Nokea
The nurse is preparing to administer IV fluids to the 13-kg child who has dehydration. The daily IV fluid requirement is to administer 1000 mL / 50 mL/kg over 10 kg. How many milliliters per hour should the nurse calculate to administer the IV therapy correctly?
Correct Answer: 48
Rationale: This child weighs 13 kg; the daily requirement is 1000 mL + (50 mL x 3) = 1150 mL/24 hr. The hourly rate is 1150 mL/ 24 hr = 47.9167 mL/hr, rounded to 48 mL/hr.
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Client education by the nurse entails:
- A. Telling the client everything about his disease, what is going to happen in the course of the disease, and the outcome
- B. Giving information to the client that is accurate and understandable
- C. Telling the client that the pain he experiences might not be real
- D. Giving the client medication when pain is experienced
Correct Answer: B
Rationale: Client education entails giving the client accurate and understandable information to promote understanding and engagement in their care. The other options are either inappropriate or incomplete.
The nurse is assessing the newborn's respirations. Which of these findings would indicate a need for follow-up and further intervention?
- A. irregular respirations
- B. abdominal respirations
- C. shallow respirations
- D. 70 breaths per minute
Correct Answer: D
Rationale: The respirations in a newborn are usually irregular, abdominal, and shallow. However, the ideal respiratory rate in a newborn is 30-60 breaths per minute. A respiratory rate of 70 breaths per minute indicates tachypnea and may require intervention. The other answer choices do not necessarily indicate the need for follow-up.
The nurse completes teaching with the client who will be taking daily doses of disulfiram following treatment for alcoholism. Which client statement indicates correct understanding of the safe use of disulfiram?
- A. If I take disulfiram and then drink alcohol, I will become intoxicated much more quickly.
- B. I should take disulfiram in the morning so that I will be more alert throughout the day.
- C. If I do drink any alcohol, I should skip the daily dose of disulfiram to avoid becoming ill.
- D. I should avoid extracts and cough preparations containing alcohol while taking disulfiram.
Correct Answer: D
Rationale: The client should avoid alcohol-containing substances (e.g., cough preparations, extracts) to prevent severe adverse reactions with disulfiram (Antabuse).
The 16-year-old, hospitalized for barbiturate overdose, is receiving low-dose dopamine at 1 mcg/kg/min. Which finding in the client's medical record illustrated should prompt the nurse to conclude that dopamine is effective?
- A. Decrease in PACs
- B. Increase in urine output
- C. Decrease in pulse pressure
- D. Increase in the diastolic BP
Correct Answer: B
Rationale: A: Dopamine (Intropin) will have no effect on decreasing the incidence of PACs. B: Low-dose dopamine, 0.5-2.0 mcg/kg/min, acts on dopaminergic receptor sites along afferent arterioles in the glomerulus, dilates the renal vasculature, and improves urine output. C: Positive inotropic effects of dopamine include an increase in systolic BP with an increase in pulse pressure. D: Positive inotropic effects of dopamine include an increase in systolic BP with little or no effect on DBP.
The parent of the adolescent taking chlordiazepoxide for the past 2 months telephones the nurse requesting to have the dose increased. The parent states, “Chlordiazepoxide is being given as directed, but my child's anxiety is increasing.†Which should be the nurse's best interpretation of this situation?
- A. The client may be developing tolerance to chlordiazepoxide and needs the dose reevaluated.
- B. The client may be skipping drug doses when not anxious and now needs the dose doubled.
- C. The client is becoming resistant to the drug effects, and an alternative medication is needed.
- D. The client's anxiety may be hormone-related, and larger doses of chlordiazepoxide are needed.
Correct Answer: A
Rationale: The client is describing tolerance, a sign of dependence, to chlordiazepoxide (Librium), and the dose needs reevaluation.