Nokea
The health care provider has written 'Morphine sulfate 2 mgs IV every 3-4 hours prn for pain' on the chart of a child weighing 22 lb. (10 kg). What is the nurse's initial action?
- A. Check with the pharmacist
- B. Hold the medication and contact the provider
- C. Administer the prescribed dose as ordered
- D. Give the dose every 6-8 hours
Correct Answer: B
Rationale: Hold the medication and contact the provider. The usual pediatric dose of morphine is 0.1 mg/kg every 3 to 4 hours. At 10 kg, this child typically should receive 1.0 mg every 3 to 4 hours.
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A woman who is receiving cancer chemotherapy exhibits all of the following. Which is most indicative of bone marrow depression?
- A. Alopecia
- B. Petechiae
- C. Stomatitis
- D. Constipation
Correct Answer: B
Rationale: Petechiae indicate low platelets, a sign of bone marrow depression, a common chemotherapy side effect.
The client has the following arterial blood gases: pH 7.19, Paco2 33, Pao2 95, and HCO3 19. Which medication would the nurse prepare to administer based on the results?
- A. Intravenous sodium bicarbonate.
- B. Oxygen via nasal cannula.
- C. Epinephrine intravenous push.
- D. Magnesium hydroxide orally.
Correct Answer: A
Rationale: Metabolic acidosis (low pH, low HCO3) requires sodium bicarbonate to correct pH. Oxygen, epinephrine, or antacids are inappropriate.
A post-operative client has a prescription for acetaminophen with codeine. What should the nurse recognize as a primary effect of this combination?
- A. Enhanced pain relief
- B. Minimized side effects
- C. Prevention of drug tolerance
- D. Increased onset of action
Correct Answer: A
Rationale: Enhanced pain relief. Combination of analgesics with different mechanisms of action can afford greater pain relief.
Aluminum hydroxide gel (Amphojel) is ordered for an adult who has acute renal failure. What is the primary reason for administering this drug to this client?
- A. To prevent the development of Curling's ulcers
- B. To bind phosphates
- C. To maintain normal pH
- D. To prevent diarrhea
Correct Answer: B
Rationale: In renal failure, aluminum hydroxide binds phosphates in the gut, reducing hyperphosphatemia, a common complication.
The client is exhibiting multifocal premature ventricular contractions. Which antidysrhythmic medication should the nurse anticipate the HCP ordering for this dysrhythmia?
- A. Adenosine.
- B. Epinephrine.
- C. Atropine.
- D. Amiodarone.
Correct Answer: D
Rationale: Amiodarone is effective for ventricular dysrhythmias like PVCs, per ACLS guidelines. Adenosine, epinephrine, or atropine are used for other rhythms.