Medication Calcs
A nurse is preparing to administer lidocaine 50 mg IV bolus. Available is lidocaine 200 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
1) 0.3 mL
A nurse is caring for a client who is postoperative following an intermaxillary fixation as a result of multiple facial fractures. Which of the following types of equipment should the nurse plan to have at the client's bedside?
1) Wire cutters
2) NG tube
3) Urinary catheter tray
4) IV infusion pump
1) Wire cutters
Answer Rationale:
Establishment and maintenance of a patent airway is a primary goal of nursing management for a client who has facial injuries. Following intermaxillary fixation, the client's jaws will be wired shut for 6 to 10 weeks postoperatively, placing him at increased risk for aspiration in the case that he vomits. Keeping wire cutters at the bedside provides a means of opening the airway by cutting the wires should this occur. In the case that the wires are cut, the client will need to return to the operating room to have his jaws rewired.
A nurse is caring for a client who has opioid toxicity and has a respiratory rate of 6/min. Which of the following medications should the nurse plan to administer?
1) Epinephrine
2) Protamine
3) Flumazenil
4) Naloxone
4) Naloxone
Answer Rationale:
The nurse should plan to administer naloxone, which is an opiate antagonist that competes with opioids at opiate receptor sites making the opioid ineffective.
A nurse is teaching a client who is receiving radiation therapy about skin care. Which of the following instructions should the nurse include?
1) Walk outside in the early mornings.
2) Wash the irradiated area following treatment sessions to remove the markings.
3) Vigorously rub the skin dry after bathing.
4) Keep the temperature in the home at least 33° C (91.4° F).
1) Walk outside in the early mornings.
Answer Rationale:
A client who is receiving radiation treatment has special skin care needs due to the drying and irritation that occurs to the skin. The client's skin is especially prone to burning, and he should be encouraged to limit time outdoors in the sun. The nurse should instruct the client to go outside during the early morning or evening to avoid intense sun rays and should encourage the client to stay under awnings, umbrellas, and other forms of shade during the time when the sun's rays are most intense.
A home health nurse is teaching a child's parents about endotracheal suctioning. Which of the following information should the nurse include in the teaching?
1) Apply suction when inserting the catheter.
2) Apply suction for less than 10 seconds.
3) Set the suction pressure to 110 mm Hg.
4) Allow the child to rest for 10 to 15 seconds after each suctioning attempt.
2) Apply suction for less than 10 seconds.
Answer Rationale:
Prolonged suctioning can cause damage to tissues and induce hypoxia. Hypoxia can interfere with stages of respiration, cellular absorption, and blood transport.
A nurse is preparing to administer dextrose 5% in water (D5W) 150 mL IV to infuse over 3 hr. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
1) 8 gtt/min
A nurse is teaching an older adult client who has an intracapsular fracture of the right hip following a fall about the purpose of Buck’s extension traction. The nurse should include which of the following information in the teaching?
1) Buck’s extension traction will reduce the fracture.
2) Buck’s extension traction will relieve muscle spasms.
3) Buck’s extension traction will maintain alignment of the pins.
4) Buck’s extension traction will allow supported movement of the extremity.
2) Buck’s extension traction will relieve muscle spasms.
Answer Rationale:
Buck’s extension traction immobilizes the fractured bone to relieve associated muscle spasms and thereby relieve pain. Any movement of the fractured extremity will aggravate severe muscle spasm and trigger pain.
A nurse is caring for a 2-month-old infant who is postoperative following surgical repair of a cleft lip. Which of the following actions should the nurse take?
1) Encourage the parents to rock the infant.
2) Offer the infant a pacifier.
3) Administer ibuprofen as needed for pain.
4) Position the infant on her abdomen.
1) Encourage the parents to rock the infant.
Answer Rationale:
A rocking motion will calm and soothe the infant. Additionally, involving the parents in the infant's care can reduce feelings of helplessness.
A nurse is caring for a client who has HIV-1 infection and is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the client for which of the following adverse effects of this medication?
1) Cardiac dysrhythmia
2) Metabolic alkalosis
3) Renal failure
4) Aplastic anemia
4) Aplastic anemia
Answer Rationale:
Severe myelosuppression that results in anemia (decreased red blood cells), agranulocytosis (decreased white blood cells), and thrombocytopenia (decreased platelets) is a life-threatening adverse reaction to zidovudine therapy. Consequently, zidovudine must be used cautiously in clients already experiencing myelosuppression, and the client must be monitored with a CBC performed every few weeks for early detection of marrow failure, which may lead to aplastic anemia.
A nurse is planning care for a child who has cystic fibrosis and a prescription to receive chest physiotherapy (CPT). Which of the following actions should the nurse plan to take?
1) Percuss each lung segment for 15 min.
2) Perform CPT immediately after the child eats.
3) Administer albuterol prior to CPT.
4) Perform vibration during the client's inspirations.
3) Administer albuterol prior to CPT.
Answer Rationale:
Albuterol is a bronchodilator that relaxes and dilates the airway to promote air exchange. The nurse should administer the medication prior to implementing CPT to improve airway clearance. Albuterol facilitates the removal of the secretions as the chest wall is being percussed.
A nurse is preparing to administer atenolol 25 mg PO every 12 hr. The amount available is atenolol 50 mg/tab. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
1) 0.5 tablet(s)
A nurse is caring for a client who has a fractured right femur and is in balanced suspension traction. The client is reporting pain from muscle spasms. Which of the following actions should the nurse take first?
1) Administer an opioid analgesic.
2) Obtain a prescription to adjust the weight amount.
3) Offer a muscle relaxant to the client.
4) Realign the client's position.
4) Realign the client's position.
Answer Rationale:
The greatest risk to this client is injury form circulatory compromise and tissue damage; therefore, the first action the nurse should take is to realign the client's position.
A nurse is reviewing the medication administration records of four clients who have a prescription for morphine PRN. Which of the following findings should the nurse identify as a contraindication to this medication?
1) The client is experiencing a myocardial infarction.
2) The client who is 24 hr postoperative following hip arthroplasty.
3) The client who has bronchitis pleurisy.
4) The client has a paralytic ileus.
4) The client has a paralytic ileus.
Answer Rationale:
Morphine is contraindicated in clients who have a paralytic ileus because morphine suppresses the propulsive contractions of the intestinal tract and inhibits secretion of fluids into the intestinal tract.
A nurse is teaching a client about self-administered peritoneal dialysis. Which of the following statements by the client indicates a need for further teaching?
1) "The fluid from my abdomen will be clear or slightly yellow."
2) "The catheter can become infected even with sterile precautions."
3) "The microwave in my kitchen can warm the solution before I use it."
4) "The volume of the output solution should be greater than the input solution."
3) "The microwave in my kitchen can warm the solution before I use it."
Answer Rationale:
It is dangerous to use a microwave to heat dialysate because microwaves heat unevenly, and the dialysate can be much hotter than it initially appears. It is recommended that dialysate be warmed using dry heat, such as a heating pad. Warming the dialysate in water is also discouraged as this can introduce non-sterile water into the ports of the dialysate bag.
A nurse in a provider's clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which of the following medications currently prescribed for the client is a contraindication to taking sildenafil?
1) Isosorbide
2) Phenytoin
3) Metronidazole
4) Prednisone
1) Isosorbide
Answer Rationale:
Clients who are on nitrates including isosorbide and nitroglycerin preparations cannot take sildenafil, because of the serious medication interaction. There is the possibility of sudden death due to hypotension.
A nurse is preparing to administer 0.9% sodium chloride (NSS) 3000 mL IV to infuse over 24 hr. The drop factor on the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
1) 21 gtt/min
A nurse is caring for a client who is postoperative following on ORIF of the right radial head. The nurse should base her pain management interventions primarily on which of the following methods of determining the intensity of the client’s pain?
1) Vital sign measurement
2) The client’s self-report of pain severity
3) Visual observation for nonverbal signs of pain
4) The nature and invasiveness of the surgical procedure
2) The client’s self-report of pain severity
Answer Rationale:
Because nurses cannot measure pain objectively, it is standard practice to accept that pain is what the client says it is and to intervene accordingly.
A nurse is providing teaching to a client who has a new diagnosis of fibromyalgia. Which of the following client statements indicates an understanding of the teaching?
1) "I should increase my caffeine intake."
2) "I will take my duloxetine in the morning, so I have more energy to accomplish tasks."
3) "Low-impact aerobics can help reduce episodes of pain."
4) "A course of chemotherapy treatment should provide a cure."
3) "Low-impact aerobics can help reduce episodes of pain."
Answer Rationale:
The nurse should reinforce that clients who have fibromyalgia can help reduce pain through regular low-impact aerobics, such as walking, swimming, and biking.
A nurse is preparing to administer amoxicillin 350 mg PO. Available is amoxicillin 250 mg/5 mL. How many mL should the nurse administer? (Round to the nearest whole number.)
1) 7 mL
A nurse is preparing to administer desipramine 150 mg PO daily to a client to treat diabetic neuropathy. The amount available is desipramine 100 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
1) 1.5 tablet(s)
A nurse is preparing to administer celecoxib 200 mg PO daily divided into two equal doses. Available is celecoxib 50 mg capsules. How many capsules should the nurse administer with each dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
1) 2 capsules
A nurse is teaching a client who has a new prescription for codeine to decrease the pain from his femur fracture. Which of the following instructions should the nurse include in the teaching?
1) 'You should take the medication on an empty stomach to prevent nausea."
2) "You should limit alcohol intake to 12 ounces daily."
3) "You should expect to experience diarrhea while taking this medication."
4) "You should change positions slowly."
4) "You should change positions slowly."
Answer Rationale:
The client should change positions slowly to avoid the risk of falls. Codeine is an opioid analgesic that causes CNS depression and orthostatic hypotension.
A nurse is caring for a client who requires cold applications with an ice bag to reduce the swelling and pain of an ankle injury. Which of the following actions should the nurse take?
1) Apply the bag for 30 min at a time.
2) Reapply the bag 30 min after removing it.
3) Allow room for some air inside the bag.
4) Place the bag directly on the skin.
1) Apply the bag for 30 min at a time.
Answer Rationale:
The nurse should leave the bag in place for 30 min, but should check the client's skin after 15 min to make sure there are no adverse effects.
A nurse is sitting in the day room at an acute care mental health facility with a group of clients who are watching television. Suddenly one of the clients jumps up screaming and runs out of the room. Which of the following actions should the nurse take?
1) Ask the group what they think about the client’s behavior.
2) Follow the client to determine the cause of the behavior.
3) Ignore the incident because it is an attention-seeking behavior.
4) Stay with the group and ask another client to go and check on the situation.
2) Follow the client to determine the cause of the behavior.
Answer Rationale:
The nurse should find the client to determine if immediate intervention is necessary to address potential risk to the client or others. A change in behavior (such as becoming loud or demonstrating hyperactive behavior) may precede aggressive or violent acts toward self or others. The nurse should find the client to determine if immediate intervention is necessary to address potential risk to the client or others.
A nurse is preparing to administer amoxicillin 2 gm/day PO divided into two doses. The amount available is amoxicillin 500 mg tablets. How many tablets should the nurse administer with each dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
1) 2 tablet(s)