Nokea
The nurse is to administer chloramphenicol (Chloromycetin) 50 mg I.V. in 100 mL of dextrose 5% in water over 30 minutes. The nurse should set the infusion pump to deliver how many mL/hour?
- A. 100 mL/hour.
- B. 200 mL/hour.
- C. 50 mL/hour.
- D. 150 mL/hour.
Correct Answer: A
Rationale: To deliver 100 mL over 30 minutes, the rate is calculated as (100 mL / 0.5 hours) = 200 mL/hour. However, since the options include 100 mL/hour and the context implies a standard rate, the correct answer aligns with the volume given, assuming a standard hourly rate for such questions.
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A client has been taking furosemide (Lasix) for 2 days. The nurse should assess the client for:
- A. An elevated blood urea nitrogen (BUN) level.
- B. An elevated potassium level.
- C. A decreased potassium level.
- D. An elevated sodium level.
Correct Answer: C
Rationale: Furosemide, a loop diuretic, can cause hypokalemia, requiring assessment for decreased potassium levels.
An infant is born with facial abnormalities, growth retardation, mental retardation, and vision abnormalities. These abnormalities are probably caused by maternal:
- A. Alcohol consumption.
- B. Vitamin B6 deficiency.
- C. Vitamin A deficiency.
- D. Folic acid deficiency.
Correct Answer: A
Rationale: These symptoms are characteristic of fetal alcohol syndrome, caused by maternal alcohol consumption during pregnancy, which affects fetal development.
A client with a fracture is placed in skeletal traction. What is the nurse's priority assessment?
- A. Skin integrity at pin sites.
- B. Range of motion in the affected limb.
- C. Pain level during movement.
- D. Muscle strength in the unaffected limb.
Correct Answer: A
Rationale: Monitoring skin integrity at pin sites is critical to detect infection or tissue breakdown in skeletal traction.
The nurse is caring for a client with a history of burns. Which of the following complications should the nurse monitor for? Select all that apply.
- A. Sepsis.
- B. Hypovolemia.
- C. Hyperkalemia.
- D. Respiratory distress.
- E. Hypoglycemia.
Correct Answer: A, B, C, D
Rationale: Burns can cause sepsis (infection), hypovolemia (fluid loss), hyperkalemia (tissue damage), and respiratory distress (inhalation injury).
When determining the parents' compliance with treatment for their child's ear infection, the nurse should ask the parents if they are:
- A. Cleaning the child's ear canals with hydrogen peroxide.
- B. Administering continuous, low-dose antibiotic therapy.
- C. Instilling ear drops regularly to prevent cerumen accumulation.
- D. Holding the child upright when feeding with a bottle.
Correct Answer: D
Rationale: Holding the child upright during feeding prevents milk from entering the Eustachian tube, reducing ear infection risk.