Dosage Calculations
The primary health care provider's prescription reads 150 mcg of a medication orally daily. The medication label reads 0.1 mg per tablet. The nurse should administer how many tablet(s) to the client? Fill in the blank.
_________ tablet(s)
What is 1.5 tablets
It is necessary to convert 150 mcg to milligrams. In the metric system, to convert smaller to larger, divide by 1000 or move the decimal 3 places to the left: 150 mcg = 0.15 mg. Next, use the formula to calculate the correct dose.
The school nurse has provided an instructional session about impetigo to parents of the children attending the school. Which statement, if made by a parent, indicates a need for further instruction?
1. "It is extremely contagious."
2. "It is most common in humid weather."
3. "Lesions most often are located on the arms and chest."
4. "It might show up in an area of broken skin, such as an insect bite."
What is 3
Impetigo is a contagious bacterial infection of the skin caused by β-hemolytic streptococci or staphylococci, or both. Impetigo is most common during hot, humid summer months. Impetigo may begin in an area of broken skin, such as an insect bite or atopic dermatitis. Impetigo is extremely contagious. Lesions usually are located around the mouth and nose but may be present on the hands and extremities.
A client is admitted to the mental health unit with a diagnosis of depression. The nurse should develop a plan of care for the client that includes which intervention?
1. Encouraging quiet reading and writing for the first few days
2. Identification of physical activities that will provide exercise
3. No socializing activities until the client asks to participate in milieu
4. A structured program of activities in which the client can participate
What is 4
A client with depression often is withdrawn while experiencing difficulty concentrating, loss of interest or pleasure, low energy, fatigue, and feelings of worthlessness and poor self-esteem. The plan of care needs to provide successful experiences in a stimulating yet structured environment. The remaining options are either too "restrictive" or offer little or no structure and stimulation.
A client is receiving a continuous intravenous infusion of heparin sodium to treat deep vein thrombosis. The client's activated partial thromboplastin time (aPTT) is 65 seconds. The nurse anticipates that which action is needed?
1. Discontinuing the heparin infusion
2. Increasing the rate of the heparin infusion
3. Decreasing the rate of the heparin infusion
4. Leaving the rate of the heparin infusion as is
What is 4
The normal aPTT varies between 30 and 40 seconds (30 and 40 seconds), depending on the type of activator used in testing. The therapeutic dose of heparin for treatment of deep vein thrombosis is to keep the aPTT between 1.5 (45 to 60) and 2.5 (75 to 100) times normal. This means that the client's value should not be less than 45 seconds or greater than 100 seconds. Thus, the client's aPTT is within the therapeutic range and the dose should remain unchanged.
A client arriving at the emergency department has experienced frostbite to the right hand. Which finding would the nurse note on assessment of the client's hand?
1. A pink, edematous hand
2. Fiery red skin with edema in the nailbeds
3. Black fingertips surrounded by an erythematous rash
4. A white color to the skin, which is insensitive to touch
What is 4
Assessment findings in frostbite include a white or blue color; the skin will be hard, cold, and insensitive to touch. As thawing occurs, flushing of the skin, the development of blisters or blebs, or tissue edema appears. Options 1, 2, and 3 are incorrect.
The primary health care provider prescribes theophylline 0.2 g orally twice daily. The medication label states 100-mg capsules. The nurse should administer how many capsule(s) to the client at the morning dose? Fill in the blank.
_______ capsule(s)
What is 2 capsules
Use the formula to calculate the correct dose. Convert 0.2 g to milligrams. In this case, multiply by 1000 or move the decimal 3 places to the right; therefore, 0.2 g = 200 mg. Next, divide 200 by 100 to yield 2 capsules. The nurse will administer 2 capsules.
Desired
––––––––– × Capsules = Capsules/dose
Available
200 mg
–––––– × 1 capsule = 2 capsules
100 mg
The emergency department nurse is caring for a child diagnosed with epiglottitis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction?
1. The child exhibits nasal flaring and bradycardia.
2. The child is leaning forward, with the chin thrust out.
3. The child has a low-grade fever and complains of a sore throat.
4. The child is leaning backward, supporting herself or himself with the hands and arms.
What is 2
Epiglottitis is a bacterial form of croup. A primary concern is that it can progress to acute respiratory distress. Clinical manifestations suggestive of airway obstruction include tripod positioning (leaning forward while supported by arms, chin thrust out, mouth open), nasal flaring, the use of accessory muscles for breathing, and the presence of stridor. Option 4 is an incorrect position. Options 1 and 3 are incorrect because epiglottitis causes tachycardia and a high fever.
The nurse is reviewing the assessment data of a client admitted to the mental health unit. The nurse notes that the admission nurse documented that the client is experiencing anxiety as a result of a situational crisis. The nurse plans care for the client, determining that this type of crisis could be caused by which event?
1. Witnessing a murder
2. The death of a loved one
3. A fire that destroyed the client's home
4. A recent rape episode experienced by the client
What is 2
A situational crisis arises from external rather than internal sources. External situations that could precipitate a crisis include loss or change of a job, the death of a loved one, abortion, change in financial status, divorce, addition of new family members, pregnancy, and severe illness. Options 1, 3, and 4 identify adventitious crises. An adventitious crisis refers to a crisis of disaster, is not a part of everyday life, and is unplanned and accidental. Adventitious crises may result from a natural disaster (e.g., floods, fires, tornadoes, earthquakes), a national disaster (e.g., war, riots, airplane crashes), or a crime of violence (e.g., rape, assault, murder in the workplace or school, bombings, or spousal or child abuse).
A magnetic resonance imaging (MRI) study is prescribed for a client with a suspected brain tumor. Which priority action should the nurse include in the client's plan of care to ensure safety?
1. Shave the groin for insertion of a femoral catheter.
2. Remove all metal-containing objects from the client.
3. Inform the client to remain motionless throughout the procedure.
4. Instruct the client in inhalation techniques for the administration of the radioisotope.
What is 2
In MRI, radiofrequency pulses in a magnetic field are converted into pictures. All metal objects, such as rings, bracelets, hairpins, and watches, should be removed. In addition, a history should be taken to ascertain whether the client has any internal metallic devices such as orthopedic hardware, pacemakers, or shrapnel. Insertion of a femoral catheter is not part of the procedure. The client needs to be motionless throughout the procedure for quality of the scan, but this action is not related to a safety issue and therefore is not the priority. A radioisotope may be prescribed with positron emission tomography.
A client has a neurological deficit involving the limbic system. On assessment, which finding is specific to this type of deficit?
1. Is disoriented to person, place, and time.
2. Affect is flat, with periods of emotional lability.
3. Cannot recall what was eaten for breakfast today.
4. Demonstrates inability to add and subtract; does not know who is the president of the United States.
What is 2
The limbic system is responsible for feelings (affect) and emotions. Calculation ability and knowledge of current events relate to function of the frontal lobe. The cerebral hemispheres, with specific regional functions, control orientation. Recall of recent events is controlled by the hippocampus.
A primary health care provider's prescription reads nitroglycerin grains 1/150 sublingually stat. The label on the bottle reads nitroglycerin 0.4 mg/tablet. The nurse prepares how many tablet(s) to administer the correct dose? Fill in the blank.
________ tablet(s)
What is 1 tablet
Use the formula to calculate the correct dose. It is necessary to convert grains 1/150 to milligrams. After converting grains to milligrams, use the formula to calculate the correct dose.
The nurse is caring for a 2-year-old child with an ear infection who requires the administration of antibiotic eardrops. The nurse observes the mother administering the eardrops to the child. Which observation by the nurse indicates that the mother is performing the procedure correctly?
1. The mother pulls the earlobe up and back.
2. The mother pulls the earlobe down and back.
3. The mother holds the child in a sitting position.
4. The mother must wear gloves to administer the medication.
What is 2
To administer eardrops to a child younger than 3 years, the earlobe should be pulled down and back. In the older child, the earlobe is pulled up and back to obtain a straight canal. Gloves do not need to be worn by the parents, but hands must be washed before and after the procedure. The child needs to be in a side-lying position with the affected ear facing upward to facilitate the flow of medication down the ear canal by gravity.
The nurse is conducting an initial assessment of a client in crisis. When assessing the client's perception of the precipitating event that led to the crisis, which is the most appropriate question?
1. "With whom do you live?"
2. "Who is available to help you?"
3. "What leads you to seek help now?"
4. "What do you usually do to feel better?"
What is 3
The nurse's initial task when assessing a client in crisis is to assess the individual or family and the problem. The more clearly the problem can be defined, the better the chance a solution can be found. The correct option would assist in determining data related to the precipitating event that led to the crisis. Options 1 and 2 assess situational supports. Option 4 assesses personal coping skills.
The nurse is assisting in the care of a group of clients on the nursing unit. When considering the effects of each medical diagnosis, the nurse determines that which client has the least risk for developing third spacing of fluid?
1. Client with a major burn
2. Client with an ischemic stroke
3. Client with Laënnec's cirrhosis
4. Client with chronic kidney disease
What is 2
Fluid that shifts into the interstitial spaces and remains there is referred to as third-space fluid. This fluid is physiologically useless because it does not circulate to provide nutrients for the cells. Common sites for third spacing include the pleural and peritoneal cavities and pericardial sac. Risk factors include older adults and those with liver or kidney disease, major trauma, burns, sepsis, major surgery, malignancy, gastrointestinal malabsorption, and malnutrition. The client who has suffered a stroke is not at risk for third spacing.
The nurse is performing an assessment on a client with a diagnosis of hyperthyroidism. Which assessment finding should the nurse expect to note in this client?
1. Dry skin
2. Bulging eyeballs
3. Periorbital edema
4. Coarse facial features
What is 2
Hyperthyroidism is clinically manifested by goiter (increase in the size of the thyroid gland) and exophthalmos (bulging eyeballs). Other clinical manifestations include nervousness, fatigue, weight loss, muscle cramps, and heat intolerance. Additional signs found in this disorder include tachycardia; shortness of breath; excessive sweating; fine muscle tremors; thin, silky hair and thin skin; infrequent blinking; and a staring appearance.
A primary health care provider prescribes regular insulin 5 units per hour by continuous intravenous (IV) infusion. The pharmacy prepares the medication and then delivers an IV bag labeled 25 units of regular insulin in 50 mL of normal saline. An infusion pump must be used to administer the medication. How many milliliters per hour are required to deliver the prescribed dose? Fill in the blank.
_______ mL/hr
What is 10 mL/hr
Calculation of this problem can be done using a 2-step process. First, you need to determine the amount of regular insulin in 1 mL. The next step is to determine the infusion rate in milliliters per hour.
Step 1: Determine the amount of regular insulin in 1 mL.
Known amount of medication
–––––––––––––––––––––––––– = Medication per mL
Total volume of diluent
25 units
–––––––– = 0.5 units/mL
50 mL
Step 2: Calculate mL per hour.
Dose per hour desired
––––––––––––––––––––– = Milliliters per hour
Concentration per mL
5 units
––––––––– = 10 mL/hr
0.5 units
The nurse provides home care instructions to the parents of a child with celiac disease. The nurse should teach the parents to include which food item in the child's diet?
1. Rice
2. Oatmeal
3. Rye toast
4. Wheat bread
What is 1
Celiac disease also is known as gluten enteropathy or celiac sprue and refers to intolerance to gluten, the protein component of wheat, barley, rye, and oats. The important factor to remember is that all wheat, rye, barley, and oats should be eliminated from the diet and replaced with corn, rice, or millet. Vitamin supplements–especially the fat-soluble vitamins, iron, and folic acid–may be needed to correct deficiencies. Dietary restrictions are likely to be lifelong.
A client with depression verbalizes feelings of low self-esteem and self-worth typified by statements such as, "I'm such a failure. I can't do anything right." Which is the best nursing response?
1. Tell the client that this is not true, that we all have a purpose in life.
2. Identify recent behaviors or accomplishments that demonstrate the client's skills.
3. Reassure the client that the nurse knows how the client is feeling and that things will get better.
4. Remain with the client and sit in silence. This will encourage the client to verbalize feelings.
What is 2
Feelings of low self-esteem and worthlessness are common symptoms of a depressed client. An effective plan of care to enhance the client's personal self-esteem is to provide experiences for the client that are challenging but that will not be met with failure. Reminders of the client's accomplishments or personal successes are ways to interrupt the client's negative self-talk and distorted cognitive view of self. Silence may be interpreted as agreement. Avoid options that give advice and devalue the client's feelings.
A client with acute glomerulonephritis has had a urinalysis sample sent to the laboratory. The report reveals the presence of hematuria and proteinuria. The nurse interprets these results as which condition?
1. Consistent with glomerulonephritis
2. Inconsistent with glomerulonephritis
3. Unclear; no conclusion can be drawn
4. Indicative of impending acute kidney injury
What is 1
Gross hematuria and proteinuria are the classic signs of glomerulonephritis. The urine may be small in volume, dark or smoky from the hematuria, and foamy from the proteinuria. Concurrent serum studies would reveal an elevated level of blood urea nitrogen, creatinine, C-reactive protein, and antistreptolysin O titer.
A primary health care provider (PHCP) prescribes a Salem sump tube for gastrointestinal intubation. Which item should the nurse obtain from the supply room?
1. A Dobbhoff weighted tube
2. A Sengstaken-Blakemore tube
3. A tube with a large lumen and an air vent
4. A tube with a single lumen that connects to suction
What is 3
A tube with a large lumen and an air vent is a Salem sump tube. A Dobbhoff weighted tube is a type of feeding tube. A Sengstaken-Blakemore tube is used to control bleeding in the esophagus. A tube with a single lumen is called a Levin tube.
Penicillin V (potassium), 75 mg orally every 8 hours, is prescribed for a child with a respiratory infection. The medication label reads penicillin V, 125 mg per 5 mL. The nurse has determined that the dosage prescribed is safe for the child. The nurse prepares to administer how many milliliters per dose to the child? Fill in the blank.
_______ mL/dose
What is 3 mL/dose
Use the formula for calculating medication dosages.
Desired
––––––––– × Volume = mL/dose
Available
75 mg
–––––– × 5 mL = 3 mL
125 mg
A 6-year-old child with diabetes mellitus and the child's mother come to the health care clinic for a routine examination. The nurse evaluates the data collected during this visit to determine if the child has been euglycemic since the last visit. Which information is the most significant indicator of euglycemia?
1. Daily glucose monitor log
2. Dietary history for the previous week
3. Glycosylated hemoglobin (hemoglobin A1c)
4. Fasting blood glucose performed on the day of the clinic visit
What is 3
The glycosylated hemoglobin assay measures the glucose molecules that attach to the hemoglobin A molecules and remain there for the life of the red blood cell, approximately 120 days. This is not reversible and cannot be altered by human intervention. Daily glucose logs are useful if they are kept regularly and accurately. However, they reflect only the blood glucose at the time the test was done. A fasting blood glucose test performed on the day of the clinic visit is time limited in its scope, as is the dietary history.
When planning activities for a child diagnosed with autism, the nurse should give priority to which consideration?
1. Encouraging social interactions
2. Assessing all activities for safety risks
3. Focus upon providing verbal stimulation
4. Providing detailed instructions to ensure success
What is 2
Safety with all activities is a priority in planning activities with the child. The child with autism is unable to anticipate danger, has a tendency for self-mutilation, and has sensoriperceptual deficits. Although providing social interactions, verbal communications, and familiarity and orientation are also appropriate interventions, the priority is safety.
The nurse instructs a client about a low-fat diet. Which menu selection indicates that the client understands the nurse's instructions?
1. Shrimp and bacon salad
2. Liver, potato salad, sherbet
3. Turkey breast, boiled rice, and fruit
4. Lean hamburger steak and macaroni and cheese
What is 3
Major sources of fats include meats, salad dressings, eggs, butter, cheese, and bacon. Options 1, 2, and 4 all contain high-fat foods.
An older client's physical examination reveals the presence of a fiery star-shaped marking with a circular, solid center. The nurse recognizes that these findings, which are caused by capillary radiations extending from the central arterial body, are representative of which lesions?
1. Purpura
2. Venous star
3. Spider angioma
4. Cherry angioma
What is 3
Spider angiomas have a bright red center with legs that radiate outward. Spider angiomas are commonly seen in liver disease and vitamin B deficiency, although they occasionally can occur without underlying pathology. Purpura results from hemorrhage into the skin. A venous star results from increased pressure in veins, usually in the lower legs, and has an irregularly shaped bluish center with radiating branches. Cherry angioma occurs with increasing age and has no clinical significance. It appears as a small, round, bright red lesion on the trunk or extremities.