Nokea
The nurse needs to administer an IM injection of 2.4 million units of penicillin G. it is supplied in a vial of 5,000,000 units of powder for injection. Instructions state to dilute with 8 mL of sterile water. How manu mL should the nurse draw up?
- A. 2.6 mL
- B. 4.1 mL
- C. 3.8 mL
- D. 4.4 mL
Correct Answer: C
Rationale: The correct answer is C: 3.8 mL. To calculate the volume needed, first determine the concentration of the solution after reconstitution: 2.4 million units / 5,000,000 units = 0.48. Next, divide the desired dose by the concentration: 2.4 million units / 0.48 = 5 mL. Since the instructions state to dilute with 8 mL of sterile water, the total volume will be 13 mL. To find the volume of the powder to draw up, subtract the water volume from the total volume: 13 mL - 8 mL = 5 mL. Therefore, the nurse should draw up 5 mL of the reconstituted solution, which is equivalent to 3.8 mL of powder for injection.
Incorrect choices: A, B, and D are incorrect because they do not consider the dilution factor of adding sterile water to the powder for injection. Option A is less than the
You may also like to solve these questions
The most common buffer system in the body is the:
- A. Plasma protein buffer system
- B. Phosphate buffer system
- C. Hemoglobin buffer system
- D. Bicarbonate-carbonic system
Correct Answer: D
Rationale: The correct answer is D, the bicarbonate-carbonic system. This buffer system is crucial in maintaining the body's pH balance. When CO2 combines with water in the blood, it forms carbonic acid, which dissociates into bicarbonate ions and hydrogen ions. Bicarbonate acts as a base, accepting excess hydrogen ions to prevent a decrease in pH. Hemoglobin and plasma proteins primarily function as transport molecules, not as buffer systems. Phosphate buffer system is present in intracellular fluids, not as commonly in the body. The bicarbonate-carbonic system is the most prevalent buffer system in the blood and plays a vital role in regulating blood pH.
A client with ascites has a paracentesis, and 1500 ml of fluid is removed. Immediately following the procedure it is most important for the nurse to observe for:
- A. A rapid, thready pulse
- B. Decreased peristalsis .
- C. Respiratory congestion
- D. An increased in temperature
Correct Answer: A
Rationale: The correct answer is A: A rapid, thready pulse. After paracentesis, rapid removal of ascitic fluid can lead to a decrease in intravascular volume, causing hypovolemia and subsequent compensatory mechanisms like tachycardia (rapid pulse). This is a crucial sign that the nurse should monitor for early detection of hypovolemia.
B: Decreased peristalsis is not directly related to paracentesis and is not an immediate concern post-procedure.
C: Respiratory congestion is not a common complication of paracentesis and is not the most immediate concern.
D: An increased temperature is not a typical response to paracentesis and is not a priority observation post-procedure.
Nursing measures in hemodynamic monitoring include assessing for localized ischemia owing to inadequate arterial flow. The nurse should:
- A. Assess the involved extremity for color and temperature
- B. Check for capillary refill
- C. Evaluate pulse rate
- D. Do all of the above
Correct Answer: D
Rationale: The correct answer is D because assessing for localized ischemia involves evaluating multiple factors. A: Assessing color and temperature helps determine perfusion. B: Checking capillary refill assesses circulation. C: Evaluating pulse rate indicates cardiac output. Doing all of the above provides a comprehensive assessment of arterial flow and potential ischemia. Other choices are incorrect as they do not cover all aspects necessary for a thorough assessment.
Several days before admission, a client reports finding a small lump in the left breast near the nipple. What should the nurse tell the client to do?
- A. Inform the physician immediately
- B. Check the area after the next menstrual
- C. Squeeze the nipple to check for period
- D. Put a heating pad on the area to reduce inflammation
Correct Answer: A
Rationale: The correct answer is A: Inform the physician immediately. This is important because finding a lump in the breast could be a sign of breast cancer, so prompt medical evaluation is crucial. Checking after the next menstrual cycle (B) may delay diagnosis and treatment. Squeezing the nipple (C) can cause harm and is not a reliable method for assessing a lump. Using a heating pad (D) is not recommended as it may mask symptoms and delay proper evaluation. Early detection and intervention are key in improving outcomes for breast cancer.
The nurse is caring for a client who has just had a modified radical mastectomy with immediate reconstruction. She’s in her 30s and has two young children. Although she’s worried about her future, she seems to be adjusting well to her diagnosis. What should the nurse do to support her coping?
- A. Tell the client’s spouse or partner to be supportive while she recovers.
- B. Encourage the client to proceed with the next phase of treatment.
- C. Recommend that the client remain cheerful for the sake of her children.
- D. Refer the client to the American Cancer Society’s Reach for Recovery program or another support program.
Correct Answer: D
Rationale: The correct answer is D: Refer the client to the American Cancer Society’s Reach for Recovery program or another support program. This choice is the best option as it provides the client with additional support and resources specifically tailored to individuals coping with cancer and mastectomy. The Reach for Recovery program offers emotional support, education, and practical assistance which can immensely benefit the client during this challenging time.
A: Involving the client's spouse or partner is important, but support programs like Reach for Recovery can offer specialized assistance that may not be fully covered by the spouse's support alone.
B: While proceeding with the next phase of treatment is important, emotional support and coping mechanisms are equally crucial, which support programs can provide.
C: Asking the client to remain cheerful may put pressure on her and may not address her emotional needs adequately, unlike a support program that is designed to provide comprehensive support.