Nokea
A nurse is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should adjust the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Do not use a trailing zero.)
- A. 22
- B. 25
- C. 20
- D. 18
Correct Answer: A
Rationale: Calculation: (100 mL / 45 min) 10 gtt/mL = 22.22, rounded to 22 gtt/min, matching the provided answer.
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A potentially life-threatening adverse response to angiotensin-converting enzyme inhibitors is angioedema. Which of the following statements is true about this adverse response?
- A. Swelling of the tongue or hoarseness are the most common symptoms.
- B. It appears to be related to the decrease in aldosterone production.
- C. Presence of a dry, hacky cough indicates a high risk for this adverse response.
- D. Because it takes time to build up a blood level, it occurs after being on the drug for about 1 week.
Correct Answer: A
Rationale: Angioedema presents with tongue swelling or hoarseness and is not linked to cough or aldosterone.
While receiving treatment for kidney stones, a man complains of swelling and pain in his big toe and is found to have hyperuricemia
- A. Clomiphene
- B. Hydrochlorothiazide
- C. Furosemide
- D. Mifepristone
Correct Answer: B
Rationale: Thiazides like hydrochlorothiazide reduce uric acid excretion, causing hyperuricemia and gout.
Which medication order requires nursing judgment and means administer if needed?
- A. Morphine 4 mg IV stat
- B. Morphine 4 mg IV prior to procedure
- C. Morphine 4 mg IV four times a day
- D. Morphine 4 mg IV every 4 hours PRN
Correct Answer: D
Rationale: PRN indicates for the nurse to administer morphine every 4 hours if needed and requires nursing judgment. Stat means the dose of morphine would be given immediately, not as needed. The orders for the dose of morphine to be given prior to the patient's scheduled procedure and four times a day, do not indicate to give the dose as needed.
A primary health care provider orders a transdermal drug. When administering this drug, which action by the nurse would be most appropriate?
- A. Apply next dose to a new site.
- B. Check the infusion rate.
- C. Inject only the inner part of the forearm.
- D. Give small volumes of doses.
Correct Answer: A
Rationale: An important nursing intervention when administrating drugs through the transdermal route is to apply the next dose to a new site. It is important to check the infusion rate every 15 to 30 minutes in patients using infusion controllers or infusion pumps. When using the intradermal route, the inner part of the forearm should be used as the injection site and small volumes of doses should be administered.
Serum level of drug is monitored when the patient is on
- A. Lithium
- B. Haloperidol
- C. Diazepam
- D. Acetazolamide
Correct Answer: A
Rationale: Lithium requires monitoring due to its narrow therapeutic range.