Dosage Calculation, Nutrition, Medication Administration
The nurse manager is orienting a new nurse to the unit's medication system. Which statements should the manager make concerning the control of narcotic (opioid) medications? Select all that apply.
"Our opioids are all kept in a locked storage cabinet." "Opioids are counted at shift changes by nurses of each of the shifts." "A description of the unit's opioid controls can be found in the policies and procedures manual." "Whenever you need to waste a portion of an opioid, you need another nurse to witness the disposal."
A postoperative client has been vomiting and has absent bowel sounds, and paralytic ileus has been diagnosed. The primary health care provider prescribes the insertion of a nasogastric tube. The nurse explains the purpose of the tube and the insertion procedure to the client. The client says to the nurse, "I'm not sure I can take any more of this treatment." Which therapeutic response should the nurse make to the client?
"You are feeling tired and frustrated with your recovery from surgery?"
A health care provider's prescription reads "phytonadione 0.5 mg intramuscular one time." The medication ampule reads "phytonadione, 1 mg/0.5 mL." How many milliliters should the nurse prepare to administer the correct dose? Fill in the blank.
0.25 mL
The health care provider prescribes dexamethasone 1 mg intravenously every 6 hours. How many milliliters should the nurse administer to deliver this dose? Refer to figure. Fill in the blank.
0.25 mL
The nurse reports that the International Normalized Ratio (INR) is 4.9 on a client receiving warfarin. In response, the health care provider prescribes phytonadione 2.5 mg. Phytonadione as 10 mg/1 mL is available. How many milliliters should the nurse administer? Fill in the blank.
0.25 mL
A client is to receive lorazepam 1 mg intravenously. The vial reads "lorazepam 2 mg/1 mL." How many milliliters (mL) should the nurse administer to the client for the correct dose? Fill in the blank.
0.5 mL
A client receiving morphine sulfate via patient-controlled anesthesia (PCA) complains of pruritus. The nurse reviews the as-needed (prn) medications and notes that the client may have diphenhydramine 25 mg intravenous (IV) for this complaint. Diphenhydramine in the form of 50 mg/1 mL is available. How many milliliters should the nurse administer for one dose? Fill in the blank.
0.5 mL
The nurse in the delivery room receives a prescription to give a newborn 0.2 mg of naloxone intramuscularly. The medication vial reads naloxone 0.4 mg/mL. How many milliliters should the nurse administer? Fill in the blank and record your answer using one decimal place.
0.5 mL
Haloperidol lactate 3 mg intramuscularly has been prescribed for a client diagnosed with delirium. The medication label reads 5 mg per mL. How many mL should the nurse prepare to administer the correct dose? Fill in the blank.
0.6 mL
A health care provider prescribes 20 mg of diltiazem by the intravenous route. The medication vial reads "50 mg/2 mL." How many milliliters should the nurse administer? Fill in the blank.
0.8 mL
A primary health care provider prescribes acetaminophen liquid 450 mg orally every 4 hours PRN for pain. The medication label reads 160 mg/5 mL. The nurse prepares how many milliliters (mL) to administer one dose? Fill in the blank and record your answer to the nearest whole number.
14 mL
A client is to receive 238 g of polyethylene glycol diluted in 64 oz of Gatorade as a bowel preparation the day before a scheduled colonoscopy. How many milliliters did the client consume thus far if the client already drank six 8-oz glasses of the mixed solution? Fill in the blank.
1440
A health care provider prescribes pentobarbital 0.1 g orally at hour of sleep. The medication label reads pentobarbital 50-mg capsules. How many capsule(s) should the nurse administer to the client? Fill in the blank.
2 capsule(s)
A client is prescribed levothyroxine 80 mcg intravenously daily. The dosage available is 200 mcg to be diluted with 5 mL of nonbacteriostatic water. How many milliliters should the nurse administer for one dose? Fill in the blank.
2 mL
A health care provider's prescription reads "adenosine, 6 mg intravenously stat." The medication ampule reads "adenosine supplied in a solution of 3 mg/1 mL." How many milliliters should the nurse prepare to administer the correct dose? Fill in the blank.
2 mL
A client is prescribed dexamethasone 0.5 mg daily. How many tablets from the provided medication container should the home care nurse instruct the client to take daily? Refer to figure. Fill in the blank.
2 tablets
Ciprofloxacin 400 mg in 200 mL of diluent is prescribed to infuse over 1 hour. At how many milliliters per hour (mL/hr) should the nurse set the electronic infusion device? Fill in the blank.
200 mL/hr
A health care provider prescribes 1000 mL of normal saline to infuse over 12 hours. The drop factor is 15 gtt per 1 mL. The nurse should prepare to set the flow rate at how many drops per minute? Fill in the blank. Round the answer to the nearest whole number.
21 gtt per minute
The client is admitted to the intensive care unit after complicated kidney transplantation. The health care provider prescribes cyclosporine 2 mg/kg daily. The client weighs 75 kg, and cyclosporine is available in 50 mg/mL in 5-mL vials. How many milliliters should the nurse administer for the daily dose? Fill in the blank.
3 mL
A client has been prescribed oral risperidone 6 mg daily. The medication label reads 2 mg/tablet. To receive the correct dose, the nurse should administer how many tablets once daily? Fill in the blank.
3 tablets
A 26-kg client is to receive prophylactic sulfamethoxazole/trimethoprim for diagnosed hydronephrosis once daily. The recommended dose is 2 mg per kilogram per day. How many milligrams will this client receive per day? Fill in the blank.
52 mg per day
A client who has been taking digoxin is admitted with the diagnosis of digoxin toxicity, and the health care provider prescribes digoxin immune Fab 228 mg by intravenous (IV) infusion. Available is digoxin immune Fab 38 mg per powdered vial. How many vials should the nurse reconstitute? Fill in the blank.
6 vials
A health care provider prescribes one liter of 5% dextrose in water (D5W) to run over 24 hours. The intravenous (IV) tubing drop factor is 10 drops (gtt) per milliliter. At what rate should the nurse set the IV to infuse in gtt per minute? Fill in the blank. Round your answer to the nearest whole number.
7 gtt per minute
The nurse needs to draw 0.6 mL of medication into a syringe. To which area on the syringe should the nurse fill the syringe with medication? Refer to figure.
A
A client has been prescribed intranasal beclomethasone dipropionate by the intranasal route. The client also has a prescription for a nasal decongestant. Which action should the nurse plan to take for the effective administration of both medications?
Administer the decongestant 15 minutes before the beclomethasone dipropionate.
The nurse is preparing to perform a Mantoux tuberculin skin test. Which interventions apply to the administration of this test? Select all that apply.
Explain the procedure to the client. Mark the test area to locate it for reading 48 to 72 hours after injection. Cleanse the injection site on the lower dorsal surface of the forearm with alcohol and allow it to dry. Ask the client about a history of receiving a positive purified protein derivative (PPD) reaction.
A client is diagnosed with hyperphosphatemia caused by hypoparathyroidism. To prevent worsening of the condition, the nurse should instruct the client to avoid which food selections? Select all that apply.
Fish, eggs, whole-grain breads
While preparing to administer an intravenous (IV) medication, the nurse notes that the medication is incompatible with the IV solution. Which intervention should the nurse implement to assure the client's safety?
Flush tubing before and after administering the medication with normal saline.
When administering a medication intramuscularly, the nurse should document the intervention by including which information? Select all that apply.
The site of the injection. The amount of medication injected. The name of the medication that was injected. Confirmation that the medication was injected intramuscularly
The nurse is preparing to administer an intramuscular injection to a toddler. The nurse determines that the safest body site to administer the injection is which location?
Vastus lateralis muscle
The nurse is preparing to administer a prescribed immunization to a 13-year-old child who is normal size and weight for his age. Which site should the nurse determine as the best location to administer the intramuscular injection?
Ventrogluteal muscle
A client is prescribed hydromorphone 0.2 mg intravenous push (IVP). Available is hydromorphone 2 mg/mL. How many milliliters should the nurse administer for a correct dose? Fill in the blank.
0.1 mL
A client is to receive lorazepam 1 mg intravenously (IV) for severe anxiety. Lorazepam 4 mg/mL is available. How many milliliters should the nurse administer? Fill in the blank.
0.25 mL
A health care provider has prescribed a phytonadione injection, 2.5 mg intramuscularly. How many milliliters should the nurse prepare to administer to the client? Refer to figure. Fill in the blank.
0.25 mL
A health care provider prescribes lorazepam 0.5 milligrams (mg) intravenously for a client with a history of diagnosed seizure disorder. The medication vial reads "lorazepam 2 mg/1 mL." How many milliliters should the nurse administer? Fill in the blank.
0.25 mL
A health care provider prescribes 25 mg of promethazine to be mixed with 35 mg of meperidine every 4 hours as needed for pain. The promethazine vial reads "50 mg/1 mL." The meperidine vial reads "50 mg/1 mL." To correctly administer the two medications together, the nurse should expect to administer a total of how many milliliters? Fill in the blank.
1.2 mL
A health care provider prescribes regular insulin 5 units per hour by continuous intravenous (IV) infusion. The pharmacy prepares the medication and then delivers an IV bag labeled 50 units of regular insulin in 100 mL of normal saline. An infusion pump must be used to administer the medication. The nurse should set the pump at how many mL per hour to deliver the correct dose? Fill in the blank.
10 mL
Penicillin V potassium 250 mg orally every 8 hours is prescribed for a child diagnosed with a respiratory infection. The medication label reads, penicillin V potassium, 125 mg per 5 mL. The nurse has determined that the dosage prescribed is a safe dose for the child and should administer how many milliliters per dose to the child? Fill in the blank.
10 mL
A health care provider prescribes aluminum hydroxide 1200 mg before meals. It is available as 600 mg per teaspoon. How many milliliters are needed per dose? Fill in the blank.
10 mL per dose
The health care provider's prescription reads to begin a client on a continuous heparin sodium infusion at 500 units/hr. The premixed infusion available is 500 mL of D5W with 25,000 units of heparin. At what hourly rate should the nurse set the electronic infusion device to deliver this dose? Fill in the blank.
10 mL/hr
A client is brought into the emergency department diagnosed in status epilepticus. The health care provider prescribes a loading dose of phenytoin 15 mg/kg in 3 divided doses 4 hours apart. The client weighs 70 kg. How many total milligrams should the client receive for the 3 doses? Fill in the blank.
1050 mg
While following a heparin protocol, the nurse is to prepare an intravenous bolus of 2500 units for a client with a confirmed diagnosed deep vein thrombosis. Heparin is available as 10,000 units in 10 mL. How many milliliters should the nurse administer? Fill in the blank.
2.5 mL
A health care provider's prescription reads morphine sulfate 0.03 mg/kg epidurally STAT. The client's weight is 105 pounds. The preservative-free morphine dose available is 0.5 mg/mL. The nurse should prepare how many milliliters to administer the correct dose? Fill in the blank and round and record your answer using one decimal place.
2.9 mL
The nurse has a prescription to administer two ophthalmic medications at 9:00 a.m. to the client who has undergone eye surgery. How many minutes after administering the first medication should the nurse wait before giving the second?
3 to 5
A client is prescribed lactulose 20 g orally. The available concentration from the pharmacy is lactulose 10 g/15 mL. How many milliliters should the nurse administer to the client to deliver the prescribed dose? Fill in the blank.
30 mL
A health care provider prescribes an intravenous (IV) heparin infusion of 1500 units per hour. The concentration of the solution is 25,000 units of heparin in 500 mL of 5% dextrose in water. At how many milliliters per hour should the nurse set the IV pump to deliver the prescribed dose? Fill in the blank.
30 mL per hour
The nurse is preparing to administer a medication by the Z-track method. Which priority order should the nurse implement actions to prepare and administer the medication? Arrange the actions in the order they should be performed. All options must be used.
Draw the medication into the syringe using aseptic technique, and add 0.25 mL air lock. Remove and discard the needle used to draw up the medication, and place a new needle (22-gauge, 2 to 3 inches long) on the syringe. Select the dorsogluteal site, and pull the skin and subcutaneous tissue sideways away from the muscle. Clean the site while holding the skin and subcutaneous tissue off to the side, and insert the needle deeply into the muscle tissue. Aspirate to determine needle placement, and inject the medication and the air bubble. Release the skin and subcutaneous tissue.
A client receiving total parenteral nutrition (TPN) via a central venous catheter (CVC) is scheduled to receive an intravenous (IV) antibiotic. Which intervention should the nurse implement before administering the antibiotic?
Ensure a separate IV access route.
Which anatomical site and method should the nurse use to administer an injection of iron to a client?
Gluteal muscle using Z-track technique
A health care provider prescribes 1000 mL of normal saline to infuse over 8 hours. The drop factor is 15 drops/mL. At how many drops per minute should the nurse set the intravenous (IV) flow rate? Fill in the blank, and round the answer to the nearest whole number.
31 drops/min
A client has primary health care provider instructions to take ibuprofen 0.4 g for mild pain. The medication bottle contains ibuprofen 200-mg tablets. How many tablets will the nurse instruct the client to take for each dose? Fill in the blank.
2 tablets
A health care provider prescribes heparin 400 units/hr by continuous intravenous (IV) infusion. The pharmacy prepares the medication and delivers an IV bag labeled "heparin sodium 10,000 units/1000 mL 0.9% NaCl." An electronic infusion device must be used to administer the medication. The nurse should set the infusion device at how many milliliters per hour to deliver 400 units/hr? Fill in the blank.
40 mL/hr
A client who weighs 172 pounds and diagnosed with diabetic ketoacidosis (DKA) is to receive 10 mL/kg of 0.9% normal saline over a 4-hour period. If the IV tubing delivers 15 drops/mL (gtt/mL), how many drops (gtt) per minute should the nurse set the infusion set to deliver? Fill in the blank and round the answer to the nearest whole number.
49 gtt/min
A 13-year-old adolescent's weight is 88 pounds. Ceftriaxone 50 mg/kg has been prescribed for a diagnosed severe infection. Each milliliter of medication as reconstituted in the vial contains 400 mg of this medication. How many milliliters should the nurse administer to this adolescent? Fill in the blank.
5 mL
When a client requests pain medication, the nurse administers a ventrogluteal intramuscular injection. After administration of the injection, what should the nurse do first?
Apply gentle pressure to the injection site.
As the nurse begins to administer scheduled doses of furosemide and nifedipine, the client asks for a PRN dose of aluminum hydroxide. Which action by the nurse would be best ensure the effectiveness of all the medications?
Assess the client's immediate need for the antacid.
Which action is included in the accurate procedure for administering heparin sodium subcutaneously?
Avoiding aspiration before administration of the medication
The nurse is preparing a small dose of a medication for administration to an infant. Which syringe should the nurse choose for preparing the medication? Refer to figure.
B
When a medication is being administered, the safest and most accurate way for the nurse to verify the identity of a client is to implement which action?
Check the client's identification bracelet.
The nurse is adding medication to an intravenous (IV) fluid bag and hanging the medication. In order of priority, which actions should the nurse take to ensure that the medication is administered in a safe and appropriate manner? Arrange the actions in the order that they should be performed. All options must be used.
Check the medication administration record (MAR) in order to address the rights of medication administration. Perform hand hygiene. Clean the port site of the bag and add the medication. Mix the medication by gently turning the bag end to end. Apply a medication added label on the IV fluid bag. Hang the intravenous bag containing the prescribed medication.
The nurse prepares a syringe of medication for intravenous (IV) bolus administration. In order of priority, which actions should the nurse take to ensure that the medication is administered in a safe and appropriate manner? Arrange the actions in the order that they should be performed. All options must be used.
Prepare medication as prescribed at appropriate time for administration. Identify the client using at least two identifiers as stated in the facility's policy. Compare the medication label with the medication administration record (MAR). Explain the procedure to the client. Perform appropriate and effective hand washing. Apply a pair of clean treatment gloves.
The nurse is preparing to administer eardrops to an infant. The nurse should plan to proceed by taking which step to assure the appropriate instillation of the medication?
Pull down and back on the auricle, and direct the solution toward the wall of the ear canal.
The nurse creates a teaching plan regarding the administration of eardrops for the parents of a 6-year-old child. The nurse tells the parents that, when administering the drops, which action is appropriate?
Pull the ear up and back.
The nurse is preparing to instill an otic solution into the adult client's left ear. Which actions should the nurse implement as part of this procedure? Select all that apply.
Pull the pinna upward and backward. Warm the solution to room temperature. Place the client in a side-lying position with the ear facing up.
The nurse prepares to give an intramuscular injection using the Z-track technique. Which should the nurse do initially to administer the medication?
Select a large, deep muscle for the intramuscular injection site.
A primary health care provider prescribes 1000 mL of 0.45% normal saline solution to run over 8 hours. The drop factor is 15 drops/mL. The nurse plans to adjust the flow rate to how many drops per minute to safely administer this intravenous (IV) solution? Fill in the blank and round answer to the nearest whole number.
31 gtt/ mL
A client is prescribed to receive 200 mg of phenytoin as an intravenous loading dose. The medication literature indicates to administer the medication at a rate of 50 mg/min. Over what minimal time period in minutes should the nurse intravenously deliver the medication? Fill in the blank.
4
Which should the nurse determine is the priority action before initiating an intermittent enteral feeding?
Determining tube placement
The nurse is preparing the client's morning prescribed NPH insulin dose and notices a clumpy precipitate inside the insulin vial. Which action should the nurse implement?
Draw the dose from a new vial.
The nurse is caring for a client receiving an intravenous (IV) infusion and has a prescription to administer an IV antibiotic that is incompatible with the primary IV infusion solution. Which is the most appropriate nursing action to safely administer the antibiotic?
Flush the tubing with normal saline, administer the antibiotic, and flush the tubing again with normal saline.
The nurse provides dietary instruction to the parents of a child with a diagnosis of cystic fibrosis. The nurse should tell the parents that which diet plan should be followed?
High in calories
A client who is receiving total parenteral nutrition (TPN) tells the nurse, "I'm not sure that I want to receive an infusion of lipids because it could make me obese." Which initial action should the nurse take?
Inquire how illness affects the client's self-concept.
A client's prescribed medication is available for injection in an ampule. The nurse determines that which is the most appropriate action when preparing to draw up this medication?
Place an alcohol wipe around the neck of the ampule.
A health care provider prescribes phenobarbital 15 mg. The medication label reads phenobarbital 20 mg/5 mL. How many milliliters should the nurse prepare to administer one dose? Fill in the blank. Round the answer to the nearest whole number.
4 mL
Which anatomic location should the nurse select to safely administer an intramuscular injection in the vastus lateralis muscle of an adult client? Refer to figure.
B
The nurse is preparing to administer prescribed heparin sodium 5000 units subcutaneously. Which action should the nurse take to safely administer the medication?
Change the needle on the syringe after withdrawing the medication from the vial.
The nurse is preparing to administer a parenteral vaccine. Place in order of priority the actions that the nurse would take to administer the vaccine. Place the actions in order of priority. All options must be used.
Verify the prescription for the vaccine. Obtain an immunization history from the parents, assess for allergies. Provide information to the parents about the vaccine and obtain parental consent. Check the lot number and expiration date and prepare the injection. Select the appropriate site for administration and administer the vaccine; document the administration, site, lot number, expiration date of the vaccine. Provide a vaccination record to the parents.
