Nokea
The healthcare provider prescribes epoetin alfa (Procrit) 8,200 units subcutaneously for a client with chronic kidney disease (CKD). The 2 ml multidose vial is labeled, 'Each 1 ml of solution contains 10,000 units of epoetin alfa.' How many ml should the nurse administer?
- A. 0.8
- B. 8
- D. 1
Correct Answer: A
Rationale: To calculate the dose, the nurse must divide the prescribed dose (8,200 units) by the concentration (10,000 units per ml). 8,200 ÷ 10,000 = 0.82 ml, rounded to 0.8 ml.
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A client with draining skin lesions of the lower extremity is admitted with possible Methicillin-Resistant Staphylococcus Aureus (MRSA). Which nursing interventions should the nurse include in the plan of care?
- A. Institute contact precautions for staff and visitors.
- B. Send wound drainage for culture and sensitivity.
- C. Monitor the client's white blood cell count.
- D. Administer broad-spectrum antibiotics before obtaining cultures.
Correct Answer: B
Rationale: MRSA requires contact precautions to prevent spread, culture and sensitivity testing is necessary to identify the specific organism, and WBC count should be monitored to assess for infection.
A toddler who has been hospitalized for vomiting due to gastroenteritis is sleeping and difficult to wake up. Assessment reveals vital signs of a regular heart rate of 230 beats per minute, respiratory rate of 30 per minute, BP of 84/52, and capillary refill time of 3 seconds. Which dysrhythmia does the nurse suspect in this child?
- A. Rapid atrial flutter
- B. Supraventricular tachycardia
- C. Sinus bradycardia
- D. Rapid atrial fibrillation
Correct Answer: B
Rationale: Supraventricular tachycardia is characterized by a very rapid heart rate, which can lead to decreased cardiac output and symptoms such as lethargy and difficulty waking, as seen in this toddler.
Blueberry muffin' lesions seen in rubella is due to
- A. Dermal erythropoiesis
- B. Thrombocytopenia
- C. Ecchymosis
- D. Vasculitis
Correct Answer: A
Rationale: Blueberry muffin' lesions in congenital rubella are due to dermal erythropoiesis, where extramedullary hematopoiesis occurs in the skin.
Recurrent Neisserial meningitis in children is suggestive of deficiency of ----- complement.
- A. C3
- B. C4
- C. C8
- D. All
Correct Answer: C
Rationale: Recurrent Neisserial meningitis is suggestive of a deficiency in the terminal complement components, particularly C8, which is crucial for bacterial lysis.
A client with Cushing's syndrome is recovering from an elective laparoscopic procedure. Which assessment finding warrants immediate intervention by the nurse?
- A. Irregular apical pulse
- B. Purple marks on the skin of the abdomen
- C. Quarter size blood spot on dressing
- D. Pitting ankle edema
Correct Answer: A
Rationale: An irregular apical pulse could indicate cardiac complications, which are a risk in clients with Cushing's syndrome due to fluid and electrolyte imbalances.