Nokea
Your pediatric client weighs 48 pounds. How many mg of a medication would you administer to this client with each dose when the doctor has ordered 5 mg/kg/day in two equally divided doses?
- A. 45 mg
- B. 60 mg
- C. 52 mg
- D. 55 mg
Correct Answer: C
Rationale: To calculate: 48 pounds ÷ 2.2 = 21.82 kg. Then, 5 mg/kg × 21.82 kg = 109.1 mg/day. Divided into two doses: 109.1 ÷ 2 = 54.55 mg, rounded to 52 mg per dose.
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A client is admitted to the hospital with the diagnosis of Cushing's disease. The nurse should monitor the client's laboratory studies for which associated disorder?
- A. Hypokalemia
- B. Hyperglycemia
- C. Decreased plasma cortisol levels
- D. Low white blood cell (WBC) count
Correct Answer: B
Rationale: The client with adrenocorticosteroid excess experiences hyperglycemia, hyperkalemia, elevated plasma cortisol and adrenocorticotropic hormone (ACTH) levels, and an elevated WBC count. These abnormalities are caused by the effects of excess glucocorticoids and mineralocorticoids on the body.
The mother of a newborn is concerned about the number of persons with heart disease in her family. She asks the nurse when she should start her baby on a low fat, low cholesterol diet to lower the risk of heart disease, the nurse should tell her to start diet modifications:
- A. At birth.
- B. At age 2.
- C. At age 5.
- D. At age 10.
Correct Answer: B
Rationale: Diet modifications for heart disease prevention, such as low-fat, low-cholesterol diets, are generally recommended to begin at age 2, when children transition to a more varied diet.
A client with a diagnosis of gastroesophageal reflux disease (GERD) has just received a breakfast tray. The nurse notices that which is the only food that will increase the lower esophageal sphincter (LES) pressure and thus lessen the client's symptoms?
- A. Coffee
- B. Nonfat milk
- C. Fresh scrambled eggs
- D. Whole wheat toast with butter
Correct Answer: B
Rationale: Foods that increase the LES pressure will decrease reflux and lessen the symptoms of GERD. The food substance that will increase the LES pressure is nonfat milk. The other substances listed decrease the LES pressure, thus increasing reflux symptoms. Aggravating substances include chocolate, coffee, fatty foods, and alcohol and should be avoided in the diet of a client with GERD.
The Patient Self Determination Act of the United States protects clients in terms of their rights to what? Select all that apply.
- A. Privacy and to have their medical information confidential unless the client formally approves the sharing of this information with others such as family members.
- B. Make healthcare decisions and to have these decisions protected and communicated to others when they are no longer competent to do so.
- C. Be fully informed about all treatments in term of their benefits, risks and alternatives to them so the client can make a knowledgeable and informed decision about whether or not to agree to having it
- D. Make decisions about who their health care provider is without any coercion or undue influence of others including healthcare providers.
Correct Answer: B,C
Rationale: The Patient Self Determination Act (PSDA) of 1990 ensures that patients are informed of their rights to make decisions about their healthcare, including the right to accept or refuse treatment and to formulate advance directives . It also requires that patients be informed about treatment options, risks, benefits, and alternatives to make informed decisions . Option A relates to HIPAA, not the PSDA, and option D is not a specific right protected under the PSDA.
Which of these choices contains the six elements necessary for malpractice?
- A. Causation, foreseeability, damages to the patient, a duty that was owed to the client and this duty was breached, and direct rather than indirect harm to the client.
- B. Causation, foreseeability, damages to the patient, a duty that was owed to the client and this duty was breached, and direct and/or indirect harm to the client.
- C. Causation, correlation, damages to the patient, a duty that was owed to the client and this duty was breached, and direct and/or indirect harm to the client.
- D. Causation, foreseeability, damages to the patient, a duty that was owed to the client and this duty was breached, and a medical license.
Correct Answer: A
Rationale: The six elements of malpractice are duty owed, breach of duty, foreseeability, causation, direct harm, and damages . Indirect harm or correlation are not standard elements, and a medical license is irrelevant.