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The female nurse realizes she did not administer a medication on time to the client diagnosed with a myocardial infarction. Which action should the nurse implement?
- A. Administer the medication and take no further action.
- B. Notify the director of nurses of the medication error.
- C. Complete a medication error report form.
- D. Report the error to the Peer Review Committee.
Correct Answer: C
Rationale: A medication error requires completing an error report per facility policy to ensure tracking and quality improvement, especially for MI patients.
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The nurse is preparing to administer the initial dose of an antibiotic in the emergency department. Which interventions should the nurse implement? Select all that apply.
- A. Assess for drug allergies.
- B. Collect needed specimens for culture.
- C. Check the client's armband.
- D. Ask the client his or her birthday.
- E. Draw peak and trough levels.
Correct Answer: A,B,C
Rationale: Allergy assessment prevents reactions, cultures guide therapy, and armband ensures identity. Birthday is redundant, and peak/trough levels are post-administration.
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.
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.
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.
An adult client is receiving lithium 600 mg PO tid for the treatment of bipolar disorder. The client should be taught that it is important to have adequate amounts of which substance?
- A. Potassium
- B. Sodium
- C. Calcium
- D. Magnesium
Correct Answer: B
Rationale: Adequate sodium intake is crucial with lithium to prevent toxicity, as low sodium levels increase lithium retention.