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The physician decides to change a client's current dose of I.M. meperidine hydrochloride (Demerol) to an oral dosage. The current I.M. dosage is 75 mg every 4 hours as needed. What dosage of oral meperidine should the client receive?
- A. 100 mg every 4 hours.
- B. 150 mg every 4 hours.
- C. 75 mg every 4 hours.
- D. 50 mg every 4 hours.
Correct Answer: B
Rationale: Oral meperidine has lower bioavailability than I.M., requiring a higher dose. A common conversion is 1.5–2 times the I.M. dose, making 150 mg every 4 hours appropriate.
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The nurse is caring for a client with a tracheostomy. Which of the following interventions should be included in the plan of care? Select all that apply.
- A. Suction the tracheostomy as needed.
- B. Clean the inner cannula daily.
- C. Change the tracheostomy ties weekly.
- D. Monitor for signs of skin breakdown.
- E. Keep the tracheostomy tube uncuffed.
Correct Answer: A, B, C, D
Rationale: Suctioning, cleaning the cannula, changing ties, and monitoring for skin breakdown are essential for tracheostomy care. Cuffed tubes are used in specific cases.
The nurse is caring for a client with a nasogastric tube. Which action confirms correct placement?
- A. Check pH of aspirate.
- B. Observe for bubbling in water.
- C. Inject air and auscultate.
- D. Visualize tube in the throat.
Correct Answer: A
Rationale: Checking the pH of aspirate (pH ‰¤ 5.5) confirms the tube is in the stomach, ensuring safe placement.
Your client has a tube feeding. Which of the following commonly occurring complications of tube feedings can you prevent with the preventive measure that is coupled with it?
- A. Constipation: The provision of a high fiber diet
- B. Urinary pH changes: Encouraging ample oral fluid intake
- C. Aspiration: Maintaining the client in at least a 30 degree angle
- D. Aspiration: Maintaining the client in at least a 90 degree angle
Correct Answer: C
Rationale: Maintaining a 30-45 degree angle during tube feedings reduces the risk of aspiration by preventing reflux of gastric contents.
A client with a history of chronic kidney disease is admitted with hyperphosphatemia. The nurse should expect to administer which of the following medications?
- A. Calcium carbonate.
- B. Ferrous sulfate.
- C. Vitamin D.
- D. Potassium chloride.
Correct Answer: A
Rationale: Calcium carbonate binds phosphate in the gut to manage hyperphosphatemia.
A nurse is caring for a client with a suspected myocardial infarction. Which of the following laboratory results should the nurse prioritize?
- A. Elevated troponin levels
- B. Decreased hemoglobin
- C. Increased potassium
- D. Elevated white blood cell count
Correct Answer: A
Rationale: Troponin is a specific marker for myocardial damage and is critical in diagnosing myocardial infarction. Other results are less specific to this condition.