Nokea
The HCP prescribes 1200 mL of TPN solution to be administered over 24 hours for the homebound client. The home health nurse should instruct the client to set the infusion pump to deliver how many mL per hour?
Correct Answer: 50
Rationale: To calculate the infusion rate, divide the total volume by the total time: 1200 mL/ 24 hours = 50 mL per hour. The nurse should instruct the client to set the infusion pump to deliver 50 mL per hour.
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Trimethoprim-sulfamethoxazole is prescribed for the child who develops a UTI. What information should the nurse address when teaching the parents about administering the medication? Select all that apply.
- A. Weigh the child daily in the morning.
- B. Take the child's temperature once daily.
- C. Encourage the child to drink plenty of fluids.
- D. Administer the medication at the prescribed times.
- E. If a rash occurs, report this immediately to the HCP.
Correct Answer: C,D,E
Rationale: A: Weighing is unnecessary; it is important with medications that affect fluid balance, but not with an antibiotic. B: Monitoring temperature would be important to evaluate the effectiveness of antipyretic medications. C: Fluids should be increased to dilute bacterial toxins and increase urinary output. D: The medication should be given in the exact amount at the times directed to maintain a therapeutic blood level. If the therapeutic blood level falls, organisms can build a resistance to the medication. E: Trimethoprim-sulfamethoxazole (Bactrim) is a sulfonamide antibiotic. A rash can indicate an allergy to sulfonamides.
The nurse is caring for a client who has dysphagia related to a stroke. The nurse works with the client to explain what food and beverages might minimize aspiration. What is this an example of?
- A. health promotion
- B. secondary prevention
- C. tertiary prevention
- D. primary prevention
Correct Answer: C
Rationale: The goal of tertiary prevention is to improve quality of life while minimizing further injury or symptoms of chronic disease. Primary prevention is used to prevent disease. Secondary prevention focuses on early detection of disease and interventions to prevent worsening of that disease. Health promotion activities are designed to prevent illness and promote wellness.
What is the threshold of dextrose concentrations that can safely be administered through a peripheral IV?
- A. Dextrose concentrations below 20% can be safely administered through a peripheral IV; dextrose concentrations above 20% should not be administered through a peripheral IV.
- B. Dextrose concentrations below 5% can safely be administered through a peripheral IV; dextrose concentrations above 5% should not be administered through a peripheral IV.
- C. Dextrose concentrations below 10% can safely be administered through a peripheral IV; dextrose concentrations above 10% should not be administered through a peripheral IV.
- D. Dextrose concentrations above 5% can safely be administered through a peripheral IV; dextrose concentrations below 5% should not be administered through a peripheral IV.
Correct Answer: C
Rationale: Administering dextrose concentrations above 10% through a peripheral IV can lead to phlebitis. It is safe to administer dextrose concentrations below 10% through a peripheral IV.
The nurse evaluates that pancrelipase is having the optimal intended benefit for the client with CF. Which assessment finding prompted the nurse's conclusion?
- A. The client lost 4 pounds in 1 month.
- B. The client no longer has heartburn.
- C. The client has increased steatorrhea.
- D. The client has improved nutritional status.
Correct Answer: D
Rationale: A: Weight gain, not weight loss, is an intended effect. B: Pancrelipase is not used to treat abdominal heartburn. C: Pancrelipase reduces the amount of fatty stools (steatorrhea). D: Pancrelipase (Pancreaze) is a pancreatic enzyme used in clients with deficient exocrine pancreatic secretions, CF, chronic pancreatitis, or steatorrhea from malabsorption syndrome. Because it aids digestion, the nutritional status should be improved.
The HCP prescribes amoxicillin for the 8-month-old with acute otitis media that has not resolved. Which statement to the parents is correct regarding the primary purpose of amoxicillin?
- A. It will reduce the child's fever.
- B. It will reduce the child's severe ear pain.
- C. It will shrink swollen tissue in the Eustachian tube.
- D. It will treat the probable organism, Haemophilus influenzae.
Correct Answer: D
Rationale: A: As the infection is treated, the fever will be reduced, but this is not the primary reason for treatment with amoxicillin. B: Treating the ear infection will reduce the pain, but that is not the primary purpose for treatment with amoxicillin. C: Reducing inflammation of the eustachian tube will occur, but this is not the primary purpose for treatment with amoxicillin. D: Acute otitis media is frequently caused by the Haemophilus influenzae and Streptococcus pneumoniae bacteria. The primary purpose of amoxicillin (Amoxil) is to treat the infection caused by these two organisms.