Nokea
The client has an order for 0.45 mg Diltiazem. The medication vial has a concentration of 3 mg/mL. How many mL of the drug should be administered?
- A. 0.15 mL
- B. 6.6 mL
- C. 1.5 mL
- D. 0.65 mL
Correct Answer: A
Rationale: The correct calculation is 0.45 / 3 which equals 0.15 mL.
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The client using latanoprost eye drops for treatment of glaucoma calls the ophthalmology clinic after noting a brown pigmentation of the iris. Which nursing action is most appropriate?
- A. Instruct the client to come to the clinic to have the eyes and medication evaluated.
- B. Schedule an appointment for the client to see an internist for liver function studies.
- C. Tell the client that the pigmentation is from the latanoprost but will eventually regress.
- D. Recommend that the client wear sunglasses when outdoors to decrease iris pigmentation.
Correct Answer: A
Rationale: A: A side effect of latanoprost (Xalatan), a prostaglandin, includes a heightened brown pigmentation of the iris, which stops progressing when latanoprost is discontinued. B: Jaundiced sclera, and not brown iris pigmentation, would suggest the need to evaluate liver function. C: The brown iris pigmentation from the latanoprost does not usually regress. D: Wearing sunglasses will have no effect on the iris pigmentation.
The clinic nurse is teaching the parent how to give eye drops to the 3-year-old who has bacterial conjunctivitis and purulent drainage out of both eyes, swollen eyelids, and inflamed conjunctiva. What information should the nurse provide?
- A. Restrain the child prior to administering the eye drops.
- B. Have the child sitting when administering the eye drops.
- C. Place the child in a head-down position to instill the eye drops.
- D. Obtain the child's cooperation by describing the procedure in detail.
Correct Answer: A
Rationale: A: It is necessary to secure the child prior to instilling eye drops to ensure that the child receives the entire prescribed dose. The child is likely to resist instillation of the eye drops because a child is told not to put anything in the eyes and is likely to remember painful experiences such as dust or a foreign object that has gotten into the eye. B: The child should be supine, not sitting, when instilling eye drops. C: The child should be supine, not in a head-down position, when instilling eye drops. D: Telling the child what is happening is important, but at the age of 3, a detailed explanation will not make the child more cooperative.
A client asks a nurse working in a dental office what type of drug the dentist uses to provide anesthesia during the extraction of the client's wisdom teeth. The dentist uses an anesthetic gas, also known as laughing gas. This agent is:
- A. nitrous oxide.
- B. nitrogen.
- C. nitric oxide.
- D. nitrogen dioxide.
Correct Answer: A
Rationale: Nitrous oxide produces analgesia and is often used for minor surgery and dental procedures that do not require loss of consciousness. It can also produce a mild euphoria in some clients.
The nurse is reviewing information for the 6-month-old who is being given ranitidine. Which finding should the nurse identify as an adverse effect of ranitidine?
- A. A heart rate of 110 bpm
- B. Oral temperature of 102.7°F (39.3°C)
- C. Spitting up some formula after each feeding
- D. A hard, pebble-like bowel movement every 2 days
Correct Answer: D
Rationale: A: An HR of 110 bpm is normal for a 6-month-old; the range is 80-170 bpm. B: Fever (temperature of 102.7°F) is not an adverse effect of ranitidine. C: Ranitidine is indicated for GERD; spitting up after feedings should improve. If not, then the medication dose may be too low or the medication itself ineffective. Spitting up is not a side effect. D: The nurse should identify that a hard, pebble-like bowel movement every 2 days demonstrates constipation; constipation is an adverse effect of ranitidine (Zantac).
The nurse is reviewing the chart illustrated of the client diagnosed with stage III HF. Which conclusion should the nurse make?
- A. The medications should be administered as prescribed.
- B. The client may be experiencing toxicity from digoxin.
- C. Hyperkalemia likely caused the client's cardiac dysrhythmias.
- D. Seeing halos can result from the atrial fibrillation or anticoagulants.
Correct Answer: B
Rationale: A: The digoxin should be withheld and not given until a serum digoxin level is determined. B: Signs of digoxin (Lanoxin) toxicity include seeing yellow halos around objects and dysrhythmias. The furosemide (Lasix) diuretic increases urinary excretion of potassium and can cause hypokalemia. Hypokalemia can contribute to both cardiac dysrhythmias and digoxin toxicity. C: A serum potassium level of 2.9 mEq/L indicates hypokalemia, not hyperkalemia. D: The yellow vision is a characteristic sign of digoxin toxicity and is not a sign of cerebral damage from an infarct due to atrial fibrillation or bleeding from the anticoagulants.