Ticket to clinical 11 *

A nurse is preparing to administer amoxicillin 100 mg PO every 8 hr to a toddler who weighs 20 kg. The recommended dosage range is 20 to 25 mg/kg/day. Which of the following actions by the nurse is appropriate?

* The nurse administers the prescribed dosage. * The nurse determines the prescription is above the recommended dosage range. * The nurse contacts the pharmacist to adjust the prescribed dosage. * The nurse determines the prescription is insufficient to achieve the desired effect. Answer: The nurse determines the prescription is insufficient to achieve the desired effect. (The dose is below the recommended range: 20 kg x 20 mg = 400 mg/kg/day; 20 kg x 25 mg = 500 mg/kg/day. Based on the toddler's weight, it would be safe for the client to receive 400 to 500 mg/day of amoxicillin. The toddler is receiving a total of 300 mg/day (100 mg x 3 doses daily). The nurse should notify the provider as the prescribed dose is below the recommended dosage range.)

When administering ear drops to a toddler. The nurse pulls the auricle down and back. The mother asks "why are you pulling the ear that way?" Which of the following is an appropriate response by the nurse?

*"This technique opens the ear canal, allowing medication to reach the inner ear region *"When this technique is used, the toddler experiences less pain." *"This is the safest and easiest way to administer this medication." *"When this technique is used, the medication will not run out of the ear." Answer: "This technique opens the ear canal, allowing medication to reach the inner ear region."

A nurse in a clinic is talking with a client who has a new diagnosis of osteoarthritis. The nurse should anticipate that the client will require teaching about which of the following medications?

*Acetaminophen *Celecoxib *Cyclobenzaprine *Ibuprofen Answer: Acetaminophen (According to the American Pain Society, acetaminophen is the primary drug of choice for treating osteoarthritis. The provider would likely begin with this medication.)

A nurse is at an ophthalmology clinic is providing teaching to a client who has an open angle glaucoma and a new treatment regimen of Timolol and pilocarpine eye drops. Which of the following instruction should the nurse provide?

*Administer the medication by touching the tip of the dropper to the sclera of the eye *Hold pressure on the conjunctiva sac for two minutes following the application drop *Administer the medication five minutes apart *It is not necessary to remove contact lenses before administering Answer : Administer the medication five minutes apart (The nurse should instruct the client that, if more than one ophthalmic medication is to be administered, they should be given five minutes apart)

A nurse is caring for a 4-year-old child who is resistant to taking medication. Which of the following strategies should the nurse use to elicit the child's cooperation?

*Offer the child a choice of taking the medication with juice or water. *Tell the child it is candy. *Hide the medication in a large dish of ice cream. *Tell the child he will have to have a shot instead. Answer: Offer the child a choice of taking the medication with juice or water. (While taking the medicine is not a choice, the child can decide what kind of fluid to take with the medication. This gives the preschool-aged child a sense of control over a stressful situation and increases the child's ability to cope.)

A nurse is planning care for a client who has a detached retina and is pre-operative for a surgical repair. The nurse should prepare to administer which of the following medications?

*Phenylephrine *Latanoprost *Pilocarpine *Timolol Answer: Phenylephrine (Mydriatic medications such as Phenylephrine, are used preoperatively to dilate pupils to facility inocular surgery)

A nurse is preparing to instill eardrops to a 5-year-old child. Which of the following techniques should the nurse use?

*Pull the auricle down and back *Pull the auricle down and out *Pull the auricle up and back *Pull the auricle up and out Answer: Pull the auricle down and back (to open the canal when administering ear drops.)

A nurse is preparing to instill ear drops to a 3-year-old child. Which of the following techniques should the nurse use?

*Pull the auricle down and back *Pull the auricle down and out *Pull the auricle up and back *Pull the auricle up and out Answer: Pull the auricle down and back (to open the canal when administering ear drops.)

A nurse is caring for a client receiving mydriatic eye drops. Which of the following clinical manifestations indicates to the nurse that the client has developed a systemic anticholinergic effect?

*Seizures *Tachypnea *Constipation *Hypothermia Answer: Constipation (Mydriatic eye drops can cause systemic anticholinergic effects such as constipation, dry mouth, photophobia, and tachycardia.)

A nurse at an ophthalmology clinic is providing teaching to a client who has open angle glaucoma and a new prescription for timolol eye drops. Which of the following instructions should the nurse provide?

*The medication is to be applied when the client is expressing our pain *The medication will be used into the client in ocular pressure return to normal *The medication should be applied on a regular schedule for the rest of the clients life *The medication is to be used for approximately 10 days following a gradual tapering off Answer: The medication should be applied on a regular schedule for the rest of the clients life (Medications prescribed for open angle glaucoma are intended to enhance adequate outflow, or decrease its production, or both. The client must continue to use the eyedrops or an on interrupted basis for life to maintain intraocular pressure at an acceptable level)