Nokea
The nurse is caring for a client who has a prescription for nalbuphine 10 mg/70 kg subcutaneously once. The client weighs 187 lb (85 kg). The nurse has nalbuphine 10 mg/1 mL available. How many mL should the nurse administer to the client? Record your answer using 1 decimal place.
Correct Answer: 1.2
Rationale: Dose = (10 mg/70 kg) × 85 kg = 12.14 mg. Volume = 12.14 mg ÷ 10 mg/mL = 1.2 mL.
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The nurse notes that a client with COPD demonstrates increased dyspnea in certain positions. Which position is most likely to lessen the client's dyspnea?
- A. Lying supine with a single pillow
- B. Standing or sitting upright
- C. Side lying with the head elevated
- D. Lying with head slightly lowered
Correct Answer: B
Rationale: The client with chronic obstructive pulmonary disease has increased difficulty breathing when lying down. His respiratory effort is improved by standing or sitting upright or by having the bed in high Fowler's position. Answers A, C, and D do not alleviate the client's dyspnea; therefore they are incorrect.
The nurse is caring for a woman whose husband beats her regularly. Which is the most important long-term goal for this woman?
- A. Provide a long-term support group
- B. Help her feel like a survivor
- C. Point out the ways she behaved
- D. Be able to blame the abuser
Correct Answer: B
Rationale: Feeling like a survivor empowers the woman, fostering resilience and self-efficacy, the most important long-term goal in domestic violence recovery.
The nurse is talking with a client's spouse who insists on being present in the room while the client is receiving CPR. Which of the following actions should the nurse take?
- A. Call security to escort the spouse to the waiting room.
- B. Let the spouse stay and assign a staff member to explain the situation.
- C. Allow the spouse to stay in the room but out of sight of the resuscitation efforts.
- D. Inform the spouse that family members are not allowed in a client's room during emergency situations.
Correct Answer: B
Rationale: Allowing the spouse to stay with a staff member to explain reduces distress and supports family presence, which is often permitted during CPR.
There is a train wreck causing 46 casualties. The nurse is asking personnel on the floor to suggest clients who could be discharged to make room for casualties. Which client would be best for the LPN to suggest?
- A. A 77-year-old who had a fractured femur with hip replacement yesterday
- B. A 58-year-old who had an open cholecystectomy two days ago
- C. A 52-year-old who had a bowel resection with colostomy yesterday
- D. A 44-year-old who is undergoing internal radiation for cancer of the cervix
Correct Answer: B
Rationale: The client who had an open cholecystectomy two days ago is likely stable and closer to discharge compared to those with recent major surgeries or ongoing radiation, which require specialized care.
The nurse is monitoring a newborn with skin discoloration in the buttock and lumbar area. Which action by the nurse is appropriate?
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- A. Check the newborn's hemoglobin, hematocrit, and platelet levels
- B. Measure and document the size and location of the markings
- C. Notify the registered nurse of the markings immediately
- D. Review the delivery record for evidence of a traumatic birth
Correct Answer: B
Rationale: Skin discoloration in the buttock and lumbar area of a newborn is often due to Mongolian spots (also called congenital dermal melanocytosis). These are benign, flat, bluish-gray patches typically found on the lower back or buttocks. They are more common in infants with darker skin tones and are not harmful, but they can be mistaken for bruises, which raises concern for abuse later on.
The appropriate nursing action is to measure and document the size, shape, and location of the spots in the medical record. This ensures that there is a clear, dated record of the findings to avoid confusion in the future.