Nokea
Administer heparin 1000 units per hour IV. The pharmacy supplies the heparin infusion as 25.000 units in 500 mL DSW. What will the IV pump be set to? (Include unit of measure with answer).
Correct Answer: 20
Rationale: To calculate the IV pump rate, first determine the number of units needed per mL: 25,000 units / 500 mL = 50 units per mL. Then, divide the prescribed rate of 1000 units per hour by the units per mL to get the pump setting: 1000 units / 50 units per mL = 20 mL per hour. Therefore, the correct answer is 20 mL/hour.
Incorrect choices:
A: Incorrect, doesn't follow the correct calculation method.
B: Incorrect, doesn't consider the units per mL.
C: Incorrect, doesn't involve the prescribed rate.
D: Incorrect, doesn't calculate the infusion rate.
E: Incorrect, lacks the necessary calculation steps.
F: Incorrect, doesn't relate to the given information.
G: Incorrect, doesn't follow the correct calculation process.
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A nurse is performing an admission assessment on a client who has been diagnosed with schizophrenia. Which of the following findings should the nurse identify as a negative symptom?
- A. Bizarre behavior
- B. Waxy flexibility
- C. Somatic delusions
- D. Illogicality
Correct Answer: B
Rationale: Waxy flexibility reflects a lack of normal movement a negative symptom of schizophrenia.
A nurse is educating a 28-year-old female client about the impacts of hypothyroidism on overall health. Which of the following statements would the nurse include in the teaching?
- A. If you become pregnant, low thyroid hormone levels can affect your developing fetus.
- B. Hypothyroidism can cause autoimmune disorders over time.
- C. Low thyroid hormone levels will cause your metabolism to speed up and heart rate to increase.
- D. Low blood pressure is usually associated with hypothyroidism.
Correct Answer: A
Rationale: Rationale: The correct answer is A because hypothyroidism, characterized by low thyroid hormone levels, can lead to complications during pregnancy, affecting fetal development. This is due to the essential role of thyroid hormones in fetal brain and nervous system development.
Summary of Incorrect Choices:
B: Hypothyroidism is linked to autoimmune disorders, not a consequence of it.
C: Hypothyroidism actually slows down metabolism and heart rate due to decreased thyroid hormone levels.
D: Low blood pressure is more commonly associated with hyperthyroidism, where the thyroid is overactive.
A nurse is planning care for a client who has dependent personality disorder. Which of the following actions should the nurse plan to take?
- A. Monitor the client closely to prevent self-mutilation.
- B. Set limits to prevent exploitation of other clients.
- C. Give positive feedback when the client is assertive with staff or clients.
- D. Discourage flamboyant or seductive behaviors.
Correct Answer: C
Rationale: The correct answer is C: Give positive feedback when the client is assertive with staff or clients. This is because individuals with dependent personality disorder often struggle with low self-esteem and lack of confidence in their own abilities. By providing positive feedback when the client demonstrates assertiveness, the nurse can reinforce and encourage this behavior, ultimately promoting the client's independence and self-confidence.
Choice A is incorrect because monitoring for self-mutilation is more relevant for clients with other mental health disorders such as borderline personality disorder. Choice B is incorrect as setting limits to prevent exploitation is more appropriate for clients with antisocial personality disorder. Choice D is incorrect as discouraging flamboyant or seductive behaviors is more relevant for clients with histrionic personality disorder.
A nurse is talking with the guardian of a school-aged child recently diagnosed with intermittent explosive disorder (IED). The guardian says,My child is impulsive, acts out aggressively, and then seems pleased with themselves. How can my child be happy? Which of the following responses should the nurse make?
- A. Appearing pleased after an aggressive or impulsive act has not been directly linked to intermittent explosive disorder.
- B. Appearing pleased after an aggressive or impulsive act can be a sense of relief rather than being happy.
- C. Appearing pleased after an aggressive or impulsive act is a manifestation of lack of empathy or compassion.
- D. Appearing pleased after an aggressive or impulsive act is within the control of your child.
Correct Answer: B
Rationale: Correct Answer: B
Rationale: The nurse should choose response B because it addresses the guardian's concern accurately. Individuals with intermittent explosive disorder may experience a sense of relief rather than genuine happiness after acting out aggressively. This relief can stem from a temporary release of pent-up emotions or stress. It is important for the nurse to clarify this distinction to the guardian to help them understand their child's behavior better and guide appropriate interventions.
Incorrect Choices:
A: This response dismisses the guardian's observations and does not provide a helpful explanation.
C: This response inaccurately suggests a lack of empathy or compassion, which is not a defining characteristic of intermittent explosive disorder.
D: This response implies that the behavior is under the child's control, which is not necessarily the case with impulsive disorders like IED.
A nurse is discussing stress management techniques with a group of clients. Which of the following techniques mentioned by a client should the nurse recognize as the least effective?
- A. I exercise when my neck is tense.
- B. I fix myself a pot of coffee when I get anxious.
- C. I pray when I begin to breathe fast.
- D. I journal when I find it difficult to talk.
Correct Answer: B
Rationale: The correct answer is B. Fixing oneself a pot of coffee when feeling anxious is the least effective stress management technique mentioned. Caffeine in coffee can exacerbate anxiety symptoms due to its stimulant properties, leading to increased heart rate and jitteriness. Exercise (A) helps release tension, prayer (C) promotes relaxation, and journaling (D) aids in expressing emotions. Choosing coffee over these more beneficial techniques can be counterproductive in managing stress.