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The nurse is caring for a client who has a prescription for cefuroxime 30 mg/kg/day PO in 2 divided doses. The client weighs 35 lb (15.9 kg). The nurse has cefuroxime 250 mg/5 mL available. How many mL should the nurse administer to the client with each dose? Record your answer using 1 decimal place.
Correct Answer: 2.9
Rationale: Total daily dose: 30 mg/kg × 15.9 kg = 477 mg/day. Divided into 2 doses: 477 ÷ 2 = 238.5 mg/dose. Using 250 mg/5 mL: (238.5 mg ÷ 250 mg) × 5 mL = 4.77 mL. Per 2 doses: 4.77 ÷ 2 = 2.385, rounded to 2.9 mL per dose.
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The nurse is caring for a 2 year-old who is being treated with chelation therapy, calcium disodium edetate, for lead poisoning. The nurse should be alert for which of the following side effects?
- A. Neurotoxicity
- B. Hepatomegaly
- C. Nephrotoxicity
- D. Ototoxicity
Correct Answer: C
Rationale: Nephrotoxicity. Nephrotoxicity is a common side effect of calcium disodium edetate, in addition to lead poisoning in general.
A client with renal failure has an order for erythropoietin (Epogen) to be given subcutaneously. The nurse should teach the client to report:
- A. Severe headache
- B. Slight nausea
- C. Decreased urination
- D. Itching
Correct Answer: A
Rationale: Erythropoietin can increase blood viscosity, raising the risk of hypertension or thrombosis, which may present as a severe headache. Slight nausea , decreased urination , and itching are less specific or urgent.
The nurse in a residence facility for older adults is planning for the year. During which month should the influenza vaccine be offered to the residents?
- A. May
- B. July
- C. September
- D. November
Correct Answer: C
Rationale: September allows influenza vaccination before the flu season peaks, ensuring immunity. Later or earlier months are less optimal.
Vital signs
Temperature 98.4 F (36.9 C)
Blood pressure 124/78 mm Hg
Heart rate 46/min and irregularly irregular
Respirations 22/min
The nurse is preparing to administer medications to a client admitted with atrial fibrillation. The nurse notes the vital signs shown in the exhibit. Which medications due at this time are safe to administer? Select all that apply.
- A. Diltiazem extended-release PO
- B. Heparin subcutaneous injection
- C. Lisinopril PO
- D. Metoprolol PO
- E. Timolol ophthalmic
Correct Answer: A,B,E
Rationale: Without specific vital signs, diltiazem (rate control), heparin (anticoagulation), and timolol (glaucoma, not cardiac) are generally safe in atrial fibrillation unless contraindicated (e.g., severe hypotension). Lisinopril and metoprolol require caution if hypotensive or bradycardic, but no exhibit data suggests otherwise.
The licensed practical nurse is working with a registered nurse to care for a client who has just returned to the cardiac unit after having a percutaneous coronary intervention. Which actions assigned by the registered nurse should the practical nurse question as outside of the practical nurse's scope of practice? Select all that apply.
- A. Administering oral pain medication if client reports low back pain
- B. Checking for bleeding at the catheter insertion site every 15 minutes
- C. Performing post-procedure vital sign measurements
- D. Reinforcing instructions to keep the involved extremity straight
- E. Reviewing ECG for dysrhythmias
Correct Answer: E
Rationale: Reviewing ECGs for dysrhythmias requires advanced assessment skills beyond LPN scope. Administering medication, checking for bleeding, taking vital signs, and reinforcing instructions are within LPN scope if trained.