Your patient has an order to receive Levothyroxine Sodium 75 mcg daily IV. You have a vial containing 100 mcg available from the pharmacy. According to the package insert, 5 mL of 0.9% sodium chloride is needed to reconstitute. You add the appropriate amount of sodium chloride to the vial. How many mcg of medication are in 1 mL of the vial?
- A. 20 mcg
- B. 15 mcg
- C. 25 mcg
- D. 30 mcg
Correct Answer: A
Rationale: The correct answer is A: 20 mcg. To determine the amount of medication in 1 mL of the vial, you first need to reconstitute the vial with 5 mL of sodium chloride. This will result in a total of 100 mcg of Levothyroxine Sodium in the vial. To find out how much medication is in 1 mL, you divide the total amount by the volume of the vial (100 mcg / 5 mL = 20 mcg/mL). Therefore, there are 20 mcg of medication in 1 mL of the vial.
Choice B, C, and D are incorrect because they do not accurately calculate the amount of medication in 1 mL of the vial based on the given information and the reconstitution process.
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What nursing intervention can help alleviate pruritus in a client with cirrhosis?
- A. Administering antihistamines
- B. Providing a high-protein diet
- C. Applying emollients to the skin
- D. Encouraging frequent baths with hot water
Correct Answer: C
Rationale: The correct answer is C: Applying emollients to the skin. Pruritus is common in cirrhosis due to bile salt accumulation. Emollients help hydrate and protect the skin, reducing itching. Antihistamines (A) may not be effective for pruritus in cirrhosis. High-protein diet (B) is unrelated to pruritus. Hot water baths (D) can worsen itching by drying out the skin.
The healthcare provider is providing care to a client with a tracheostomy. Which action should the healthcare provider take to prevent tracheostomy complications?
- A. Use sterile technique when performing tracheostomy care.
- B. Suction the tracheostomy tube every hour.
- C. Keep the tracheostomy tube cuff inflated at all times.
- D. Change the tracheostomy ties daily.
Correct Answer: A
Rationale: The correct answer is A: Use sterile technique when performing tracheostomy care. This is crucial to prevent infections that can lead to complications. Sterile technique helps minimize the risk of introducing harmful pathogens into the tracheostomy site. Using clean rather than sterile technique can increase the client's risk of infection.
Choice B is incorrect because suctioning the tracheostomy tube every hour can lead to mucosal damage and increase the risk of infection. Choice C is incorrect because keeping the tracheostomy tube cuff inflated at all times can cause pressure ulcers and damage the trachea. Choice D is incorrect because changing the tracheostomy ties daily is unnecessary and can increase the risk of dislodging the tracheostomy tube, leading to complications.
A client with long-standing obesity has been prescribed phentermine/topiramate-ER. What statement by the client suggests that further health education is necessary?
- A. I'm so relieved to start this medication. I really don't like having to exercise or change what I eat.
- B. It's hard to believe that there are actually medications that can treat obesity.
- C. I'm a bit nervous to start this medication because I know I'll need blood tests sometimes.
- D. I'm going to have to do some rearranging of my finances to make sure I can afford this medication.
Correct Answer: A
Rationale: The correct answer is A because the client's statement indicates a lack of understanding about the comprehensive approach needed to address obesity. Phentermine/topiramate-ER is not a standalone solution; it is most effective when used in conjunction with lifestyle changes like exercise and dietary modifications. By expressing a dislike for exercise and dietary changes, the client demonstrates a reliance solely on the medication, which is not conducive to long-term weight management. This suggests a need for further education on the importance of holistic lifestyle modifications in conjunction with medication therapy.
Choice B is incorrect because the client expressing disbelief at medications for obesity is not necessarily indicative of a need for further education; it may simply reflect surprise or lack of awareness. Choice C is incorrect as the client's nervousness about blood tests is a common concern and does not necessarily indicate a need for more education. Choice D is also incorrect as financial concerns are valid but do not directly relate to the need for additional health education.
A 60-year-old man presents with fatigue, polyuria, and polydipsia. Laboratory tests reveal hyperglycemia and ketonuria. What is the most likely diagnosis?
- A. Type 1 diabetes mellitus
- B. Type 2 diabetes mellitus
- C. Diabetes insipidus
- D. Hyperthyroidism
Correct Answer: A
Rationale: The most likely diagnosis for a 60-year-old man with fatigue, polyuria, polydipsia, hyperglycemia, and ketonuria is Type 1 diabetes mellitus. The key clues are the presence of ketonuria, which indicates the body is breaking down fats for energy due to lack of insulin in Type 1 diabetes. Additionally, the acute onset of symptoms in an older individual suggests an autoimmune destruction of pancreatic beta cells seen in Type 1 diabetes. Type 2 diabetes is less likely due to the acute presentation and ketonuria. Diabetes insipidus presents with polyuria but not hyperglycemia or ketonuria. Hyperthyroidism typically presents with symptoms such as weight loss, tremors, and heat intolerance, not the classic symptoms seen in this case.
A 30-year-old woman presents with fatigue, polyuria, and polydipsia. Laboratory tests reveal hyperglycemia and ketonuria. What is the most likely diagnosis?
- A. Type 1 diabetes mellitus
- B. Type 2 diabetes mellitus
- C. Diabetes insipidus
- D. Hyperthyroidism
Correct Answer: A
Rationale: Step 1: Symptoms of fatigue, polyuria, polydipsia point to diabetes.
Step 2: Hyperglycemia and ketonuria suggest uncontrolled diabetes.
Step 3: Onset in a 30-year-old woman is more common in Type 1 diabetes.
Step 4: Type 1 diabetes is characterized by autoimmune destruction of pancreatic beta cells leading to insulin deficiency.
Step 5: Treatment for Type 1 diabetes involves insulin therapy.
Summary:
- Choice B (Type 2 diabetes) is less likely due to the acute presentation and ketonuria.
- Choice C (Diabetes insipidus) does not involve hyperglycemia or ketonuria.
- Choice D (Hyperthyroidism) does not typically present with hyperglycemia and ketonuria.
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