fundamentals

the healthcare provider prescribes morphine sulfate 4mg IM stat. Morphine comes in 8 mg per ml. how many ml should the nurse administer?

.5 ml

Seconal 0.1 gram PRN at bedtime is prescribed to a client for rest. The scored tablets are labeled grain 1.5 per tablet. How many tablets should the nurse plan to administer? A. 0.5 tablet. B. 1 tablet. C. 1.5 tablets. D. 2 tablets.

1 tablet 15=1 gram .1 x 15 = 1.5 grains

the healthcare provider prescribes furosemide (lasix) 15 mg IV stat. on hand is lasix 20 mg/2 ml. how many milliliters should the nurse administer?

1.5 ml 20/2 =15/x

the healthcare provider prescribes the diuretic metolazone 7.5 mg PO zaroxolyn is available in 5 mg tablets. how much should the nurse plan to administer?

1.5 tablets

Heparin 20,000 units in 500 ml D5W at 50 ml/hour has been infusing for 5½ hours. How much heparin has the client received? A. 11,000 units. B. 13,000 units. C. 15,000 units. D. 17,000 units.

11,000 20,000/500 = 40 units 40 units/ml x 50 ml/hr= 2000 units/hr 2000 x 5.5=11,000

the nurse mixes 50 mg of Nipride in 250 ml of D5W and plans to administer the solution at a rate of 5 mcg/kg/min to a client weighing 182 pounds. using a drip factor of 60 gtt/ml" how many drops per minute should the client receive?

124 gtt/min 182/2.2= 82.73 kg dosage for the client= 5mcg x 82.73 = 413.65 mcg/min 50,000mcg/50 ml = 200 mcg/ml 413.65/200 = 2.07 ml/min 2.07 x 60 = 124

A client is to receive cimetidine (tagamet) 300 mg qsh IVPBthe preparation arrives from the pharmacy diluted in 50 ml of 0.9 NaCl. the nurse plans to administer the IVPB dose over 20 minutes. for how many ml/hr should the infusion pump be set to deliver the secondary infusion?

150 50 ml/20 min = x ml/60 min

A physician orders the following preoperative medications to be administered to a clientby the I.M. route: meperidine (Demerol), 50 mg: hydroxyzine pamoate (Vistaril), 25 mg; andglycopyrrolate (Robinul), 0.3 mg. The medications are dispensed as follows: meperidine, 100mg/ml; hydroxyzine pamoate, 100 mg/2 ml; and glycopyrrolate, 0.2 mg/ml. How manymilliliters in total should the nurse administer?

2.5 ml .5 + .5 + 1.5

the nurse prepares a 1000 ml IV of 5% dextrose and water to be infused over 8 hours. the infusion set delivers 10 drops per milliliter. the nurse should regulate the IV to administer approximately how many drops per minute

21 drops/min = infusion in 1 hr x drop factor/time for infusion in min 1000/8=125 ml/hr 125 x 10=1250 drops/hr 1250/60=20.8

what is the percentage of oxygen in inhaled hair

21%

The physician orders an IV solution of dextrose 5% in water at 100ml/hour. What would the flow rate be if the drop factor is 15 gtt = 1ml?

25 gtt/min

the appropriate needle for insulin injection is

25G, 5/8 in long

the appropriate needle gauge for intradermal injection is

26G

After undergoing small-bowel resection, a client is ordered Metronidazole (Flagyl) 500mg IV The mixed IV solution contains 100 ml. The nurse is to run the drug over 30 minutes. The drip factor of the available IV tubing is 15 gtts/ml. What is the drip rate? Round your answer to the nearest whole number.

50 gtts/min 100 ml/30 min x 15

A client is to receive 10 mEq of KCl diluted in 250 ml of normal saline over 4 hours. At what rate should the nurse set the client's intravenous infusion pump?

63 ml/hr 250 ml/4hr

the healthcare provider prescribes 1000 ml of ringer's lactate with 30 units of pitocin to run in over 4 hours for a client who has just delivered a 10 pound infant by cesarean section. the tubing has been changed to a 20 gtt/ml administration set. the nurse plans to set the flow rate at how many gtt/min?

83 gtts/min 20 x 1000/240

a male client discharged with a prescription for the bronchodilator theophylline tells the nurse that he understands he is to take three doeses of the medication each day. since at the time of discharge time-release capsules are not available which dosing schedule should the nurse advise the client to follow?

9 am, 1 pm, 5pm

parenteral penicillin can be administered as an:

IM injection or an IV solution

Which of the following types of medications can be administered via gastrostomy tube

Most tablets designed for oral use, except for extended-duration compounds

A nurse is caring for a client who required chest tube insertion for a pneumothorax. Toassess for pneumothorax resolution, the nurse anticipates that the client will require:

a chest x ray

What is the most important reason for starting intravenous infusions in the upper extremities rather than the lower extremities of adults?

a decreased flow rate could result in the formation of a thrombosis

&he nurse is assessing the nutritional status of several clients. Which client has the greatest nutritional need for additional inta+e of protein

a lactating woman nursing her 3 day old infant

A nurse is caring for a client with a history of GI bleeding, sickle cell diseaseand platelet count of 22,000/ul. The client is dehydrated and receivingdextrose 5% in half-normal saline solution at 150 ml/hr. the client complainsof severe bone pain and is scheduled to receive a dose of morphine sulfate.In administering the medication, the nurse should avoid which route

adding air prevent the drug from flowing back into the needle track

to prevent skin breakdown around the nares of a patient receiving oxygen through a nasal cannuls, the nurse should

adjust the cannula so it is comfortable

a nurse preparing to administer a sustained-release capsule to a client. which is an appropriate nursing intervention

administering the capsule whole with a glass of water

the nurse teaches a client about insulin and how to inject it. the nurse explains to the client techniques to prevent inflammation and damage to tissue at the injection site. which of the following techniques is best

administering the insulin in alternate sites

A patient who develops hives after receiving an antibiotic is exhibiting drug

allergy

a client is to receive a glycerin suppository. which nursing action is appropriate when administering a suppository

applying a lubricant to the suppository

after receiving an IM injection, a client complains of burning pain at the injection site. which nursing action would be most appropriate at this time

applying a warm compress to dilate the blood vessels

The best way of determining whether a patient has learned to instill ear medication properly is for the nurse to:

ask the patient to demonstrate the procedure

A nurse is caring for a client who is exhibiting signs and symptoms characteristic of a myocardial infarction (MI). which statement describes priorities the nurse should establish while performing the physical assessment

assess the clients level of pain and administer prescribed analgesics

A client with pneumonia has a decrease in oxygen saturation from 94% to 88% while ambulating. Based on these findings" which intervention should the nurse implement first?

assist the ambulating client back to the bed

During a meal, a client with hepatitis B dislodges her IV line and bleeds onto the surface of the overbed table. It would be most appropriate for the nurse to instruct a housekeeper to clean the table with

bleach

which of the following blood tests should be performed before a blood transfusion

blood typing and cross-matching

The two blood vessels most commonly used for TPN infusion are the:

brachial and femoral veins

A nurse is assigned to care for a client with a tracheostomv tube. How can the nursecommunicate with this client?

by supplying a magic slate or similar device

The nurse is caring for a client who is receiving 24-hour total parenteral nutrition (TPN) via a central line at 54 ml/hr. When initially assessing the client, the nurse notes that the TPN solution has run out and the next TPN solution is not available. What immediate action should the nurse take? A. Infuse normal saline at a keep vein open rate. B. Discontinue the IV and flush the port with heparin. C. Infuse 10 percent dextrose and water at 54 ml/hr. D. Obtain a stat blood glucose level and notify the healthcare provider.

c

The nurse is helping a client with asthma take his inhaled medication. which of the following could be done to provide better results&

call the pharmacy for a spacer

the mid deltoid injection site is seldom used for IM injection because it

can only accomodate only 1 ml or less of medication

A client complains of difficulty of swallowing, when the nurse try to administer capsule medication. Which of the following measures the nurse should do?

check the availability of a liquid preparation

what should the nurse do if a patient pulse is full and bounding

check the flow rate of the IV fluids

what should the nurse do if the patients pulse is full and bounding

check the flow rate of the IV fluids

you are called to a residence for a sick 5 year old. when you arrive and begin your assessment you that the child is unconscious with a RR of 8 breaths/min and HR of 50 beats/min. managemnt of this child should consist of

chest compression, artifical ventilation and transport

A client with burns on his groin has developed blisters. As the client is bathing, a few blisters break. The best action tor the nurse to take is to

clean the area with normal saline solution and cover it with a protective dressing

The nurse is performing nasotracheal suctioning. After suctioning the client's trachea for fifteen seconds, large amounts of thick yellow secretions return. What action should the nurse implement next? A. Encourage the client to cough to help loosen secretions. B. Advise the client to increase the intake of oral fluids. C. Rotate the suction catheter to obtain any remaining secretions. D. Re-oxygenate the client before attempting to suction again.

d

After completing an assessment and determining that a client has a problem, which action should the nurse perform next? A. Determine the etiology of the problem. B. Prioritize nursing care interventions. C. Plan appropriate interventions. D. Collaborate with the client to set goals.

determine the etiology of the problem

what should the nurse do first when injectin an intraavenious med via an already existing intravenous line

determine the patency of the intraveneous line

In a client with a urine specific gravity of 1.040, a subnormal serum osmolality, and a serum sodium level of 128 mEq/L, the nurse should question an order for which I.V. fluid?

dextrose 5% on water (D5W)

why would the nurse be interested in a clients dietary history when administering drugs

dietary intake can alter the effectiveneness of some drugs

A nurse is assisting with a subclavian vein central be insertion when the client's oxygens aturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include

diminished or absent breath sounds on the affected side

what should the nurse do when blood appears at the ub of the needles while aspirating an intramuscular injection

discard the syrinnge and prepare a new injection

a nurse notes that clients IV insertion site is red, swollen, and warm to the touch. which action should the nurse take first

discontinue the IV infusion

the correct method for determining the vastus lateralis site for IM injection is to

divide the area between the greater femoral trochanter and the lateral femoral condyle into thirds and select the middle third on the anterior of the thigh

One aspect of implementation related to drug therapy is:

documenting drugs given

the nurse is teaching a client proper use of an inhaler. when should the client administer the inhaler-deliverd medication to demonstrate correct use of the inhaler?

during inhalation

when inserting an oral airway, the initial action of the nurse is to

ensure that the airway is the correct size

when oxygen therapy via nasal cannula is ordered for a patient, the first action by the nurse is to

explain the rules of fire safety and oxygen use

&he nurse is administering medications through a nasogastric tube which is connected to suction. After ensuring correct tube placement" what action should the nurse ta+e next?

flush the tube with water

An elderly male client who is unresponsive following a cerebral vascular accident is receiving bolus enteral feedings though a gastrostomy tube. What is the best client position for administration of the bolus tube feedings?

fowlers

31. $ll of the following are common signs and symptoms of phlebitis e-cept"

frank bleeding at the insertion site

All of the following are common signs and symptoms of phlebitis except:

frank bleeding at the insertion site

An elderly client with a fractured left hip is on strict bedrest. Which nursing measure is essential to the client's nursing care

gently lift the client when moving into a desired position

A client is in the radiology department at 0900 when the prescription levofloxacin 500 mg IV q24h is scheduled to be administered. &he client returns to the unit at 1300. What is the best intervention for the nurse to implement?

give the missed dose at 1300 and change the schedule to administer daily at 1300

A client who is in hospice care complains of increasing amounts of pain. &he healthcare provider prescribes an analgesic every four hours as needed. Which action should the nurse implement?

giving an around the clock schedule for administration of analgesics

A physician orders regular insulin 10 units LV. along with 50 ml of dextrose 50% for a client with acute renal failure. What problem is this client most likely experiencing?

hyperkalemia

$fter # days of diuretic therapy with 2,mg of furosemide /asi- daily% a patient begins to e-hibit fatigue% muscle cramping and muscle weakness. hese symptoms probably indicate that the patient is e-periencing

hypokalemia

During her morning assessment, a nurse notes that a client has severe dyspnea, his respirations are 34 breaths/minute and labored. Oxygen saturation is 79% on 3L of oxygen. The nurse remembers that the client's chart includes his living will, When considering best practice, the nurse should:

initiate potentially life-prolonging treatment unless the client refuses

the nurse recognizes that the patient understands the teaching about how to self administer a rectal supposity when the patient

inserts the suppository immediately after its removal from the refrigerator

to prevent aspiration after meal by a patient who has difficulty swallowing, the nurse should first

inspect the mouth for pocketed food

a nurse is using the computer when a client calls for pain medication. which action by the nurse is the best

logging out of the computer, then administering the pain medication

Which of the following instructions would be inappropriate in attempting to increase Mr. Bob's lung ventilation and blood oxygenations after general anesthesia?

lying on your back, slowly take a deep breath hold that breath briefly, then slowly exhale

A client's infusion of normal saline infiltrated earlier today" and approximately 500 ml of saline infused into the subcutaneous tissue. &he client is now complaining of excruciating arm pain and demanding "stronger pain medications" What initial action is most important for the nurse to take?

measure the pulse volume and capillary refill distal to the infiltration

a physician orders an intenstinal tube to decompress a clients GI tract. when gathering equipment for this procedure the nurse should obtain a:

miller-abbott tube sengstaken-blakemore is an esophageal levin and salen are NG

what is the primary purpose of implementing chest physiotherapy

mobilize secretions

A nurse is caring for a client who is receiving total parenteral nutrition(TPN) via a central line. Which nursing intervention would specifically provide assessment data related to the most common complicationrelated to TPN

monitoring the temperature

cross-tolerance to a drug is defined as:

one drug reduces response to another drug

A nurse is monitoring a client for adverse reactions during barbiturate therapy. What isthe major disadvantage of barbiturate use?

potential for drug dependence

which behavior would indicate an inappropriate technique to use with a metered dose inhaler (MDI)

pressing down on the inhaler while inhaling quickly

an elderly client who experiences several adverse drug reaction may benefit from:

reduced drug dosages

When a central venous catheter dressing becomes moist or loose, what should a nurse do first?

remove the dressing, clean the site, and apply a new dressing

what is the most important intervention by the nurse to increase both circulation and respiration in a patient

reposition the patient every 2 hours

all of the following nursing interventions are correct when using the Z track method of drug injection except

rub the sit vigorously after the injection to promote absorption

the ear canal of an infant or young child

slants upward older child and adult slant down

mr simon is obese.when administering a subcutaneous injection to an obese patient it is best for the nurse to

spread skin or pinch at the injection site and inject needle at a 45-90 degree angle

when positioned properly, the top of a central venous catheter should lie in the:

superior vena cava

a client has a nursing diagnosis of ineffective airways clearance related to poor coughing. when planning this clients care, the nurse should include which intervention

teaching the client how to deep-breathe and cough

A client with toxoplasmosis and cytomegalovirus is confused and has beendislodging his IV access device. He is scheduled to receive amphotericin B(Amphotec) IV. Which action would be most appropriate for the nurse to take

telling a nursing assistant to stay with the client during the infusion

which action is unique when administering medicaiton via z tract injection method

the skin is pulled laterally before needle insertion

what is a common source of airway obstruction in an unconscious client?

the tongue

When caring for a client with a 3-cm stage I pressure ulcer on the coccyx, which action may the nurse institute independently?

using normal saline solution to clean the ulcer and applying a protective dressing as necessary

the best site for injecting a drug to a 6 month child is the

vastus lateralis

what is the most important for the nurse to do when administering a topical medicated cream to a patients skin

wash the area before administering the medication

a patient with NKA is to receive penicillin every 6 hours. when administering the medication, the nurse observes a fine rash on the patients skin. the most appropriate nursing action would be to

withold the medicaiton and notify the physician