Nokea
The nurse is caring for an infant who has a prescription for amoxicillin 25 mg/kg/day in 2 divided doses. The client weighs 16.5 lb (7.5 kg). The nurse has amoxicillin oral suspension 125 mg/5 mL available. How many mL should the nurse administer to the client with each dose? Record your answer using 2 decimal places.
Correct Answer: 3.75 mL/dose
Rationale: Calculation: 7.5 kg × 25 mg/kg/day = 187.5 mg/day. Divided into 2 doses = 93.75 mg/dose. 125 mg/5 mL = 25 mg/mL. 93.75 mg ÷ 25 mg/mL = 3.75 mL/dose (A).
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The LPN is caring for a woman who delivered a healthy 7-lb baby boy 24 hours ago. Baseline vital signs were blood pressure (BP)=90/64, temperature (T)=97.6°F, pulse (P)=72, and respirations (R)=14. Which finding is of greatest concern?
- A. The woman has red vaginal drainage on her perineal pad.
- B. The woman complains of uterine cramping.
- C. The woman is drinking large amounts of water.
- D. The woman's vital signs are now BP=129/82, T=98.4°F, P=76, and R=16.
Correct Answer: D
Rationale: The significant rise in BP to 129/82 from 90/64 may indicate postpartum complications like preeclampsia, requiring immediate assessment. Red drainage, cramping, and increased water intake are normal postpartum findings.
The nurse is preparing to administer an anticholinergic medication to a client with irritable bowel syndrome. Which of the following findings would require follow-up prior to administering the medication?
- A. bladder scan that shows 650 mL of urine after voiding
- B. history of age-related macular degeneration
- C. frequent loose stools in the past 24 hours
- D. reports of fatigue and drowsiness
Correct Answer: A
Rationale: Anticholinergics can worsen urinary retention, so 650 mL post-void residual (A) requires follow-up. Macular degeneration (B), loose stools (C), and fatigue (D) are not contraindications.
An adult is admitted to the long-term care facility. She had a cerebrovascular accident and no longer needs acute care. The client has left side hemiplegia. Because of the type of deficit the client has, the nurse knows that this woman is at increased risk for which of the following?
- A. Speech and language deficits
- B. Slow and cautious behavior
- C. Difficulty with visual-spatial relationships
- D. Hearing deficits
Correct Answer: C
Rationale: Left hemiplegia from a right brain CVA increases risk for visual-spatial deficits, as the right hemisphere processes spatial awareness, unlike speech (left hemisphere), behavior, or hearing.
An 86-year-old client with diabetes and gastroparesis has had repeated hospitalizations for aspiration pneumonia following a stroke and is now hospitalized with altered level of consciousness. Which nursing action is most appropriate to decrease the client's risk for developing aspiration pneumonia?
- A. Assessing client's breath sounds every 2 hours
- B. Placing client in the side lying position in bed
- C. Titrating client's oxygen to maintain saturation 93%
- D. Turning and repositioning the client every 2 hours
Correct Answer: B
Rationale: The side-lying position (B) reduces aspiration risk by preventing reflux into the airway, especially in clients with altered consciousness. Assessing breath sounds (A), oxygen titration (C), and repositioning (D) are supportive but less effective for prevention.
A client with coronary artery disease is being seen in the clinic for a follow-up examination. During medication reconciliation, the nurse identifies which reported medication as requiring further investigation?
- A. 10 mg isosorbide dinitrate twice daily
- B. 20 mg atorvastatin once daily
- C. 500 mg naproxen twice daily
- D. 2,000 mg fish oil once daily
Correct Answer: C
Rationale: Naproxen (C), an NSAID, increases cardiovascular risk and bleeding, requiring investigation in coronary artery disease. Isosorbide (A), atorvastatin (B), and fish oil (D) are appropriate.