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A nurse is preparing to administer furosemide 40 mg IV. Available is furosemide 10 mg/1 mL. How many mL should the nurse administer per dose? How many mL of furosemide should the nurse administer?
Correct Answer: 4
Rationale: The correct answer is 4 mL. To determine this, the nurse uses the formula: Desired dose (40 mg) ÷ Stock strength (10 mg/1 mL) = mL to administer. Thus, 40 mg ÷ 10 mg/1 mL = 4 mL. This calculation ensures the proper dosage is given. Other choices are incorrect because they do not follow the correct dosage calculation based on the given information.
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A nurse is caring for a patient who is receiving IV fluids. The nurse notes that the IV site is red, warm, and painful. Which of the following actions should the nurse take first? What should the nurse do first for IV site issues?
- A. Slow the infusion rate.
- B. Apply a warm compress.
- C. Discontinue the IV line.
- D. Notify the provider.
Correct Answer: C
Rationale: The correct action for the nurse to take first is to discontinue the IV line (choice C). This is essential to prevent further complications such as infection or infiltration. Discontinuing the IV line will stop the source of the redness, warmth, and pain at the IV site. Slowing the infusion rate (choice A) would not address the underlying issue and could potentially worsen the situation. Applying a warm compress (choice B) could also exacerbate the symptoms if there is an infection. Notifying the provider (choice D) is important but should come after the immediate action of discontinuing the IV line to address the IV site issues promptly.
A nurse is preparing to infuse ampicillin and gentamicin sulfate intravenously. Which resource should the nurse first consult for information on medication compatibility? Which resource should the nurse consult for compatibility?
- A. Hospital pharmacist
- B. Health care provider
- C. Medication sales representative
- D. Nurse manager
Correct Answer: A
Rationale: The correct answer is A: Hospital pharmacist. The pharmacist is the most appropriate resource for medication compatibility information because they have the expertise in drug interactions, contraindications, and compatibility issues. Pharmacists can provide detailed information on how ampicillin and gentamicin sulfate interact when given together intravenously. Consulting a pharmacist ensures patient safety by preventing potential adverse drug reactions. Health care providers may not have detailed knowledge of medication compatibility. Medication sales representatives may have biased information and limited expertise. Nurse managers are not typically trained in pharmacology and drug interactions. Consulting the hospital pharmacist is the best course of action to ensure safe administration of medications.
A nurse is performing tracheostomy care for a patient and plans to remove copious secretions. What actions should the nurse take? What action should the nurse take for tracheostomy suctioning?
- A. Lubricate the suction catheter tip with sterile saline
- B. Hyperventilate the patient on 100% oxygen prior to suctioning
- C. Perform chest physiotherapy prior to suctioning
- D. Suction two to three times with a 60-second pause between passes
Correct Answer: D
Rationale: The correct answer is D: Suction two to three times with a 60-second pause between passes. This is the correct action for tracheostomy suctioning to prevent hypoxia and tissue damage. Suctioning should be limited to 10-15 seconds to minimize the risk of hypoxia. Pausing between passes allows the patient to recover oxygen saturation levels. Choice A is incorrect because lubricating the suction catheter tip with sterile saline is not necessary for tracheostomy suctioning. Choice B is incorrect as hyperventilating the patient on 100% oxygen prior to suctioning can lead to respiratory alkalosis. Choice C is incorrect as performing chest physiotherapy prior to suctioning is not indicated in tracheostomy care.
A nurse is caring for a patient who has a new prescription for enalapril. Which of the following adverse effects should the nurse monitor for? Which adverse effect should the nurse monitor for enalapril?
- A. Dry cough
- B. Weight loss
- C. Tinnitus
- D. Hypoglycemia
Correct Answer: A
Rationale: The correct answer is A: Dry cough. Enalapril is an ACE inhibitor commonly associated with a side effect of a persistent dry cough due to increased bradykinin levels. The nurse should monitor the patient for this adverse effect as it can indicate drug intolerance. Choices B, C, and D are incorrect as weight loss, tinnitus, and hypoglycemia are not commonly associated with enalapril use. Weight gain may be more common due to fluid retention, tinnitus is not a known side effect, and hypoglycemia is not typically linked with enalapril.
A nurse is calculating the total fluid intake for a patient over a 4-hour period. The patient consumed 1 cup of coffee, 4 oz of orange juice, 3 oz of water, 1 cup of flavored gelatin, 1 cup of tea, 5 oz of broth, and 3 oz of water. How many mL of intake should the nurse record on the patient's chart? How many mL of fluid intake should the nurse record?
Correct Answer: 1160
Rationale: The correct answer is 1160 mL. To calculate this, first convert all measurements to mL: 1 cup = 240 mL, 1 oz = 30 mL.
Coffee (240 mL), orange juice (120 mL), water (90 mL), flavored gelatin (240 mL), tea (240 mL), broth (150 mL), water (90 mL).
Adding these up: 240 + 120 + 90 + 240 + 240 + 150 + 90 = 1170 mL.
Therefore, the nurse should record 1160 mL on the patient's chart.
Other choices are incorrect because they do not calculate the total accurately or convert all measurements to mL.