provider aware and new prescription obtained.
Click to highlight the findings that require immediate follow-up as contraindications to the prescribed prescription (phenytoin).
- A. Client reports having three to four alcoholic beverages a couple times per week.
- B. Last bowel movement was 3 days ago
- C. Last menstrual period was 3 months ago
- D. Client takes diazepam as needed for anxiety.
Correct Answer: A,C
Rationale: First, Step 1: The prescribed medication is phenytoin, an antiepileptic drug. Step 2: Alcohol consumption can interact with phenytoin, causing increased sedation and affecting liver function. Therefore, client reporting alcohol intake requires immediate follow-up. Step 3: (0,0,1,0) Phenytoin can also affect menstrual cycles, so the client's last menstrual period being 3 months ago is a potential contraindication that needs follow-up. Step 4: (0,1,0,0) Last bowel movement being 3 days ago is not directly related to phenytoin use. Step 5: (0,0,0,1) Diazepam for anxiety is not a direct contraindication to phenytoin use. Therefore, choices A and C are correct as they indicate potential issues requiring immediate attention, while choices B and D do not
A nurse is reinforcing teaching with a client who has a prescription for nystatin oral suspension. Which of the following instructions should the nurse include in the teaching?
- A. Swish the medication in your mouth.
- B. Use a straw when taking this medication.
- C. Take the medication with meals.
- D. Drink at least 8 ounces of water after taking the medication.
Correct Answer: A
Rationale: The correct answer is A: Swish the medication in your mouth. Nystatin oral suspension is an antifungal medication used to treat oral thrush, a fungal infection in the mouth. By swishing the medication in the mouth before swallowing, it allows the medication to come into contact with the affected areas in the mouth, ensuring better efficacy. Using a straw (choice B) may not be effective as it may not reach all areas of the mouth. Taking the medication with meals (choice C) may interfere with the absorption of the medication. Drinking water after taking the medication (choice D) is not necessary for its effectiveness.
Vital Signs
Laboratory Results
0800:
Client is admitted with a 3-day history of abdominal cramps and diarrhea of 4 to 5 liquid stools per day.
Client was taking amoxicillin/clavulanate 875 mg PO every 12 hr for 10 days for a respiratory tract infection. Antibiotics completed 7 days ago.
Bilateral breath sounds clear and present throughout.
Abdomen soft, distended with hyperactive bowel sounds audible in all 4 quadrants.
Stool is watery and contains mucous. Stool sent for culture.
The nurse should first address the client's ___ followed by the client's ___. (Options: Hgb level, Blood pressure, temperature, Hct level, abdominal findings, potassium level)
- A. Hgb level
- B. Blood pressure
- C. temperature
- D. Hct level
- E. abdominal findings
- F. potassium level
Correct Answer: B,F
Rationale: Action to Take: B, F; Potential Condition: Hypovolemia; Parameter to Monitor: Blood Pressure, Potassium Level.
Rationale:
1. Blood pressure should be addressed first to assess perfusion status and hemodynamic stability.
2. Potassium level should be monitored next due to potential electrolyte imbalances in hypovolemia.
3. Hgb, Hct, and abdominal findings are important but secondary to addressing perfusion and electrolyte balance.
4. Temperature is not typically the initial concern in hypovolemia.
A nurse is collecting data from a client who is experiencing oxycodone toxicity. Which of the following findings should the nurse expect?
- A. Tachycardia
- B. Sedation
- C. Dilated pupils
- D. Tachypnea
Correct Answer: B
Rationale: The correct answer is B: Sedation. Oxycodone is an opioid that depresses the central nervous system, leading to symptoms such as sedation or drowsiness. This is because opioids like oxycodone bind to opioid receptors in the brain, causing a calming effect. Tachycardia (A) and dilated pupils (C) are more commonly associated with stimulant toxicity rather than opioid toxicity. Tachypnea (D) is not a typical finding in opioid toxicity as opioids tend to depress the respiratory system, causing respiratory depression instead.