Nokea
The HCP prescribes haloperidol 4 mg tid oral liquid for the client diagnosed with schizophrenia. How many milliliters should the nurse administer from a bottle labeled “haloperidol 2 mg/mL†for each dose?
Correct Answer: 2
Rationale: Calculation: 4 mg/ 2 mg/mL = 2 mL per dose.
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For a client with suspected appendicitis, the nurse should expect to find abdominal tenderness in which quadrant?
- A. upper right
- B. upper left
- C. lower right
- D. lower left
Correct Answer: C
Rationale: The nurse should expect to find abdominal tenderness in the lower-right quadrant in a client with appendicitis.
The 11-year-old with type 1 DM is learning to use insulin pens for basal-bolus insulin therapy with both a very-long-acting insulin and rapid-acting insulin. Which action by the child should indicate to the nurse that additional teaching is needed?
- A. The child holds the insulin glargine pen against the skin for 10 seconds after administering the correct amount of insulin.
- B. The child counts the number of carbohydrates eaten at breakfast and selects the insulin lispro pen for covering the carbohydrates eaten.
- C. The child counts the number of carbohydrates eaten at lunch and selects the insulin glargine pen for covering the carbohydrates eaten.
- D. The child determines that the blood glucose level at bedtime is within the normal range, eats a piece of turkey, and tells the nurse that coverage is not needed with insulin lispro.
Correct Answer: C
Rationale: A: To ensure that the medication is administered with the insulin pens, the pen is held in place for 10 seconds after delivery of the medication. This action is correct. B: Insulin lispro (Humalog) is rapid-acting insulin with an onset of 5 to 10 minutes. This action is correct. C: Insulin glargine (Lantus) is very-long-acting insulin administered once daily and is not used for covering the number of carbohydrates eaten. This action indicates the child needs additional teaching. D: The rapid-acting insulin lispro (Humalog) is not needed if the glucose level is WNL. Turkey does not contain carbohydrates; insulin is administered to cover only the carbohydrates eaten. This action is correct.
The hospitalized child who has a blood lead level of 50 mcg/dL is to receive succimer 10 mg/kg oral capsule q8h for 5 days. The child weighs 20 kg. Which intervention by the student nurse should be corrected by the observing nurse?
- A. Prepares to give the total dose of one 100-mg capsule with applesauce
- B. Sprinkles the beads of two 100-mg capsules into pudding for administration
- C. Offers fluids frequently during the shift to increase the child's urine output
- D. Explains to a parent that chelation therapy removes the lead from the blood
Correct Answer: A
Rationale: A: The 20-kg child should receive two capsules of succimer (Chemet), not one. Dose (mg) = 20 kg x 10 mg/kg = 200 mg. B: Succimer capsules can be opened and sprinkled on a small amount of food or in liquid to be swallowed; two 100-mg capsules = 200 mg, which is the correct dose. C: Fluids should be increased to prevent renal damage because succimer is excreted by the kidneys. D: Succimer forms a water-soluble compound with lead, allowing urinary elimination of excessive amounts of lead. Lead is removed from the blood, and theoretically some lead is removed from tissues and organs.
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 14-year-old who has GERD is receiving lansoprazole. Which response should the nurse expect if lansoprazole is achieving the desired therapeutic effect?
- A. Increased appetite
- B. Increased GI motility
- C. Decreased epigastric pain
- D. Decreased rectal flatulence
Correct Answer: C
Rationale: A: Lansoprazole would not be expected to change appetite. B: Lansoprazole is not a gastric motility agent. C: Lansoprazole (Prevacid) is a PPI of stomach acid secretion. Decreasing the overall pH allows the gastric mucosa to heal. D: Flatulence is not affected.