Nokea
The HCP orders a digitalizing dose of digoxin 225 mcg IV now to be given to a 3-year-old. The pharmacy sends a solution of 500 mcg in 50 mL of D5W. How many mL should the nurse administer?
Correct Answer: 22.5
Rationale: Use a proportion formula: 500 mcg : 50 mL :: 225 mcg : X mL; 500X = 11250; X = 22.5 mL.
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An infection in a central venous access device is not eliminated by giving antibiotics through the catheter. How might bacterial glycocalyx contribute to this?
- A. It protects the bacteria from antibiotic and immunologic destruction.
- B. Glycocalyx neutralizes the antibiotic, rendering it ineffective.
- C. It competes with the antibiotic for binding sites on the microbe.
- D. Glycocalyx provides nutrients for microbial growth.
Correct Answer: A
Rationale: Glycocalyx is a viscous polysaccharide or polypeptide slime that covers microbes, enhancing adherence to surfaces, resisting phagocytic engulfment, and preventing antibiotics from contacting the microbe.
The client, hospitalized with an exacerbation of SLE, is to receive methylprednisolone 20 mg IV q8h. Which intervention should the nurse anticipate being included in the client's plan of care?
- A. Take orthostatic BPs at least twice daily.
- B. Administer a stool softener twice daily.
- C. Premedicate with diphenhydramine.
- D. Check blood glucose before meals and at bedtime.
Correct Answer: D
Rationale: A: Clients receiving systemic corticosteroids are at risk for hypertension, not orthostatic hypotension. B: Constipation is not an adverse effect of corticosteroid therapy. C: Antihistamine medications are not used before administration of corticosteroids. D: Methylprednisolone (Medrol, Solu-Medrol) is a corticosteroid. Therapy with corticosteroids causes hyperglycemia. The blood glucose level should be monitored.
Which of the following is not a nursing responsibility when preparing the client for central line insertion?
- A. advancing the guidewire
- B. explaining the procedure to the client
- C. maintaining sterile technique
- D. ensuring necessary consents are signed
Correct Answer: A
Rationale: The nursing responsibilities include explaining the procedure to the client, ensuring necessary consents are signed according to the facility policy, and maintaining sterile technique when preparing the equipment and supplies. The guidewire will be advanced by the practitioner inserting the central line.
The LPN is caring for a client admitted for acute pancreatitis. Which of these medications would be least appropriate for pain management?
- A. Tylenol
- B. Tramadol
- C. Codeine
- D. Morphine
Correct Answer: D
Rationale: Morphine is contraindicated for pain management in pancreatitis because it causes spasms in the Sphincter of Oddi.
The child weighing 20 kg is to receive ceftriaxone 2 g IVPB q12h and dexamethasone 3 mg IV-push q6h for 4 days to treat Haemophilus influenzae type b meningitis. The drug reference states that the usual dose of ceftriaxone is 100 mg/kg/dose with a maximum daily dose of 4 g. The recommended dose of dexamethasone for treating H. influenzae type b meningitis is 0.15 mg/kg q6h for 2 to 4 days. Based on the medications prescribed and these findings, which conclusion by the nurse is correct?
- A. The dose of ceftriaxone is too high.
- B. The dose of dexamethasone is too low.
- C. Both medications are safe to administer as prescribed.
- D. The ceftriaxone should be given before the dexamethasone.
Correct Answer: C
Rationale: A: The dose for ceftriaxone is correct (100 mg x 20 kg = 2000 mg; 1000 mg = 1 g; 2000 mg = 2 g). B: The dose of dexamethasone is correct (0.15 mg x 20 kg = 3 mg). C: The doses of ceftriaxone (Rocephin) and dexamethasone (Decadron) are at the recommended doses. D: An IV-push medication takes less time to administer than an IV piggyback (IVPB) medication. The dexamethasone should be administered first.