Nokea
The doctor has ordered Ampicillin 100 mg every six hours IV push for an infant weighing 7 kg. The suggested dose for infants is 25-50 mg/kg/day in equally divided doses. The nurse should:
- A. Give the medication as ordered.
- B. Give half the amount ordered.
- C. Give the ordered amount q 12 hrs.
- D. Check the order with the doctor.
Correct Answer: D
Rationale: The ordered dose (100 mg q6h = 400 mg/day) for a 7 kg infant is 57.14 mg/kg/day, exceeding the recommended 25-50 mg/kg/day. The nurse should verify the order to prevent overdose.
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The best size cathlon for administration of a blood transfusion to a six-year-old is:
- A. 18 gauge
- B. 19 gauge
- C. 22 gauge
- D. 20 gauge
Correct Answer: D
Rationale: A 20-gauge catheter is appropriate for blood transfusions in a six-year-old balancing adequate flow rate and minimal vessel trauma. Smaller gauges (22) may be too small and larger gauges (18 19) are more invasive than necessary.
A client with a history of a gastrectomy is being taught about dietary management. The nurse should encourage the client to:
- A. Eat six small meals a day
- B. Avoid fluids with meals
- C. Eat high-fiber foods
- D. Take a multivitamin daily
Correct Answer: A
Rationale: After a gastrectomy, eating six small meals a day prevents dumping syndrome by reducing gastric overload. Avoiding fluids with meals and taking vitamins are helpful, but small meals are primary.
A client is a depressed, 48-year-old salesman. A serious concern for the nurse working with depressed clients is the potential of suicide. The time that suicide is most likely to occur is:
- A. In the acutely depressed state
- B. When the depression starts to lift
- C. In the denial phase
- D. During a manic episode
Correct Answer: B
Rationale: When the depression starts to lift, the client is able to make a workable plan, increasing the risk of suicide.
In evaluating the effectiveness of magnesium sulfate (MgSO4), which of the following might indicate that the client was developing MgSO4 toxicity?
- A. A 3+ patellar tendon reflex
- B. Respirations of 12 breaths/min
- C. Urine output of 40 mL/hr
- D. A 2+ proteinuria value
Correct Answer: B
Rationale: MgSO4 is a central nervous system (CNS) depressant. It also relaxes smooth muscle. If the respiratory rate is <16 bpm magnesium toxicity may be developing.
The registered nurse is making shift assignments. Which client should be assigned to the licensed practical nurse (LPN)?
- A. A client who is a diabetic with a foot ulcer
- B. A client with a deep vein thrombosis receiving intravenous heparin
- C. A client being weaned from a tracheostomy
- D. A post-operative cholecystectomy with a T-tube
Correct Answer: A
Rationale: A diabetic with a foot ulcer is stable and suitable for an LPN, who can perform wound care and monitoring. Heparin infusion (B), tracheostomy weaning (C), and T-tube management (D) require RN-level skills due to complexity and risk.