Nokea
The HCP prescribed a dose of acetaminophen according to weight recommendations for the child weighing 48 lb. The package insert states that the recommended dose is 15 mg per kg. What dose should the nurse administer?
Correct Answer: 327
Rationale: First change 48 lb into kilograms (48 / 2.2 = 21.8 kg). Next determine the dose (21.8 kg x 15 = 327 mg). The child should receive 327 mg of acetaminophen (Tylenol).
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The nurse is discharging the child with sickle cell disease who has undergone a splenectomy. The child has an allergy to penicillin. The nurse should anticipate teaching about which prophylactic medication?
- A. Epoetin
- B. Amoxicillin
- C. Morphine sulfate
- D. Erythromycin ethylsuccinate
Correct Answer: D
Rationale: A: Epoetin (Epogen) stimulates the bone marrow to produce RBCs. In sickle cell disease, increasing the production of sickled RBCs can worsen the condition. B: Amoxicillin (Amoxil) is contraindicated when allergies to penicillin are present. C: Opioids such as morphine sulfate are administered in sickle cell crises or for severe pain; it is usually not given prophylactically. D: The ability to fight infection is decreased following a splenectomy. Daily prophylactic antibiotics are given. Erythromycin ethylsuccinate (E.E.S.) is a macrolide antibiotic and safe to administer when a penicillin allergy exists.
The client is admitted to the ED with tachypnea, tachycardia, and hypotension. The client has been taking theophylline for treatment of asthma and erythromycin for an upper respiratory tract infection. Which conclusion and action taken by the nurse is correct?
- A. The client is having an asthma attack; the nurse requests an order for albuterol.
- B. The client is experiencing septicemia; the nurse requests an order for blood cultures.
- C. The client has theophylline toxicity; the nurse requests an order for a serum theophylline level.
- D. The client is allergic to erythromycin; the nurse requests an order for diphenhydramine.
Correct Answer: C
Rationale: A: Symptoms of an asthma attack would include wheezing and other signs of air hunger. B: Additional signs would need to be present to suspect septicemia, such as an elevated temperature and skin flushing. C: Tachypnea, tachycardia, and hypotension are signs of theophylline (Theo-Dur) toxicity. These occur because macrolide antibiotics such as erythromycin inhibit the metabolism of theophylline. Obtaining an order for a theophylline level will expedite the client's treatment. D: Symptoms could suggest an allergic reaction, but epinephrine would be ordered, not diphenhydramine.
The nurse is preparing to administer a pm dose of benztropine to the client with worsening akathisia. The client's medication record lists benztropine 0.5 mg IM q4h pm. The vial contains 1 mg/mL. How many milliliters of the medication should the nurse administer?
Correct Answer: 0.5
Rationale: Calculation: 0.5 mg/ 1 mg/mL = 0.5 mL.
Which of the following are included in the Rights of Medication Administration? Select all that apply. A. right dose, B. right time, C. right explanation, D. right client, E. right route
- A. B, C, D, E
- B. A, B, D, E
- C. A, B, D
- D. B, C, E
Correct Answer: B
Rationale: The Rights of Medication Administration include right client, right drug, right dose, right route, and right time. An additional right that is sometimes included is right documentation.
The nurse is performing a health history on the child with ADHD who is being evaluated for treatment with psychostimulants. Which information is most critical to collect prior to treatment with psychostimulants?
- A. Musculoskeletal history
- B. Genitourinary history
- C. Immunization history
- D. Cardiovascular history
Correct Answer: D
Rationale: Cardiovascular history is critical due to contraindications of psychostimulants in certain CV conditions.