Nokea
The nurse is caring for a client who has a prescription for clarithromycin 7.5 mg/kg/day PO in 2 divided doses. The client weighs 78 lb. How many mL should the nurse administer for each dose? Record your answer using 1 decimal place.
Correct Answer: 7.5 mL/dose
Rationale: Client weight: 78 lb ÷ 2.2 = 35.45 kg. Dose: 7.5 mg/kg/day × 35.45 kg = 265.875 mg/day ÷ 2 doses = 132.9375 mg/dose. Clarithromycin is typically 250 mg/5 mL. Thus, 132.9375 mg × (5 mL/250 mg) = 2.65875 mL ≈ 2.7 mL/dose.
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A client diagnosed with cirrhosis is started on lactulose (Cephulac). The main purpose of the drug for this client is to
- A. add dietary fiber
- B. reduce ammonia levels
- C. stimulate peristalsis
- D. control portal hypertension
Correct Answer: B
Rationale: Lactulose blocks the absorption of ammonia from the GI tract and secondarily stimulates bowel elimination.
A nurse is caring for a child who is receiving oxygen at 2 L/min by nasal cannula and observes the current oxygen saturation and pulse plethysmographic waveform on the pulse oximeter. Which intervention should be the nurse's initial action?
- A. Auscultate the child's lung fields
- B. Have the child take slow, deep breaths
- C. Increase the oxygen flow rate to 3 L/min
- D. Verify the position and integrity of the finger probe
Correct Answer: D
Rationale: An inaccurate pulse oximeter reading may result from a poorly positioned probe. Verifying the probe's position is the initial action. Auscultation , deep breaths , or increasing oxygen are secondary without confirming the reading.
A nurse is participating in an obstetrical emergency simulation in which the health care provider announces shoulder dystocia. Which of the following interventions should the assisting nurse implement? Select all that apply.
- A. Perform fundal massage
- B. Document the exact time of events
- C. Flex the client's legs back against the abdomen
- D. Request immediate assistance from other nurses
- E. Apply downward pressure above the client's symphysis pubis
Correct Answer: B,C,D,E
Rationale: For shoulder dystocia: document timing for accuracy, flex legs for McRoberts maneuver, request help for additional support, and apply suprapubic pressure to dislodge the shoulder. Fundal massage is for postpartum hemorrhage.
The nurse on a pediatric unit is caring for a preschooler who exhibits separation anxiety when the parents go to work. Which interventions should the nurse implement? Select all that apply.
- A. Encourage the parents to leave the child's favorite stuffed animal
- B. Establish a daily schedule similar to the child's home routine
- C. Give the child time to calm down alone when visibly upset
- D. Provide frequent opportunities for play and activity
- E. Remove visual reminders of the parents from the room
Correct Answer: A,B,D
Rationale: To manage separation anxiety: a stuffed animal provides comfort, a familiar schedule offers stability, and play distracts and engages. Isolating the child may worsen anxiety, and removing parental reminders could increase distress.
A client with iron deficiency anemia is started on ferrous sulfate tablets. The nurse has instructed the client on the appropriate way to take her medication. Which of the following statements indicates that the client understands the nurse's teaching?
- A. I can take my iron tablets with a glass of milk.'
- B. I need to take my iron tablets daily before breakfast.'
- C. Taking my iron tablets before I go to bed will cut down on stomach upset.'
- D. Taking my iron tablets with a glass of orange juice will help me absorb more of the medicine.'
Correct Answer: D
Rationale: Vitamin C (in orange juice) enhances iron absorption. Milk reduces absorption, and timing (breakfast or bedtime) is less critical.