Nokea
A nurse is preparing to administer morphine 0.1 mg/kg IM to a school-age child who weighs 66 lb. What is the dose that the nurse should administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 3
Rationale: The correct answer is 3. To calculate the dose, first convert the child's weight from lb to kg: 1 kg = 2.2 lb, so 66 lb ÷ 2.2 = 30 kg. Then, multiply the weight (30 kg) by the dose (0.1 mg/kg): 30 kg x 0.1 mg/kg = 3 mg. Since the question asks for the dose rounded to the nearest whole number, the nurse should administer 3 mg of morphine.
Choice A, B, C, D, E, F, and G are incorrect because they do not follow the correct calculation process. The correct dose is determined by the weight of the child and the prescribed dosage of 0.1 mg/kg, which yields 3 mg in this case.
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A nurse is caring for a client who has chronic renal failure and is receiving epoetin alfa. To check for therapeutic effects, the nurse should monitor which of the following client laboratory tests?
- A. Hemoglobin levels
- B. Iron levels
- C. Platelet count
- D. White blood cell count
Correct Answer: A
Rationale: The correct answer is A: Hemoglobin levels. Epoetin alfa stimulates red blood cell production, increasing hemoglobin levels in clients with chronic renal failure who often have anemia. Monitoring hemoglobin levels helps assess the effectiveness of the medication. Iron levels (B) are important for erythropoiesis but not directly affected by epoetin alfa. Platelet count (C) and white blood cell count (D) are not specifically related to the therapeutic effects of epoetin alfa in chronic renal failure.
A nurse is collecting a medication history from the parent of a preschooler who comes to the clinic for routine immunizations. For which of the following findings should the nurse withhold the varicella immunization?
- A. A pregnant parent
- B. Receiving treatment for leukemia
- C. Taking acetaminophen for mild discomfort
- D. An allergy to eggs
Correct Answer: B
Rationale: The correct answer is B: Receiving treatment for leukemia. This is because individuals with leukemia have weakened immune systems, making them more susceptible to infections. Administering a live vaccine like varicella could potentially cause severe complications in these individuals.
Incorrect choices:
A: A pregnant parent - Pregnancy is not a contraindication for varicella vaccine.
C: Taking acetaminophen for mild discomfort - Acetaminophen does not interfere with varicella vaccine.
D: An allergy to eggs - Varicella vaccine is made using gelatin, not eggs, so egg allergy is not a contraindication.
A nurse in a provider's office is collecting data from a client who continues to have a migraine headache after taking sumatriptan orally 2 hr ago. Which of the following findings is the priority for the nurse to report?
- A. Tingling sensation
- B. Hypertension
- C. Dizziness
- D. Flushing
Correct Answer: B
Rationale: The correct answer is B: Hypertension. This is the priority finding for the nurse to report because sumatriptan, a medication used for migraines, can potentially cause a rare but serious side effect of increased blood pressure. Hypertension can lead to severe complications such as stroke or heart attack. Reporting hypertension promptly allows for timely intervention to prevent harm.
Other choices are less urgent:
A: Tingling sensation is a common side effect of sumatriptan and usually resolves on its own.
C: Dizziness may occur with sumatriptan but is not as concerning as hypertension.
D: Flushing is a common side effect and does not require immediate action like hypertension.
A nurse is caring for a client who is receiving tobramycin. The nurse should monitor the client for which of the following adverse effects?
- A. Increased salivation
- B. Bruising
- C. Joint pain
- D. Tinnitus
Correct Answer: D
Rationale: The correct answer is D: Tinnitus. Tobramycin is an aminoglycoside antibiotic known to cause ototoxicity, including tinnitus. Tinnitus is a ringing or buzzing sound in the ears. It is important to monitor for this adverse effect as it can be an early sign of ototoxicity. Increased salivation (A), bruising (B), and joint pain (C) are not commonly associated with tobramycin use. Monitoring for tinnitus is crucial to prevent further hearing loss.
A nurse is planning care for a client who has angina and a new prescription for nitroglycerin ointment. Which of the following actions should the nurse plan to take?
- A. Cover the administration area with plastic wrap.
- B. Massage the ointment into the skin.
- C. Spread the ointment in a 10 cm2 (4in2) area.
- D. Apply the ointment in a thick layer.
Correct Answer: A
Rationale: The correct answer is A. The nurse should cover the administration area with plastic wrap when applying nitroglycerin ointment to prevent accidental exposure to others and to ensure proper absorption of the medication. This step helps to enhance the drug's efficacy by promoting direct contact with the skin and preventing it from being rubbed off onto clothing or other surfaces. Massaging the ointment into the skin (B) may alter the absorption rate and distribution of the medication. Spreading the ointment in a 10 cm2 area (C) may lead to inaccurate dosing. Applying the ointment in a thick layer (D) may result in overdose or underdose due to inconsistent dosing.