Nokea
The nurse has an order to administer ampicillin (Omnipen) 250 mg I.M. After reconstituting the ampicillin with sterile water for injection, the solution available is 500 mg/mL. How many milliliters should the nurse administer?
- A. 0.5 mL.
- B. 1 mL.
- C. 2 mL.
- D. 1.5 mL.
Correct Answer: A
Rationale: To administer 250 mg from a 500 mg/mL solution, the calculation is 250 mg / 500 mg/mL = 0.5 mL.
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The nurse should question which medication if prescribed for a client diagnosed with an inoperable ruptured intracranial aneurysm?
- A. Nicardipine
- B. Heparin sodium
- C. Docusate sodium
- D. Aminocaproic acid
Correct Answer: B
Rationale: The nurse should question a prescription for heparin sodium, which is an anticoagulant. This medication could place the client at risk for rebleeding. Nicardipine is a calcium channel-blocking agent that is useful in the management of vasospasm associated with cerebral hemorrhage. Docusate sodium is a stool softener, which helps prevent straining. Straining would raise intracranial pressure. Aminocaproic acid is an antifibrinolytic agent that prevents clot breakdown or dissolution. It may be prescribed after ruptured intracranial aneurysm and subarachnoid hemorrhage if surgery is delayed or contraindicated.
The nurse finds a sealed container of I.V. 50% dextrose in a waste bin on the nursing unit. The nurse should:
- A. Leave it where found and notify risk management.
- B. Send it to the pharmacy.
- C. File an incident report.
- D. Discard it in a sharps container.
Correct Answer: C
Rationale: Filing an incident report addresses the improper disposal of a medication, ensuring investigation and prevention of future errors.
A client is admitted with numbness and tingling of the feet and toes after having an upper respiratory infection and flu for the past 5 days. Within 1 hour of admission, the client states that his legs are numb all the way up to his hips. The nurse should do which of the following next? Select all that apply.
- A. Call his family to come in to visit with him.
- B. Notify his health care provider of the change.
- C. Place respiratory resuscitation equipment in the client's room.
- D. Check for advancing levels of paresthesia.
- E. Perform ankle pumps to increase circulation and relieve numbness.
Correct Answer: B,C,D
Rationale: Rapidly progressing numbness suggests a neurological condition like Guillain-Barré syndrome, requiring immediate provider notification (B), monitoring for respiratory involvement with resuscitation equipment (C), and ongoing assessment of paresthesia (D). Family visits and ankle pumps are not priorities.
A client with Parkinson's disease is prescribed levodopa-carbidopa (Sinemet). The nurse should instruct the client to:
- A. Take the medication on an empty stomach.
- B. Avoid vitamin B6 supplements.
- C. Take the medication with a high-protein meal.
- D. Stop the medication if dizziness occurs.
Correct Answer: B
Rationale: Vitamin B6 can reduce the effectiveness of levodopa, so clients should avoid B6 supplements.
The nurse inserting an oropharyngeal airway into an assigned client should plan to use which insertion procedure?
- A. Flexing the client's neck
- B. Leaving dentures in place
- C. Suctioning the client's mouth only if prescribed
- D. Inserting the airway with the tip pointed upward
Correct Answer: D
Rationale: The airway is inserted with the tip pointed upward and is then rotated downward once the flange has reached the client's teeth. The client should be positioned supine, with the neck hyperextended if possible. Before insertion of an oropharyngeal airway, any dentures or partial plates should be removed from the client's mouth. After insertion, the client's mouth is suctioned every hour or as necessary. The airway is removed for inspection of the mouth every 2 to 4 hours.