General Concepts - NCLEX-PN
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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 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?
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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
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
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 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?
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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
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
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?
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?
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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.
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.
The pediatric nurse must convince a 4-year-old boy to take his medication. Which phrase is the most acceptable?
The pediatric nurse must convince a 4-year-old boy to take his medication. Which phrase is the most acceptable?
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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.
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.
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 .
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 .
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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.
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.
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?
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?
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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.
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.
Which of the following is an appropriate reason to delay antibiotic administration in a stable patient?
Which of the following is an appropriate reason to delay antibiotic administration in a stable patient?
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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.
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.
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?
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?
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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.
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.
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?
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?
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All are true except for the use of lactated Ringer's this may cause a hemolytic reaction, only normal saline 0.9% is utilized.
All are true except for the use of lactated Ringer's this may cause a hemolytic reaction, only normal saline 0.9% is utilized.
You are taking care of a patient undergoing chemotherapy for breast cancer and she complains of nausea. Her physician prescribes her ondansetron for nausea relief. What is the mechanism of action of ondansetron?
You are taking care of a patient undergoing chemotherapy for breast cancer and she complains of nausea. Her physician prescribes her ondansetron for nausea relief. What is the mechanism of action of ondansetron?
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The correct answer is "Serotonin 5HT-3 receptor antagonist."
Ondansetron functions by antagonizing the serotonergic 5HT-3 receptors both centrally in the brain and peripherally at vagal nerve endings. It is frequently given as an anti-nausea and anti-emetic agent for patients with cancer undergoing chemotherapy and/or radiation therapy, as well as in post-operative patients, and for patients with gastroenteritis, among other uses.
Ondansetron is neither a full nor a partial agonist of the 5HT-3 receptors, making those answer choices incorrect.
Metaclopramide, which is another anti-nausea agent, is an anatagonist of the dopamine D2 receptor, but ondansetron is not, so this choice is incorrect. Neither metaclopramide nor ondansetron is an agonist of the dopamine D2 receptor.
The correct answer is "Serotonin 5HT-3 receptor antagonist."
Ondansetron functions by antagonizing the serotonergic 5HT-3 receptors both centrally in the brain and peripherally at vagal nerve endings. It is frequently given as an anti-nausea and anti-emetic agent for patients with cancer undergoing chemotherapy and/or radiation therapy, as well as in post-operative patients, and for patients with gastroenteritis, among other uses.
Ondansetron is neither a full nor a partial agonist of the 5HT-3 receptors, making those answer choices incorrect.
Metaclopramide, which is another anti-nausea agent, is an anatagonist of the dopamine D2 receptor, but ondansetron is not, so this choice is incorrect. Neither metaclopramide nor ondansetron is an agonist of the dopamine D2 receptor.
You start a patient in the intensive care unit on a drip of phenylephrine, as the patient is persistently hypotensive. You think that this will raise the patient's blood pressure because phenylephrine's primary mechanism of action is which of the following?
You start a patient in the intensive care unit on a drip of phenylephrine, as the patient is persistently hypotensive. You think that this will raise the patient's blood pressure because phenylephrine's primary mechanism of action is which of the following?
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The correct answer is "alpha-1 adrenergic agonist."
Phenylephrine is frequently administered in the intensive care unit setting for patients with hypotension that is refractory to simple fluid resuscitation. It is a vasopressor, as its mechanism of action is to serve as an alpha-1 adrenergic agonist.
The other choices are incorrect, as they represent the primary mechanisms of action of a handful of medications other than phenylephrine.
An example of an alpha-2 adrenergic agonist would be methyldopa.
An example of a beta-1 adrenergic agonist would be dobutamine.
An example of a beta-2 adrenergic agonist would be albuterol.
An example of a beta-1 adrenergic antagonist would be atenolol.
The correct answer is "alpha-1 adrenergic agonist."
Phenylephrine is frequently administered in the intensive care unit setting for patients with hypotension that is refractory to simple fluid resuscitation. It is a vasopressor, as its mechanism of action is to serve as an alpha-1 adrenergic agonist.
The other choices are incorrect, as they represent the primary mechanisms of action of a handful of medications other than phenylephrine.
An example of an alpha-2 adrenergic agonist would be methyldopa.
An example of a beta-1 adrenergic agonist would be dobutamine.
An example of a beta-2 adrenergic agonist would be albuterol.
An example of a beta-1 adrenergic antagonist would be atenolol.
You are the nurse taking care of a patient with asthma. The patient reports using his albuterol inhaler about once a month for wheezing and shortness of breath. Albuterol functions by which of the following mechanisms of action?
You are the nurse taking care of a patient with asthma. The patient reports using his albuterol inhaler about once a month for wheezing and shortness of breath. Albuterol functions by which of the following mechanisms of action?
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The correct answer is "Beta-2 adrenergic receptor agonist."
This question tests your knowledge of the mechanism of action of albuterol, a short-acting medication, frequently used in the treatment of acute asthma flares. Albuterol is an agonist of the Beta-2 adrenergic receptor in the bronchial smooth muscle, which helps to dilate the bronchioles, often providing relief to patients who are suffering from asthma flares, as bronchospasm plays a large role in causing their symptoms. Additional effects of albuterol include increased heart rate, increased insulin release, and vasodilation among others.
An example of a beta-1 adrenergic agonist would be dobutamine.
An example of a beta-1 adrenergic antagonist would be atenolol.
An example of a beta-2 adrenergic antagonist would be butoxamine.
An example of an alpha-1 adrenergic agonist would be phenylephrine.
The correct answer is "Beta-2 adrenergic receptor agonist."
This question tests your knowledge of the mechanism of action of albuterol, a short-acting medication, frequently used in the treatment of acute asthma flares. Albuterol is an agonist of the Beta-2 adrenergic receptor in the bronchial smooth muscle, which helps to dilate the bronchioles, often providing relief to patients who are suffering from asthma flares, as bronchospasm plays a large role in causing their symptoms. Additional effects of albuterol include increased heart rate, increased insulin release, and vasodilation among others.
An example of a beta-1 adrenergic agonist would be dobutamine.
An example of a beta-1 adrenergic antagonist would be atenolol.
An example of a beta-2 adrenergic antagonist would be butoxamine.
An example of an alpha-1 adrenergic agonist would be phenylephrine.
You are a nurse at a gastroenterology practice and your patient is being started on ranitidine for gastroesophageal reflux disease (GERD). Which of the following describes the mechanism of action of ranitidine?
You are a nurse at a gastroenterology practice and your patient is being started on ranitidine for gastroesophageal reflux disease (GERD). Which of the following describes the mechanism of action of ranitidine?
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The correct answer is "Histamine-2 receptor antagonist."
This question tests your knowledge of the mechanism of action of the commonly prescribed antacid medication, ranitidine. Ranitidine functions by antagonizing the histamine-2 receptors within the parietal cells (acid-producing cells) of the stomach. This helps to reduce acid production, which can provide symptomatic relief to patients who suffer from epigastric burning, discomfort, and pain due to gastroesophageal reflux disease and peptic ulcer disease, among other conditions.
An example of a histamine-1 receptor antagonist would be diphenhydramine.
An example of a beta-2 adrenergic receptor agonist would be albuterol.
An example of a proton pump inhibitor would be omeprazole.
An example of a direct acid neutralizer would be calcium carbonate.
The correct answer is "Histamine-2 receptor antagonist."
This question tests your knowledge of the mechanism of action of the commonly prescribed antacid medication, ranitidine. Ranitidine functions by antagonizing the histamine-2 receptors within the parietal cells (acid-producing cells) of the stomach. This helps to reduce acid production, which can provide symptomatic relief to patients who suffer from epigastric burning, discomfort, and pain due to gastroesophageal reflux disease and peptic ulcer disease, among other conditions.
An example of a histamine-1 receptor antagonist would be diphenhydramine.
An example of a beta-2 adrenergic receptor agonist would be albuterol.
An example of a proton pump inhibitor would be omeprazole.
An example of a direct acid neutralizer would be calcium carbonate.
Which of the following is considered a schedule II drug?
Which of the following is considered a schedule II drug?
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Schedule II drugs are monitored drugs that have an accepted medical use and are highly addictive (both physically and psychologically). Schedule II drugs include oxycodone/acetaminophen, fentanyl, and hydromorphone.
Schedule II drugs are monitored drugs that have an accepted medical use and are highly addictive (both physically and psychologically). Schedule II drugs include oxycodone/acetaminophen, fentanyl, and hydromorphone.
The nurse is preparing to administer 250,000 units of medication to a patient. The ampule sent from the pharmacy contains 500,000 units/mL. How many mL should the nurse administer?
The nurse is preparing to administer 250,000 units of medication to a patient. The ampule sent from the pharmacy contains 500,000 units/mL. How many mL should the nurse administer?
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The medication dose formula is as follows: Milliliters to be administered = (Dose to be administered)/(Available solution). Thus, the calculation for this problem is (250,000 units)/(500,000 units/mL) = 0.5 mL
The medication dose formula is as follows: Milliliters to be administered = (Dose to be administered)/(Available solution). Thus, the calculation for this problem is (250,000 units)/(500,000 units/mL) = 0.5 mL
Hayden is a 9-year-old boy who has been admitted to the emergency room with a fever. He weighs 71lbs. If the dosing guideline for acetaminophen is 
at 4 hour intervals, how many milligrams of acetaminophen should the nurse administer?
Hayden is a 9-year-old boy who has been admitted to the emergency room with a fever. He weighs 71lbs. If the dosing guideline for acetaminophen is
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First convert Hayden's weight from pounds to kilograms. This is done by dividing Hayden's weight by 2.2 because 1 pound is 2.2 kilograms.
Next set up the equation as follows:
Solve for 
:
First convert Hayden's weight from pounds to kilograms. This is done by dividing Hayden's weight by 2.2 because 1 pound is 2.2 kilograms.
Next set up the equation as follows:
Solve for
Evelynn is a 3-year-old girl who has been bitten by her family's dog. She has had an incision and drainage (I&D) of her left hand to prevent infection and she has been prescribed cefazolin. The guidelines for cefazolin are 
. Evelynn weighs 42 lbs. How many milligrams of cefazolin should the nurse administer daily?
Evelynn is a 3-year-old girl who has been bitten by her family's dog. She has had an incision and drainage (I&D) of her left hand to prevent infection and she has been prescribed cefazolin. The guidelines for cefazolin are
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First convert Evelynn's weight from pounds to kilograms. This is done by dividing Evelynn's weight by 2.2 because 1 pound is 2.2 kilograms.
Set up the equation as follows:
Solve for 
First convert Evelynn's weight from pounds to kilograms. This is done by dividing Evelynn's weight by 2.2 because 1 pound is 2.2 kilograms.
Set up the equation as follows:
Solve for
An 11-month-old child weighing 8.6kg enters the emergency room with symptoms of a severe respiratory infection. Her physician suspects bacterial origin and prescribes Ampicillin. The guidelines state that Ampicillin is to be administered as 
in a dose q6 hours. Ampicillin comes in 250mg IV solutions of 50 milliliters. How many milliliters should the nurse administer for each dose?
An 11-month-old child weighing 8.6kg enters the emergency room with symptoms of a severe respiratory infection. Her physician suspects bacterial origin and prescribes Ampicillin. The guidelines state that Ampicillin is to be administered as
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The child's weight is already in kilograms. There is no need to change the unit of weight.
Set up the equation as follows
Solve for 
:
By solving for 
, we have determined that the child is to receive 
.
Next, divide the dose by 4 because the dose is to be given every 6 hours.
By calculating this number, we have determined that the child should receive a dose of 107.5mg every six hours. If Ampicillin comes packaged with 250mg in 50mL, we can set up an equation to determine how many milliliters we need to reach 107.5mg.
Solve for 
:
The child's weight is already in kilograms. There is no need to change the unit of weight.
Set up the equation as follows
Solve for
By solving for
Next, divide the dose by 4 because the dose is to be given every 6 hours.
By calculating this number, we have determined that the child should receive a dose of 107.5mg every six hours. If Ampicillin comes packaged with 250mg in 50mL, we can set up an equation to determine how many milliliters we need to reach 107.5mg.
Solve for
An infant on his 14th day of life enters the emergency room. He are tachycardic, has poor skin turgor, and is crying without the formation of tears. The nurse knows that this child is showing symptoms of dehydration. The doctor orders fluid replacement of 544ml over 5 hours. What is the drip rate of the infusion?
An infant on his 14th day of life enters the emergency room. He are tachycardic, has poor skin turgor, and is crying without the formation of tears. The nurse knows that this child is showing symptoms of dehydration. The doctor orders fluid replacement of 544ml over 5 hours. What is the drip rate of the infusion?
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Use the following formula to calculate drip rate:
Use the following formula to calculate drip rate:
The nurse must administer 1 liter of sodium chloride solution over 8 hours. What is the appropriate rate in milliliters per hour that the nurse must set on the IV pump?
The nurse must administer 1 liter of sodium chloride solution over 8 hours. What is the appropriate rate in milliliters per hour that the nurse must set on the IV pump?
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In order to calculate the proper rate in milliliters per hour 
, we must first convert 
to 
, which is 
. Then, we divide this volume in milliliters by 8 hours to get 
. This can be shown mathematically using dimensional analysis:
In order to calculate the proper rate in milliliters per hour