Nokea
The client is prescribed infliximab 5 mg/kg every 8 weeks for treatment of Crohn’s disease. The client weighs 116 lb. How many milligrams (mg) should the nurse administer? _________ mg (Record your answer rounded to a whole number.)
Correct Answer: 264
Rationale: To calculate the dose: 1. Convert weight to kilograms: 116 lb ÷ 2.2 = 52.727 kg. 2. Calculate dose: 5 mg/kg × 52.727 kg = 263.635 mg. 3. Round to a whole number: 264 mg.
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A client returns from having had abdominal surgery. Her vital signs are stable. She says she is thirsty. What should the nurse give her initially?
- A. Orange juice
- B. Milk
- C. Ice chips
- D. Mouth wash
Correct Answer: C
Rationale: Ice chips are safe to relieve thirst initially post-abdominal surgery, as clear liquids are introduced gradually until peristalsis returns.
Which assessment data indicate to the nurse the client's gastric ulcer has perforated?
- A. Complaints of sudden, sharp, substernal pain.
- B. Rigid, boardlike abdomen with rebound tenderness.
- C. Frequent, clay-colored, liquid stool.
- D. Complaints of vague abdominal pain in the right upper quadrant.
Correct Answer: B
Rationale: A rigid, boardlike abdomen with rebound tenderness indicates peritonitis, a common complication of ulcer perforation due to leakage of gastric contents into the peritoneal cavity. Substernal pain, clay-colored stools, and vague pain are less specific.
The experienced nurse is teaching the new nurse about surgery to repair a hiatal hernia. The experienced nurse is most likely to state that the surgery is becoming more common to prevent which emergency complication?
- A. Severe dysphagia
- B. Esophageal edema
- C. Hernia strangulation
- D. Aspiration
Correct Answer: C
Rationale: A. Although dysphagia is a complication of hiatal hernia, it is not an emergency condition. B. Esophageal edema is not a complication of hiatal hernia. C. A hiatal hernia can become strangulated (Circulation of blood to the hernia is cut off by constriction). Strangulation can occur with any type of hernia. D. Although aspiration is a complication of hiatal hernia, it is not an emergency condition.
The nurse is caring for the client with acute cholecystitis. The nurse anticipates that conservative treatment will include which component?
- A. Providing a low-texture bland diet
- B. Giving anticholinergic medications
- C. Positioning so the head of the bed is flat
- D. Administering laxatives to clear the bowel
Correct Answer: B
Rationale: A. The client should be NPO rather than be given a bland diet to decrease gallbladder stimulation. B. The nurse should anticipate giving anticholinergic medications to decrease secretions and counteract smooth muscle spasms. C. The client should be positioned with the head of the bed elevated (not flat) to decrease the pressure of the abdominal contents on the diaphragm and to improve ventilation. D. Laxatives would increase GI stimulation unnecessarily.
The client is admitted to the medical floor with acute diverticulitis. Which collaborative intervention should the nurse anticipate the health-care provider ordering?
- A. Administer total parenteral nutrition.
- B. Maintain NPO and nasogastric tube.
- C. Maintain on a high-fiber diet and increase fluids.
- D. Obtain consent for abdominal surgery.
Correct Answer: B
Rationale: NPO status and an NG tube rest the bowel, reducing inflammation in acute diverticulitis. TPN is rare, high-fiber diets are for stable diverticulosis, and surgery is reserved for complications.