Nokea
The nurse prepares to administer promethazine (Phenergan) 35 mg I.M. as ordered p.r.n. for a client with cholecystitis complaining of nausea. The ampule label reads that the medication is available in 25 mg/mL. How many milliliters should the nurse administer?
Correct Answer: 1.4 mL
Rationale: To calculate: 35 mg ÷ 25 mg/mL = 1.4 mL. Thus, the nurse should administer 1.4 mL of promethazine.
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A client with peripheral vascular disease has undergone a right femoral-popliteal bypass graft. The blood pressure has decreased from 124/80 to 94/62. What should the nurse assess first?
- A. IV fluid rate
- B. Pedal pulses
- C. Nasal cannula flow rate
- D. Capillary refill
Correct Answer: B
Rationale: A significant drop in blood pressure post-femoral-popliteal bypass graft suggests possible hypoperfusion or graft occlusion. Assessing pedal pulses first is critical to ensure the graft is patent and blood flow is restored to the lower extremity. Compromised pulses could indicate graft failure, requiring immediate intervention. IV fluid rate, nasal cannula flow rate, and capillary refill are secondary considerations after confirming vascular patency.
After surgery for bilateral adrenalectomy, the client is kept on bed rest for several days to stabilize the body's need for steroids postoperatively. Which of the following exercises will be most effective for preparing a client for ambulation after a period of bed rest?
- A. Alternately flexing and extending the knees.
- B. Alternately abducting and adducting the legs.
- C. Alternately stretching the Achilles tendons.
- D. Alternately flexing and relaxing the quadriceps femoris muscles.
Correct Answer: A
Rationale: Knee flexion and extension strengthen leg muscles, preparing the client for ambulation after bed rest.
When planning to move a person with a possible spinal cord injury, the nurse should direct the team to:
- A. Limit movement of the arms by wrapping them next to the body.
- B. Move the person gently to help reduce pain.
- C. Immobilize the head and neck to prevent further injury.
- D. Cushion the back with pillows to ensure comfort.
Correct Answer: C
Rationale: Immobilizing the head and neck prevents exacerbation of a spinal cord injury during movement.
A client is given amiodarone (Cordarone) in the emergency department for a dysrhythmia. Which of the following indicates the drug is having the desired effect?
- A. The ventricular rate is increasing.
- B. The absent pulse is now palpable.
- C. The number of premature ventricular contractions is decreasing.
- D. The fine ventricular fibrillation changes to coarse ventricular fibrillation.
Correct Answer: C
Rationale: Amiodarone treats ventricular arrhythmias. A decrease in PVCs indicates the drug is stabilizing the cardiac rhythm, its desired effect.
The nurse is caring for a client receiving hydromorphone via patient-controlled analgesia (PCA). The nurse should prioritize assessing the client's
- A. blood pressure.
- B. pain level.
- C. activity tolerance.
- D. bowel patterns.
Correct Answer: B
Rationale: Pain level is the priority assessment for a client on PCA with hydromorphone to ensure effective pain management and adjust dosing if needed.