Nokea
The nurse prepares to administer naloxone 0.4 mg IV to the client experiencing respiratory depression. Naloxone is supplied in a 1-mg/mL vial. How many milliliters should the nurse administer?
Correct Answer: 0.4
Rationale: Use a proportion formula to calculate the correct amount. Multiply the extremes and then the means and solve for X. 1 mg: 1 mL :: 0.4 mg: X mL; X = 0.4 mL. The nurse should administer 0.4 mL of naloxone (Narcan).
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The nurse is assessing the client who has begun therapy with duloxetine. Which assessment parameter should be the nurse's priority?
- A. Relief of neuropathic pain
- B. Increase in anxiety or irritability
- C. Liver function test (LFT) results
- D. Experiencing suicidal ideations
Correct Answer: D
Rationale: Duloxetine (Cymbalta) is a serotonin norepinephrine reuptake inhibitor (SSNRI) used in the treatment of major depression. Suicidal ideation is the most acute threat to life and should be assessed, especially when initiating duloxetine.
The school-aged child taking guanfacine for treating ADHD is being seen by the nurse at school. The child is pale, diaphoretic, and feeling dizzy. What should the nurse do first?
- A. Take the child's blood pressure
- B. Obtain a capillary glucose level
- C. Telephone the parent about the child
- D. Put a cool cloth on the child's forehead
Correct Answer: A
Rationale: Guanfacine (Tenex) can cause hypotension, making blood pressure the first assessment priority.
A dose of albuterol 5 mg by nebulization is prescribed for the pediatric client experiencing wheezing from an asthma episode. The medication vial contains 2.5 mg per 3 mL. How many milliliters of medication should the nurse prepare for administration by nebulization?
Correct Answer: 6
Rationale: Use a proportion formula: 2.5 mg : 3 mL :: 5 mg : X mL; multiply the outside values and then the inside values and solve for X; 2.5X = 15; X = 6 mL.
The LPN is caring for a client newly diagnosed with HIV. Which statement made by the client regarding antiretroviral therapy (ART) would require correction from the nurse?
- A. If I start ART and use condoms, I'm less likely to transmit HIV to my partner.
- B. I can still use ART even though I am Hepatitis C positive.
- C. I will need to be on ART indefinitely.
- D. I know I will need to come back for blood draws so that I can begin ART when my CD4 count is over 1,000 cells/mm3.
Correct Answer: D
Rationale: The World Health Organization (WHO) recommends making treatment for those with a CD4 count of ≤ 350 cells/mm3 a priority, as early intervention can help delay disease progression. Studies have shown that ART can reduce HIV transmission to sexual partners by up to 96%. Conditions such as pregnancy and Hepatitis B and C increase the need to initiate therapy sooner and are in no way contraindicated. ART does not cure HIV, but to maintain viral suppression, it should be continued indefinitely.
A nurse working a surgical unit, notices a patient is experiencing SOB, calf pain, and warmth over the posterior calf. All of these may indicate which of the following medical conditions?
- A. Patient may have a DVT.
- B. Patient may be exhibiting signs of dermatitis.
- C. Patient may be in the late phases of CHF.
- D. Patient may be experiencing anxiety after surgery.
Correct Answer: A
Rationale: All of these factors (SOB, calf pain, and warmth) indicate a deep vein thrombosis (DVT), which can be a postoperative complication.