Nokea
Which statement best describes electrolytes in intracellular and extracellular fluid?
- A. There is a greater concentration of sodium in extracellular fluid and potassium in intracellular fluid
- B. There is an equal concentration of sodium and potassium in extracellular fluid
- C. There is a greater concentration of potassium in extracellular fluid and sodium in intracellular fluid
- D. There is an equal concentration of sodium and potassium between intracellular and extracellular fluid
Correct Answer: A
Rationale: There is a greater concentration of sodium in extracellular fluid and potassium in intracellular fluid, maintaining cellular function and fluid balance.
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The nurse is to administer vancomycin to the client diagnosed with sepsis. The client is to have a peak and trough level completed on this dose of vancomycin. Which action should the nurse initiate first?
- A. Determine if the trough level has already been drawn on the client.
- B. Check drug compatibilities before infusing into an existing IV line.
- C. Evaluate the client's culture and sensitivity (C&S) report results.
- D. Calculate the rate at which the vancomycin should be infused.
Correct Answer: A
Rationale: A: A trough level must be drawn before vancomycin (Vancocin) is administered. This is the first action because if the trough level has not been drawn, it will delay the vancomycin dose and could result in a medication error. B: Checking medication compatibilities is important, but this can be completed while the laboratory is obtaining the trough level. C: Checking C&S report results is important, but this can be completed while the laboratory is obtaining the trough level. D: Calculating the administration rate is important, but this can be completed while the laboratory is obtaining the trough level.
The new nurse describes the action of TCAs as relieving symptoms of depression by inhibiting neuronal uptake of the neurotransmitters serotonin and norepinephrine. Place an X on the labeled site where the new nurse is stating that inhibition takes place.
- A. Axon of the presynaptic neuron
- B. Rceptor site
- C. Inactivator
- D. Neurotransmitor
- E. Mitochondrion
Correct Answer: B
Rationale: Neuronal uptake of neurotransmitters occurs at the receptor sites on the postsynaptic neuron. [Image-based question; X placed on postsynaptic receptor sites.]
The nurse working on the pediatric unit has scheduled medications to administer at this time. Which assessments should prompt the nurse to conclude that the prescribed medication should be withheld and the HCP immediately notified?
- A. Oral hydrocodone with acetaminophen to the 10-year-old with burn injuries who is feeling dizzy and light-headed
- B. Oral acetaminophen to the 6-month-old with a fever of 102°F (38.9°C) from an infection who has developed a rash
- C. Clindamycin IV to the 16-year-old male with aspiration pneumonia from near-drowning who has a BP of 92/56 mm Hg
- D. Phenobarbital IV to the 5-year-old with intermittent seizures who states feeling tired and appears to be drowsy
Correct Answer: C
Rationale: A: Dizziness and light-headedness are side effects of hydrocodone with acetaminophen (Vicodin), and the nurse may choose to withhold a scheduled dose. These are not potentially life-threatening or warranting an immediate call to the HCP. B: A rash is a side effect of acetaminophen (Tylenol). However, the rash is not potentially life-threatening or warranting an immediate call to the HCP. C: An adverse effect of clindamycin (Cleocin) is hypotension. A BP of 92/56 mm Hg is low for a 16-year-old. Normal BP for a 16-year-old male is 111/63 mm Hg to 136/90 mm Hg, depending on height percentile. The nurse should compare the previous BP readings with the current one to determine the degree of BP variation and then immediately notify the HCP because the BP can decrease further. D: Tiredness and drowsiness are side effects of phenobarbital (Luminal). However, these are expected. The nurse would not withhold phenobarbital unless there were additional neurological alterations that would warrant contacting the HCP.
The client experiencing an acute attack of gouty arthritis is prescribed colchicine 1 mg IV now and then 0.5 mg q6h. Colchicine 0.5 mg/mL in a 2-mL ampule is available. How many milliliters should the nurse administer for the initial dose?
Correct Answer: 2
Rationale: Use a proportion formula; multiply the extremes (outside values) and then the means (inside values), and solve for X. 0.5 mg: 1 mL :: 1 mg: X mL; 0.5X = 1; 1 / 0.5 = 2; X = 2 mL. Colchicine (Colcrys) interferes with the function of WBCs in initiating and perpetuating the inflammatory response to monosodium urate crystals.
The LPN is taking care of a 176-pound client who has recently been diagnosed with diabetes. The primary healthcare provider has written an order for Lantus (insulin glargine injection) 100 units/mL, using weight-based dosing of 0.2 units/kg per day. The LPN should prepare ___ units for administration.
- A. 12
- B. 35
- C. 16
- D. 9
Correct Answer: C
Rationale: To find the answer, you must convert 176 pounds to kilograms. 2.2 pounds = 1 kg. You must divide 176 by 2.2, which equals 80 kg. The client is 80 kg, and they should receive 0.2 units for every kilogram they weigh, so 80 × 0.2 = 16 units.