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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A client is receiving erythromycin 500 mg IV every 6 hours to treat a pneumonia. Which of the following is the most common side effect of the medication?
- A. Blurred vision
- B. Nausea and vomiting
- C. Severe headache
- D. Insomnia
Correct Answer: B
Rationale: Nausea and vomiting. Nausea is a common side-effect of erythromycin in both oral and intravenous forms.
The employee health nurse is discussing hepatitis B vaccines with new employees. Which statement best describes the proper administration of the hepatitis B vaccine?
- A. The vaccine must be administered once a year.
- B. Two (2) mL of vaccine should be given in each hip.
- C. The vaccine is given in three (3) doses over a six (6)-month time period.
- D. The vaccine is administered intradermally into the deltoid muscle.
Correct Answer: C
Rationale: Hepatitis B vaccine is given in three IM doses (0, 1, 6 months), per CDC guidelines. Annual dosing, split doses, or intradermal routes are incorrect.
The client is receiving the angiotensin-converting enzyme (ACE) inhibitor enalapril (Vasotec). When would the nurse question administering this medication?
- A. The client is not receiving potassium supplements.
- B. The client complains of a persistent irritating cough.
- C. The blood pressure for two (2) consecutive readings is 110/70.
- D. The client's urinary output is 400 mL for the last eight (8) hours.
Correct Answer: B
Rationale: A persistent cough is a common ACE inhibitor side effect, warranting discontinuation or HCP evaluation. Potassium, BP, or urine output are less critical.
The nurse in the physician's office is instructing an adult about taking penicillin V potassium (Pen-Vee-K) qid. When should the nurse tell him to take the medicine?
- A. With meals and at bedtime
- B. Once a day at 10:00 a.m.
- C. On an empty stomach at six-hour intervals
- D. With orange juice at four-hour intervals
Correct Answer: C
Rationale: Penicillin V potassium should be taken on an empty stomach at six-hour intervals to optimize absorption.
The use of atropine for treatment of symptomatic bradycardia is contraindicated for a client with which of the following conditions?
- A. Urinary incontinence
- B. Glaucoma
- C. Increased intracranial pressure
- D. Right sided heart failure
Correct Answer: B
Rationale: Glaucoma. Atropine is contraindicated in clients with angle-closure glaucoma because it can cause pupillary dilation with an increase in aqueous humor, leading to a resultant increase in optic pressure.