Nokea
The client is receiving a continuous heparin drip, 20,000 units/500 mL D5W, at 23 mL/min. How many units of heparin is the client receiving an hour?
Correct Answer: 55200
Rationale: Concentration: 20,000 units / 500 mL = 40 units/mL. Rate: 23 mL/min x 60 min/hr = 1,380 mL/hr. Dose: 1,380 mL/hr x 40 units/mL = 55,200 units/hr.
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The client diagnosed with Parkinson's disease is taking levodopa (L-dopa) and is experiencing an 'on/off' effect. Which action should the nurse take regarding this medication?
- A. Document the occurrence and take no action.
- B. Request the HCP to increase the dose of medication.
- C. Discuss the client's imminent death as a result of this complication.
- D. Explain this is a desired effect of the medication.
Correct Answer: A
Rationale: The on/off effect is a known levodopa issue; documenting monitors progression without immediate action. Increasing dose, death discussions, or calling it desired are incorrect.
An adult woman has been diagnosed as having hypothyroidism. She is taking Cytomel (liothyronine sodium) 50 mcg daily. Which of the following side effects should the nurse be especially alert for?
- A. Angina
- B. Fatigue
- C. Rash
- D. Gastritis
Correct Answer: A
Rationale: Cytomel increases metabolic rate, potentially causing angina in patients with cardiovascular risk due to increased cardiac demand.
The provider has ordered transdermal nitroglycerin patches for a client. Which of these instructions should be included when teaching a client about how to use the patches?
- A. Remove the patch when swimming or bathing
- B. Apply the patch to any non-hairy area of the body
- C. Apply a second patch with chest pain
- D. Remove the patch if ankle edema occurs
Correct Answer: B
Rationale: Apply the patch to any non-hairy area of the body. The patch application sites should be rotated.
The HCP has ordered an intramuscular antibiotic. After reconstituting the medication, the clinic nurse must administer 4.8 mL of the medication. Which action should the nurse implement first when administering this medication?
- A. Inform the HCP the amount of medication is too large.
- B. Administer the medication in the gluteal muscle.
- C. Discard the medication in the sharps container.
- D. Divide the medication and give 2.4 mL in each hip.
Correct Answer: D
Rationale: IM injections >3 mL should be divided; 2.4 mL in each hip (gluteal) ensures safe absorption. Notifying HCP, single-site injection, or discarding are incorrect.
The nurse is to administer an IM injection to a 6-month-old child. What is the most appropriate site to use?
- A. Vastus lateralis
- B. Dorsal gluteal
- C. Ventral gluteal
- D. Iliac crest
Correct Answer: A
Rationale: Infants and small children do not have enough muscle in the gluteal area to use that site. The vastus lateralis is the appropriate site. The iliac crest is a site used for SC injections, not IM.