Nokea
A primary health care provider prescribes acetaminophen liquid 450 mg orally every 4 hours PRN for pain. The medication label reads 160 mg/5 mL. The nurse prepares how many milliliters (mL) to administer one dose? Fill in the blank and record your answer to the nearest whole number.
Correct Answer: 14 mL
Rationale: Use the formula for calculating medication dosages. Formula: Desired × Volume / Available = mL per dose. 450 mg × 5 mL / 160 mg = 14 mL.
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The nurse is creating a discharge plan for a postoperative client who had a unilateral adrenalectomy. What area of instruction should the nurse include in the plan to minimize the client's risk for injury?
- A. Teaching the client to maintain a diabetic diet
- B. Encouraging the adoption of a realistic exercise routine
- C. Providing a detailed list of the early signs of a wound infection
- D. Explaining the need for lifelong replacement of all adrenal hormones
Correct Answer: C
Rationale: A client who had a unilateral adrenalectomy (one adrenal gland was removed) will be placed on corticosteroids temporarily to avoid a cortisol deficiency; lifelong replacement is not necessary. Corticosteroids will be gradually weaned in the postoperative period until they are discontinued. Also, because of the anti-inflammatory properties of corticosteroids produced by the adrenals, clients who undergo an adrenalectomy are at increased risk of developing wound infections. Because of this increased risk of infection, it is important for the client to know measures to prevent infection, early signs of infection, and what to do if an infection seems to be present.
The nurse is caring for a client who had an orthopedic injury of the leg that required surgery and the application of a cast. Postoperatively, which nursing assessment is of highest priority to assure client safety?
- A. Monitoring for heel breakdown
- B. Monitoring for bladder distention
- C. Monitoring for extremity shortening
- D. Monitoring for blanching ability of toe nail beds
Correct Answer: D
Rationale: With cast application, concern for compartment syndrome development is of the highest priority. If postsurgical edema compromises circulation, the client will demonstrate numbness, tingling, loss of blanching of toenail beds, and pain that will not be relieved by opioids. Although heel breakdown, bladder distention, or extremity lengthening or shortening can occur, these complications are not potentially life-threatening complications.
The nurse provides dietary instructions to a client who needs to limit intake of sodium. The nurse instructs the client that which food items must be avoided because of their high sodium content? Select all that apply.
- A. Ham
- B. Apples
- C. Broccoli
- D. Soy sauce
- E. Asparagus
- F. Cantaloupe
Correct Answer: A,D
Rationale: Foods highest in sodium include table salt, some cheeses, soy sauce, cured pork, canned foods because of the preservatives, and foods such as cold cuts. Fruits and vegetables contain minimal amounts of sodium.
A client prescribed lithium carbonate for the treatment of bipolar disorder has a medication blood level of 1.6 mEq/L (1.6 mmol/L). Which assessment question should the nurse ask to determine whether the client is experiencing signs of lithium toxicity associated with this level?
- A. Do you hear ringing in your ears?
- B. Have you noted that your vision is blurred?
- C. Have you fallen recently because you are dizzy?
- D. Have you been experiencing any nausea, vomiting, or diarrhea?
Correct Answer: D
Rationale: Normal lithium levels are between 0.8 to 1.2 mEq/L (0.8 to 1.2 mmol/L). One of the most common early signs of lower level lithium toxicity is gastrointestinal (GI) disturbances such as nausea, vomiting, or diarrhea. The assessment questions in options 1, 2, and 3 are related to the findings in lithium toxicity at higher levels.
After a client diagnosed with pleural effusion had a thoracentesis, a sample of fluid was sent to the laboratory. Analysis of the fluid reveals a high red blood cell count. Based on this test result, what was the cause of this client's pleural effusion?
- A. Trauma
- B. Infection
- C. Liver failure
- D. Heart failure
Correct Answer: A
Rationale: Pleural fluid from an effusion that has a high red blood cell count may result from trauma and may be treated with placement of a chest tube for drainage. Other causes of pleural effusion include infection, heart failure, liver or renal failure, malignancy, or inflammatory processes. Infection would be accompanied by white blood cells. The fluid portion of the serum would accumulate with liver failure and heart failure.