FA-NUR310 EAQ1

A client with gastroesophageal reflux is to receive metoclopramide 15 mg orally before meals. The concentrated solution contains 10 mg/mL. How much solution should the nurse administer? Record your answer using one decimal place.

1.5 mL

A client with a stage IV pressure ulcer is to receive 0.22 g of zinc sulfate by mouth. Each tablet contains 110 mg. How many tablets should the nurse administer? Record your answer using a whole number.

2 Tablets

Atenolol 150 mg by mouth is prescribed for a client with hypertension. Each tablet contains 50 mg. How many tablets should the nurse administer? Record your answer using a whole number.

3

Acetaminophen 15 mg/kg is prescribed for a child with a temperature of 102° F (38.9° C). How much will the nurse tell the parent to administer if the child weighs 9.6 kg and the acetaminophen strength is 160 mg/5 mL? Record your answer using one decimal place.

4.5 mL

An 18-month-old toddler is to receive an intravenous infusion of 1000 mL 5% dextrose and 0.45% sodium chloride over 24 hours. At what rate will the nurse set the volume-control device?

42 mL/Hr

An infant is undergoing parenteral therapy. The healthcare provider has instructed that 400 mL of D5W 0.45% sodium chloride be infused over 8 hours. At how many milliliters per hour should the nurse maintain the hourly rate? Record your answer using a whole number.

50 mL

Phenytoin suspension 200 mg is prescribed for a client with epilepsy. The suspension contains 125 mg/5 mL. How much solution will the nurse administer? Record your answer using a whole number.

8 mL

A nurse is evaluating the results of treatment with erythropoietin. Which assessment finding indicates an improvement in the underlying condition being treated? A. 2+ pedal pulses B. Decreased pallor C. Decreased jaundice D. 2+ deep tendon reflexes

B. Decreased Pallor Erythropoietin stimulates red blood cell production, thereby decreasing the pallor that accompanies anemia. It would not have a role in alleviating jaundice. It would not have an appreciable effect on pulses or deep tendon reflexes.

What therapeutic effect does the nurse expect to identify when mannitol is administered parenterally to a client with cerebral edema? A. Improved renal blood flow B. Decreased intracranial pressure C. Maintenance of circulatory volume D. Prevention of the development of thrombi

B. Decreased inter cranial pressure As an osmotic diuretic, mannitol helps reduce cerebral edema. Although there may be a transient increase in blood volume as a result of an increased osmotic pressure, which increases renal perfusion, this is not the therapeutic effect. Prevention of the development of thrombi is not the reason for giving this drug.

A 2-year-old toddler is to have intravenous (IV) antibiotic therapy. What will the nurse plan to do to prevent the child from pulling out the IV line? A. Keep the arms restrained. B. Tell the child not to touch the IV site. C. Cover the IV site with a protective device. D. Have the parent hold the child continuously.

C. Cover the IV site with a protective device. Restraints are a last resort; they cause more anxiety and agitation as the child attempts to get free. Verbal instructions are not sufficient for a 2-year-old child. Securing the IV site and putting protection around it decreases the likelihood that the IV line will be pulled out. Although the family should be involved in care, the staff, not the family, is responsible for preventing the child from pulling out the IV line.

Which drug may cause sudden infant death syndrome? A. alidixic acid B. Promethazine C. Phenothiazines D. Hexachlorophene

C. Phenothiazines ^May cause sudden infant death syndrome. Nalidixic acid may cause cartilage erosion in children. Promethazine may cause respiratory depression in children under the age of 2 years. Hexachlorophene causes central nervous system toxicity, especially in infants.

A client has been receiving digoxin. The client calls the clinic and complains of "yellow vision." What is the nurse's best response? A. "This is related to your illness rather than to your medication." B. "Take the medication because this is not a serious side effect." C. "This side effect is only temporary. You should continue the medication." D. "The medication may need to be discontinued. Come to the clinic this afternoon."

D. "The medication may need to be discontinued. Come to the clinic this afternoon." Yellow vision indicates digoxin toxicity; the medication should be withheld until the healthcare provider can assess the client and check the digoxin blood level. Yellow vision is related to digoxin therapy, not the client's underlying medical condition. Yellow vision is a sign of digoxin toxicity; taking more digoxin will escalate the digoxin toxicity.

A client who is receiving phenytoin to control a seizure disorder questions the nurse regarding this medication after discharge. How will the nurse respond? A. "Antiseizure drugs will probably be continued for life." B. "Phenytoin prevents any further occurrence of seizures." C. "This drug needs to be taken during periods of emotional stress." D. "Your antiseizure drug usually can be stopped after a year's absence of seizures."

A. "Antiseizure drugs will probably be continued for life." Seizure disorders usually are associated with marked changes in the electrical activity of the cerebral cortex, requiring prolonged or lifelong therapy. Seizures may occur despite drug therapy; the dosage may need to be adjusted. A therapeutic blood level must be maintained through consistent administration of the drug irrespective of emotional stress. Absence of seizures will probably result from medication effectiveness rather than from correction of the pathophysiologic condition.

Nitroglycerin sublingual tablets are prescribed for a client with the diagnosis of angina. The client asks the nurse how long it should take for the chest pain to subside after nitroglycerin is taken. What should the nurse tell the client? A. 1 to 3 minutes B. 4 to 5 seconds C. 30 to 45 seconds D. 20 to 45 minutes

A. 1 to 3 minutes The onset of action of sublingual nitroglycerin tablets is rapid (1 to 3 minutes); duration of action is 30 to 60 minutes. If nitroglycerin is administered intravenously, the onset of action is immediate, and the duration is 3 to 5 minutes. It takes longer than 30 to 45 seconds for sublingual nitroglycerin tablets to have a therapeutic effect. Sustained-release nitroglycerin tablets start to act in 20 to 45 minutes, and the duration of action is 3 to 8 hours.

A teenage client has a prescription for oral solution levofloxacin to treat a sinus infection, and the nurse explains when the medication should be taken. The nurse concludes that the teaching has been effective when the client makes which statement? A. "I should take the medication at mealtime." B. "I should take the medication just before a meal." C. "I should take the medication 1 hour before a meal." D. "I should take the medication 30 minutes after a meal."

C. "I should take the medication 1 hour before a meal." Absorption of the oral solution levofloxacin is enhanced when the stomach is empty, and it should be taken one hour before meals or two hours after meals. Tablets can be taken without regard to food. Food in the stomach will interfere with absorption. If the medication is taken just before a meal, food in the stomach shortly afterward will interfere with absorption. If the medication is taken 30 minutes after a meal, food remaining in the stomach will interfere with absorption.

After teaching a family member how to administer subcutaneous enoxaparin sodium, how should a nurse evaluate the effectiveness of the training? A. Return demonstration on a manikin B. Verbalization of the side effects of the medication C. Observing the family member administering enoxaparin sodium to the client D. Correctly verbalizing all necessary steps in enoxaparin sodium administration

C. Observing the family member administering enoxaparin sodium to the client The best way to evaluate the effectiveness of the teaching is to observe the family member administering the medication to the client. The family member may be able to perform a subcutaneous injection on a manikin but fear hurting the family member. Knowing the side effects of enoxaparin sodium is important, but it does not provide any information as to the family member's ability to administer the medication. The family member may be able to verbalize all the steps but fear puncturing the skin with the needle.

A client who is receiving chemotherapy for lung cancer has nausea and vomiting because of the therapy. The client wants to know if it is true that smoking marijuana will help. What is the nurse's best response? A. "Smoking marijuana is not legal in any state." B. "Marijuana is effective for nausea and vomiting if it is injected." C. "Marijuana is not proven to be effective in preventing chemotherapy-induced nausea and vomiting." D. "There are some tetrahydrocannabinol (THC)-based medications that contain marijuana that control chemotherapy-induced nausea and vomiting in some people."

D. "There are some tetrahydrocannabinol (THC)-based medications that contain marijuana that control chemotherapy-induced nausea and vomiting in some people." THC, an ingredient in marijuana, acts as an antiemetic in some people and can be absorbed through the gastrointestinal tract or inhaled. THC-based medications, dronabinol (Marinol) and nabilone (Cesamet), are available by prescription to control nausea and vomiting resulting from cancer chemotherapy. The statement, "Smoking marijuana is not legal in any state," does not answer the client's question and is inaccurate. Marijuana is not injected. THC is an effective antiemetic for some clients.

A 3-year-old child is to receive a liquid iron preparation. What will the nurse teach the mother regarding this medication? A. Monitor the stools for diarrhea. B. Administer with meals to improve absorption. C. Avoid giving the child orange juice with the iron preparation. D. Have the child drink the diluted iron preparation through a straw.

D. Have the child drink the diluted iron preparation through a straw. A liquid iron preparation may stain tooth enamel; therefore it should be diluted and administered through a straw. Constipation, rather than loose stools, often results from the administration of iron. Iron absorption is improved when taken on an empty stomach. The exception is acidic foods, such as citrus juices, which improve absorption.

A nurse is planning to administer albuterol to a 4-year-old child. How will the nurse evaluate the effectiveness of this medication? A. Auscultate breath sounds B. Collect a sputum sample C. Conduct a brief neurologic examination D. Palpate chest excursion to gauge promotion of intercostal contractility

A. Auscultate breath sounds Albuterol is an adrenergic drug that stimulates beta-receptors, leading to relaxation of the smooth muscles of the airway. The lungs should be auscultated to evaluate the effectiveness of this medication. Albuterol does not affect the consistency of pulmonary secretions. Albuterol will not cause central nervous system stimulation. Albuterol does not affect intercostal contractility; chest excursion is not the appropriate assessment.

A client with systemic lupus erythematosus is taking prednisone. The nurse anticipates that the steroid may cause hypokalemia. What food will the nurse encourage the client to eat? A. Broccoli B. Oatmeal C. Fried rice D. Cooked carrots

A. Broccoli Potassium is plentiful in green leafy vegetables; broccoli provides 207 mg of potassium per half cup. Oatmeal provides 73 mg of potassium per half cup. Rice provides 29 mg of potassium per half cup. Cooked fresh carrots provide 172 mg of potassium per half cup; canned carrots provide only 93 mg of potassium per half cup.

Loratadine, 10 mg by mouth once a day in the morning, is prescribed for a 15-year-old girl with hay fever. The girl tells the school nurse that she is concerned that she will be sleepy for a quiz the next day. How should the nurse respond? A. By explaining that this medication rarely causes drowsiness B. By advising her to take half a tablet in the morning before school C. By suggesting that she skip the next day's dose if she can tolerate the hay fever D. By recommending that she call the allergist for a prescription containing a stimulant

A. By explaining that this medication rarely causes drowsiness Loratadine causes little or no drowsiness or anticholinergic side effects. Even if the medication did cause drowsiness, the nurse does not have the legal authority to alter the prescribed dose. It is not necessary to call the allergist because loratadine rarely causes drowsiness.

A client is admitted to the hospital for an adrenalectomy. The nurse is providing postoperative care before the client's replacement steroid therapy is regulated fully. The nurse should monitor the client for which complication? A. Hypotension B. Hypokalemia C. Hypernatremia D. Hyperglycemia

A. Hypotension Because of instability of the vascular system and the lability of circulating adrenal hormones after an adrenalectomy, hypotension frequently occurs until the hormonal level is controlled by replacement therapy. Hyperglycemia is a sign of excessive adrenal hormones; after an adrenalectomy, adrenal hormones are not secreted. Sodium retention is a sign of hyperadrenalism; it does not occur after the adrenals are removed. Potassium excretion is a response to excessive adrenal hormones; after an adrenalectomy, adrenal hormones are decreased until replacement therapy is regulated.

A client with hyperthyroidism is to receive methimazole. What instructions does the nurse provide? A. Initial improvement will take several weeks. B. There are few side effects associated with this drug. C. This medication may be taken at any time during the day. D. Large doses are used to quickly correct the functions of the thyroid.

A. Initial improvement will take several weeks. Methimazole blocks thyroid hormone synthesis; it takes several weeks of medication therapy before the hormones stored in the thyroid gland are released and the excessive level of thyroid hormone in the circulation is metabolized. There are many common side effects that include nausea, vomiting, diarrhea, rash, urticaria, pruritus, alopecia, hyperpigmentation, drowsiness, headache, vertigo, and fever. Methimazole should be spaced at regular intervals because blood levels are reduced in approximately 8 hours. Large doses cause toxic side effects that can be life threatening, including nephritis, hepatitis, agranulocytosis, leukopenia, thrombocytopenia, hypothrombinemia, and lymphadenopathy.

A nurse is caring for a preschool child who is receiving prednisone. What is most important for the nurse to consider when administering adrenocorticosteroid therapy? A. It suppresses inflammation. B. It may produce hyperkalemia. C. Wound healing is accelerated. D. Antibody production increases.

A. It suppresses inflammation. Because of suppression of the inflammatory manifestations of infection, such as increase in body temperature, the nurse must be alert to the subtle signs and symptoms of infection (e.g., changes in appetite, sleep patterns, and behavior). Adrenocorticosteroid therapy may cause hypokalemia, not hyperkalemia, because of the retention of sodium and fluid. Adrenocorticosteroid therapy delays, not accelerates, wound healing. Adrenocorticosteroid therapy decreases, not increases, the production of antibodies.

A 12-year-old child has just received a dose of epinephrine. What is the priority assessment after this medication is administered? A. Tachycardia B. Hypoglycemia C. Constricted pupils D. Decreased blood pressure

A. Tachycardia Epinephrine is a sympathetic nervous system stimulant that causes tachycardia. Hyperglycemia, not hypoglycemia, may result. The pupils will dilate, not constrict. Epinephrine is more likely to cause hypertension than hypotension because of its effect of peripheral vasoconstriction.

After surgery for a ruptured appendix, a 12-year-old child is receiving morphine for pain control by way of a patient-controlled analgesia (PCA) infusion. A bolus of morphine can be delivered every 6 minutes. A parent will be staying with the child during the immediate postoperative period. What statement indicates to the nurse that the instructions about the PCA pump have been understood? A. "I'll make sure that she pushes the PCA button every 6 minutes." B. "She needs to push the PCA button whenever she needs pain medication." C. "I'll have to wake her up on a regular basis so she can push the PCA button." D. "I'll press the PCA button every 6 minutes so she gets enough pain medication while she's sleeping."

B. "She needs to push the PCA button whenever she needs pain medication." Morphine, an opioid analgesic, relieves pain; when control of pain is given to the child, anxiety and pain are usually diminished, resulting in a decreased need for the analgesic; only the child should press the PCA button. Having the child press the PCA button every 6 minutes is unnecessary. Although pain medication can be delivered as often as every 6 minutes, it should be used only if necessary. If the child is sleeping, the pain is under control; waking the child will interfere with rest. If the child is sleeping, the pain is under control; also, this will result in an unnecessary and excessive dosage of the opioid.

A nurse is teaching the parents of an 8-year-old child who is taking a high dose of oral prednisone for asthma. What critical information about prednisone will be included? A. It protects against infection. B. It should be stopped gradually. C. An early growth spurt may occur. D. A moon-shaped face will develop.

B. It should be stopped gradually Gradual weaning from prednisone is necessary to prevent adrenal insufficiency or adrenal crisis. Prednisone depresses the immune system, thereby increasing susceptibility to infection. The drug usually suppresses growth. A moon face may occur, but it is not a critical, life-threatening side effect

What is the priority nursing intervention for a school-aged child with lead poisoning who is undergoing chelation therapy? A. Scrupulous skin care B. Provision of a high-protein diet C. Careful monitoring of intake and output D. Daily blood sampling for liver function tests

C. Careful monitoring of intake and output Kidney function must be adequate to excrete the lead; if it is not adequate, nephrotoxicity or kidney damage may result. Skin breakdown is not associated with chelation therapy. A high-protein diet is not necessary. Liver damage does not occur with chelation therapy

A school nurse teaches a 13-year-old child with hay fever that the prescribed phenylephrine nasal spray must be used exactly as directed. What complication may occur if the nasal spray is used more frequently or longer than recommended? A. Tinnitus B. Nasal polyps C. Bleeding tendencies D. Increased nasal congestion

D. Increased nasal congestion Frequent and continued use of phenylephrine can cause rebound congestion of mucous membranes. Tinnitus is not a side effect of phenylephrine nasal spray; however, hypotension, tachycardia, and tingling of the extremities may occur. Nasal polyps may be associated with allergies but are unrelated to phenylephrine nasal spray. Bleeding tendencies are unrelated to the use of phenylephrine nasal spray.

Ranitidine has been prescribed to help treat a client's gastric ulcer. The nurse expects this drug to act specifically by which mechanism? A. Lowering the gastric pH B. Promoting the release of gastrin C. Regenerating the gastric mucosa D. Inhibiting the histamine at H 2 receptors

D. Inhibiting the histamine at H 2 receptors Ranitidine inhibits histamine at H 2 receptor sites in parietal cells, which limits gastric secretion. Lowering the gastric pH is not the direct action of this drug. Promoting the release of gastrin is undesirable; gastric hormones increase gastric acid secretion. Ranitidine does not regenerate the gastric mucosa; the drug prevents its erosion by gastric secretions.