Med Error?
The nurse is preparing to administer depotestosterone 120 mg IM. Depotestosterone 100 mg/mL is available. How much will the nurse administer (volume)?
1.2 mL
Which of the following patients is at risk for digitalis toxicity?
A. A 60-year-old pt after a myocardial infarction
OR
B. An 80-year-old pt with CHF
B. An 80-year-old pt with CHF
*Rationale: When it comes to adversity, the very old and very young are at a higher risk of toxicity. This is due to how the drug is metabolized and excreted. CHF pt are also commonly on diuretics which can cause hypokalemia which is a risk factor for digitalis (digoxin) toxicity.
An elderly pt with pneumonia may appear with which of the following symptoms FIRST?
A. Altered mental status and dehydration
OR
B. Pleuritic chest pain and cough
A. Altered mental status and dehydration
*Rationale: In elderly pt, infections such as pneumonia often appear atypically. The first signs are often nonspecific (confusion, weakness, lethargy, and dehydration). This is due to age related changes in the immune system and a blunted febrile response.
A pt is admitted to the hospital and is currently receiving hypertonic fluids. Nursing management includes monitoring for what complication?
A. Cell Shrinkage
OR
B. Water Intoxication
A. Cell Shrinkage
*Rationale: Hypertonic fluids (e.g., 3% saline, D10W, D5NS) have a higher osmolarity than the fluid inside cells. When administered:
They pull water out of cells into the intravascular space via osmosis.
This can cause cellular dehydration and cell shrinkage.
Hypertonic solutions create an osmotic gradient that draws water out of cells, causing them to shrink. Close monitoring is essential to prevent neurological complications like confusion, seizures, or coma—especially if administered too quickly or in large amounts.
The nurse is preparing to administer 30 mg of morphine sulfate oral solution to a patient. 20 mg of morphine sulfate per 5 mL oral solution is available. How much will the nurse administer (volume)?
7.5 mL
Which of the following is a contraindication for digoxin administration?
A. BP 140/90
OR
B. Heart rate less than 60 bpm
B. Heart rate less than 60 bpm
*Rationale: Digoxin slows heart rate by increasing vagal tone and decreasing conduction in the AV node. BRADYCARDIA would be a contraindication. Apical heart rate must be monitored with digoxin and is held for heart rate < 60 bpm.
Which of the following types of asthma involves an acute asthma attach brought on by an upper respiratory tract infection?
A. Extrinsic
OR
B. Intrinsic
B. Intrinsic
*Rationale: Intrinsic asthma is also called non-allergic asthma and is typically triggered by non-allergen factors.
NCLEX tip: Extrinsic=external triggers (pollen, animal dander, food, etc.)
Intrinsic=internal triggers (stress, infection, exercise, etc.)
Your pt is scheduled to receive an isotonic solution; which one is an example of an isotonic solution?
A. 0.9% saline
OR
B. D10%
A. 0.9% saline
*Rationale: It expands extracellular fluid without shifting fluids into or out of cells. Ideal for volume expansion.
The nurse is preparing to administer digoxin 200 mcg IV push to a patient. Digoxin 0.5 mg/2 mL is available. How much will the nurse administer (volume)?
0.8 mL
A nurse is about to administer albuterol 2 puffs and budesonide 2 puffs by a metered-dose inhaler. How does the nurse plan to administer the medication?
A. Albuterol first then budesonide
OR
B. Budesonide first then albuterol
A. Albuterol first then budesonide
*Rationale: Albuterol is a short-acting beta-agonist (SABA) that works by relaxing bronchial smooth muscles, causing rapid bronchodilation.
Budesonide is a corticosteroid that reduces inflammation in the airways. Albuterol will open up the airways first and allow the budesonide to reach deeper in the lungs and be more effective.
NCLEX tip: When administering multiple inhalers the bronchodilator is always first.
A 66-year-old pt has marked dyspnea at rest, is thin, and uses accessory muscles to breathe. He's tachypneic, with a prolonged expiratory phase. He has no cough and uses the tripod position to assist with breathing. Pt has symptoms of which disorder?
A. Emphysema
OR
B. Asthma
A. Emphysema
*Rationale: This patient is showing classic signs of emphysema, a form of chronic obstructive pulmonary disease (COPD) characterized by alveolar wall destruction and air trapping.
Which of the following ABG values indicates uncompensated metabolic alkalosis?
A. pH 76.48, PaCO2 42, HCO3 30
OR
B. pH 76.48, PaCO2 34, HCO3 26
A. pH 76.48, PaCO2 42, HCO3 30
*Rationale:
pH is high (alkalosis)
HCO₃⁻ is high → points to metabolic cause
PaCO₂ is normal → no compensation by lungs yet
Diagnosis: Uncompensated metabolic alkalosis
NCLEX TIP: Uncompensated = one value abnormal with no compensation from the other system.
Partially compensated = pH abnormal + both PaCO₂ and HCO₃⁻ abnormal.