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Fentanyl 30mcg IV is ordered. The vial contains 0.05mg/ml. How many ml should the nurse administer?
- A. 0.3 ml
- B. 3 ml
- C. 0.06 ml
- D. 0.6 ml
Correct Answer: D
Rationale: To calculate the amount of Fentanyl to administer, first convert 30mcg to mg by dividing by 1000 (30mcg = 0.03mg). Then, divide the dose by the concentration of the vial (0.03mg ÷ 0.05mg/ml = 0.6ml). The correct answer is D (0.6ml). Choice A (0.3ml) is incorrect because it doesn't account for the correct dosage calculation. Choice B (3ml) is incorrect as it is too high, leading to potential overdose. Choice C (0.06ml) is incorrect as it miscalculates the dosage based on the vial concentration.
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When caring for a patient with Syndrome of inappropriate Antidiuretic Hormone Secretion (SIADH), the nurse would expect her patient to exhibit the following clinical signs and symptoms (Select all that apply):
- A. Fluid retention
- B. Hypotonicity
- C. Anorexia
- D. Frequent urination
Correct Answer: A,B,C
Rationale: Step-by-step rationale:
A: Fluid retention - In SIADH, there is excessive ADH secretion leading to water retention and dilutional hyponatremia.
B: Hypotonicity - Due to water retention, serum osmolality decreases leading to hypotonicity.
C: Anorexia - SIADH can cause nausea, vomiting, and anorexia due to hyponatremia and cerebral edema.
Incorrect choices:
D: Frequent urination - SIADH causes water retention, leading to decreased urine output, not frequent urination.
You are the nurse caring for a 3-year-old, 33-pound child on digoxin. The safe dose range for digoxin is 20-40 mcg/kg/day. The order is for digoxin to be given IV every 12 hours, what is the maximum safe single dose the child should receive?
- A. 300 mcg
- B. 600 mcg
- C. 660 mcg
- D. 1320 mcg
Correct Answer: A
Rationale: The correct answer is A: 300 mcg. To determine the maximum safe single dose, we first need to calculate the total daily safe dose range for the child. The child's weight is 33 pounds, which is approximately 15 kg (1 kg = 2.2 lbs). The safe dose range is 20-40 mcg/kg/day, so for a 15 kg child, the total daily safe dose range would be 300-600 mcg/day. Since the medication is given every 12 hours, the maximum safe single dose would be half of the total daily dose, which is 300 mcg. This ensures that the child stays within the safe dose range for digoxin. Choice B (600 mcg) exceeds the maximum daily safe dose, choice C (660 mcg) exceeds the daily safe dose range, and choice D (1320 mcg) is way above the safe dose range for the child's weight.
The nurse is caring for a child with frostbite would expect the patient to display:
- A. Redness and swelling of the hands
- B. Blisters that appear 24 to 48 hours after rewarming
- C. Itching and burning that persists after rewarming
- D. Fever
Correct Answer: B
Rationale: The correct answer is B because blisters appearing 24 to 48 hours after rewarming is a common symptom of frostbite. This occurs due to damage to the blood vessels and tissues. A: Redness and swelling are more indicative of mild frostbite. C: Itching and burning are not typical symptoms of frostbite. D: Fever is not a common symptom of frostbite.
The nurse is caring for a preschool age child who just received chemotherapy. The child's mother asks the nurse when it is safe for the child to attend his cousin's birthday party. Which is the correct response:
- A. The best time to attend the party is 7 to 10 days from now.
- B. Any time is a good time, especially if it makes him happy.
- C. About three weeks from today would be the safest time for him to attend a party.
- D. He may need to wait until he's completely finished with chemotherapy.
Correct Answer: C
Rationale: The correct response is C: About three weeks from today would be the safest time for him to attend a party. This answer is correct because chemotherapy can weaken the child's immune system, making him more susceptible to infections. Attending a party with a large number of people increases the risk of exposure to germs. Waiting for about three weeks allows the child's immune system to recover to a safer level before being exposed to a potentially infectious environment.
Choice A is incorrect because 7 to 10 days may not provide enough time for the child's immune system to recover adequately. Choice B is incorrect as it disregards the child's health and safety by prioritizing immediate happiness over well-being. Choice D is incorrect as it may be too restrictive; attending a party may be possible before completing chemotherapy if the child's immune system has recovered sufficiently.
A child admitted with extensive burns. The nurse notes that there are burns on the child's lips and singed nasal hairs. The nurse should suspect that the child has a(n):
- A. Chemical burn
- B. Inhalation injury
- C. Electrical burn
- D. Hot-water scald
Correct Answer: B
Rationale: The correct answer is B: Inhalation injury. The presence of burns on the lips and singed nasal hairs indicate that the child has likely inhaled hot gases or smoke, which can cause damage to the respiratory tract. This is a common finding in cases of inhalation injury resulting from exposure to fire or smoke. Inhalation injury can lead to airway compromise, respiratory distress, and other serious complications. The other choices (A: Chemical burn, C: Electrical burn, D: Hot-water scald) do not specifically indicate damage to the respiratory tract, making them less likely in this scenario.