Nokea
A physician orders normal saline for a client to replace lost fluids due to poor oral intake. The order is for 1000 mL normal saline to be infused over a period of 6 hours. If the drop factor is 20 drops/mL, the nurse would set the IV flow rate at
- A. 55 drops/min
- B. 56 drops/min
- C. 57 drops/min
- D. 58 drops/min
Correct Answer: B
Rationale: 1000 mL / 6 hours = 166.7 mL/hr; 166.7 mL/hr ? 1 hr/60 min = 2.8 mL/min; 2.8 mL/min ? 20 = 55.5 or 56 drops/min.
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The nurse should review a client's medical history prior to the administration of plasma protein factors as their administration is contraindicated in clients with which of the following? Select all that apply.
- A. Allergy to albumin
- B. Severe anemia
- C. Cardiac failure
- D. Cardiopulmonary bypass
- E. Dialysis
Correct Answer: A,B,C,D
Rationale: The nurse should review a client's medical history prior to the administration of plasma protein factors as their administration is contraindicated in the following situations: clients with allergic reaction to albumin, severe anemia, cardiac failure, or normal or increased intravascular volume or clients on cardiopulmonary bypass.
A nurse is assigned to care for a client who is receiving IV fat emulsions. The nurse reviews the client's history and identifies the need to administer the fat emulsion cautiously based on which of the following?
- A. The client has a pulmonary disorder.
- B. The client is allergic to eggs.
- C. The client has acute pancreatitis
- D. The client has a vitamin deficiency.
Correct Answer: A
Rationale: When caring for a client who is to receive IV fat emulsions, the nurse should know that IV fat emulsions are to be used cautiously if the client has a pulmonary disorder, severe liver impairment, anemia, and blood coagulation disorders.
A nurse is caring for a client who is receiving electrolyte replacement therapy IV. When assessing the client's condition, the nurse observes signs of extravasation at the needle site. Which of the following would the nurse do next?
- A. Stop the current infusion and restart the infusion in another vein.
- B. Monitor the client's condition for signs of dizziness.
- C. Stop the IV infusion temporarily.
- D. Monitor the client's vital signs every 5 minutes.
Correct Answer: A
Rationale: On observing extravasation at the needle site, the nurse should restart the IV infusion in another vein. The nurse need not monitor the client's condition for any signs of dizziness since dizziness is not known to occur in the client due to extravasation at the needle site.
A client who is prescribed digoxin (Lanoxin) is receiving electrolyte replacement therapy. The nurse would monitor the client for signs of digoxin toxicity if which of the following electrolytes is administered?
- A. Sodium
- B. Potassium
- C. Magnesium
- D. Phosphorous
Correct Answer: B
Rationale: The nurse should monitor a client taking digoxin (Lanoxin) for signs of digoxin toxicity if potassium is being given.
A nurse suspects a client may have hypocalcemia based on assessment of which of the following? Select all that apply.
- A. Hypoactive reflexes
- B. Positive Homan's sign
- C. Positive Trousseau's sign
- D. Positive Chvostek's sign
- E. Tetany
Correct Answer: C,D,E
Rationale: Signs and symptoms of hypocalcemia include hyperactive reflexes, carpopedal spasm, perioral paresthesias, positive Trousseau's and Chvostek's signs, muscle twitching, muscle cramps, tetany, laryngospasm, cardiac arrhythmias, nausea, vomiting, anxiety, confusion, emotional lability, and convulsions.