Card 0 of 2292
The nurse is preparing to administer 100,000 units of medication to a patient. The ampule sent from the pharmacy contains 600,000 units/mL. How many mL should the nurse administer?
The medication dose formula is as follows: Milliliters to be administered = (Dose to be administered)/(Available solution). Thus, the calculation for this problem is (100,000 units)/(600,000 units/mL) = 0 mL mL
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The nurse is preparing a bag of heparin sodium solution with a mix of 120,000 units/400 mL intravenously. At what rate should the nurse set the infusion pump if intending to deliver 1800 units/hr?
The required rate can be calculated as follows: (Delivered units/hr x mL)/units. Thus, the answer can be calculated as (1800 units/hr x 400 mL)/120,000 units = 6.0 mL/hr
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The new pediatric nurse has just given a suppository to a 5-year-old boy. He has a bowel movement 7 minutes post administration. Which action should the nurse take next?
First, examine the stool for the suppository. Based on the findings, inform the physician. If the suppository was fully present in the stool, the physician may want to prescribe another dose. If not, he may choose to re-order half of the prescribed dose or none at all.
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The pediatric nurse must convince a 4-year-old boy to take his medication. Which phrase is the most acceptable?
When convincing a child to take medicine, be straightforward and clear. Try not to offer the child a choice, as they likely won't take it. Stay away from using bribery, punishment, or comparing medicine to candy. Be honest about the taste of the medicine or risk losing the trust of the child.
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The pediatric nurse is summoned to a room by the parents of a 2-year-old child. The peripheral IV line has been removed by the patient. When starting a new line, the nurse carefully chooses placement. The nurse should attempt to start the IV __________.
Most peripheral IV's are started in the right or left arm. Distal to the arm would mean closest to the fingertips. When starting an IV, always start looking for potential sites closest to the fingertips and work upwards. If a vein is punctured and becomes unusable, it is possible to move above the previous attempt and start a successful IV.
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Jane is a 49-year-old woman who has recently had a peripherally inserted central catheter (PICC) placed. The nurse is teaching Jane how to flush her PICC. She knows that the teaching was effective when Jane states which of the following?
One should always use a 10mL syringe or larger to flush a PICC line. Smaller syringes place greater pressure on the line which could result in damage. For example, a 3mL syringe places greater pressure on a PICC line than a 5mL syringe.
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Which of the following is an appropriate reason to delay antibiotic administration in a stable patient?
Obtaining a set of blood cultures before treating a bacterial infection helps to individualize care and reduce antibiotic resistance (using a narrow-spectrum antibiotic doesn't work against so many types of bacteria). By identifying specific bacteria in the blood, a narrow-spectrum antibiotic may be chosen. A physician may prescribe a broad-spectrum antibiotic initially and change treatment later based on the results of the blood cultures.
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A nurse is teaching a mother how to administer nystatin to her 2-month-old child in the treatment of oral candidiasis. Which of the following is an appropriate instruction given by the nurse to the mother?
Apply medication to the mouth using a cotton-tipped applicator. Give the medication after meals and avoid rinsing the mouth. The medication should have contact with the mucosa without being washed away. Do not place the medication in a child's bottle, they may refuse to eat due to the bitter taste of the medication. Do not use a syringe to squirt the liquid to the back of the mouth since the child will likely spit it out.
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When performing a blood transfusion, which of the following procedures should not be adhered to in order to ensure safe delivery of blood product to the patient?
All are true except for the use of lactated Ringer's this may cause a hemolytic reaction, only normal saline 0.9% is utilized.
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Levodopa is not generally given alone due to what side effects?
Levodopa (L-DOPA), a common treatment for Parkinson's disease, is generally given in combination with carbidopa or another peripheral dopa-decarboxylase inhibitor. This is because levodopa alone will stimulate dopamine receptors in the GI tract and the chemotrigger receptor zone (CTZ) in the brain, resulting in nausea, vomiting and anorexia. A peripheral dopa-decarboxylase inhibitor prevents levodopa from being prematurely converted into dopamine in the adrenal glands or other peripheral tissues.
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How does adalimumab function to reduce inflammation in rheumatoid arthritis?
Adalimumab is a tumor necrosis factor alpha (TNF-alpha) inhibitor. This class of drugs suppresses response to TNF-alpha, a potent pro-inflammatory cytokine. Inhibition of folic acid metabolism is the method of action of methotrexate. Reversible inhibition of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) is the mechanism of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Rheumatoid arthritis drugs such as rituximab, and almost all drugs that end in -mab, including adalimumab function as monoclonal antibodies.
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You are the nurse taking care of a patient who is started on a two-week course of oral prednisone. Which of the following is a known side effect of oral steroids?
The correct answer is "insomnia," as steroids are known to increase patients' vigilance and energy levels, thereby frequently making it difficult for patients to fall asleep and/or stay asleep while taking their steroid medication. The other choices are incorrect. Decreased appetite is not a side effect of taking steroid medications. Patients on steroids often have increased appetite. Hyponatremia and hyperkalemia both are not side effects of taking steroid medications. Hypernatremia and hypokalemia are more common side effects of steroids. Hypertension, rather than hypotension is a known side effect of steroid use.
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Which of the following analgesic medications should be used with caution in patients with hepatic disease?
The correct answer is "acetaminophen." This is the correct answer because acetaminophen, also known as Tylenol, is initially metabolized into a hepatotoxic intermediate (it transiently becomes a reactive oxygen species, which can cause liver hepatotoxicity). As such, in patients who already have pre-existing liver disease who are already more prone to liver injury from substances and diseases that affect the liver, it is prudent to avoid medications like acetaminophen that have a known potential to cause liver damage.
Meloxicam, ibuprofen, naproxen, and ketorolac are all examples of non-steroidal anti-inflammatory drugs (NSAIDs). These medications have the potential to cause renal damage or gastrointestinal damage if used in excess, but do not have the known hepatotoxic properties that acetaminophen does.
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You are the nurse taking care of a patient with severe lower back pain. He is being treated with oxycodone and hydromorphone. Which of the following analgesic medications produces dilated pupils?
The correct answer is "meperidine." Meperidine, a potent opioid analgesic, also known as Demerol, is one of the only opioids that produces dilated pupils, rather than constricted, "pinpoint" pupils. A way to remember this is to remember the phrase, "Demerol Dilates." The other choices are incorrect. Acetaminophen has no known effect on pupil size. Morphine, oxycodone, and hydromorphone, all opioid analgesics, are known to constrict the pupils.
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Ciprofloxacin belongs to what class of antibiotic?
Ciprofloxacin belongs to the fluoroquinolone class of antibiotics. Other antibiotics in this class include norfloxacin, levofloxacin, and nadifloxacin.
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Fluoroquinolones such as ciprofloxacin may cause which of the following serious side effects?
Fluoroquinolones (the most commonly prescribed of which is ciprofloxacin) carry a risk of all of the following adverse effects: sudden tendon rupture or tendonitis, hepatotoxicity or liver failure, seizures, and permanent peripheral neuropathy. Other adverse effects include C_lostridium difficile_ associated diarrhea, bone marrow suppression, Steven-Johnson's Syndrome, tremors, and psychosis. The majority of these adverse effects are seen in higher numbers in children and the elderly.
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Which of the following antibiotics is contraindicated in pregnant women and small children due to it's tendency to irreversibly stain developing teeth?
Tetracycline antibiotics are contraindicated in pregnant women and small children due to their tendency to irreversibly stain developing teeth. They can also affect fetal bone growth and so are pregnancy category D (known incidence and risk of fetal harm).
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Which of the following antibiotics is considered safe in pregnancy?
Of the antibiotics listed, amoxicillin is the only one considered safe in pregnancy. Doxycycline and gentamicin are both pregnancy category D (known to cause fetal harm). Levofloxacin is category C (fetal harm can not be ruled out).
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Which of the following antibiotics is least likely to cause C_. difficile_ overgrowth and C_. difficile_ associated diarrhea?
All of the drugs listed frequently cause C_. difficile_ overgrowth and C_. difficile_ associated diarrhea except vancomycin, which is often used as a treatment for persistent C_. difficile_ infections.
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Penicillin us used to treat what type of microbe?
Penicillins belong to a larger class of antibiotics known as beta-lactams. These antibiotics inhibit cell-wall synthesis and are exclusively used to treat Gram positive bacteria. They are not effective against Gram negative bacteria or fungi.
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