Download NURS 3003 Ati Pharm 1 answer and more Exams Nursing in PDF only on Docsity!
- A nurse is caring for a client who has heart failure and a prescription for digoxin 125 mcg PO daily. Available is digoxin PO 0.25 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
0.5 tablet(s)
Correct Rationale: Ratio and ProportionSTEP 1: What is the unit of measurement the nuse should calculate? tablet
STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 125 mcg
STEP 3: What is the dose available? Dose available = Have 0.25
STEP 4: Should the nurse convert the units of measurement? Yes (mcg does not equal mg)
1 mg/1000 mcg = x mg/125 mcgX = 0.125 mgSTEP 5: What is the quantity of the dose available? 1 tablet
STEP 6: Set up an equation and solve for X.
Have/Quantity = Desired/X
0.25 mg/1 tablet = 0.125 mg/X tablet
X = 0.5
STEP 7: Round if necessary.
STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 0.25 mg/tab and the provider prescribed 0.025 mg, it makes sense to administer 1/2 tab. The nurse should administer digoxin tab PO daily.
Desired Over HaveSTEP 1: What is the unit of measurement the nurse should calculate? Tablet
STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 125 mcg
STEP 3: What is the dose available? Dose available = Have 0.25 mg/tablet
STEP 4: Should the nurse convert the units of measurement? Yes (mcg does not equal mg)
1 mg/1000 mcg = x mg/125 mcgX = 0.125 mgSTEP 5: What is the quantity of the dose available? 1 tablet
STEP 6: Set up an equation and solve for X.
Desired x Quantity/Have =
X
0.125 mg x 1 tablet/0.25 mg = X tab0.5 = X
STEP 7: Round if necessary.
STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 0.25 mg/tab and the provider prescribed 0.125 mg, it makes sense to administer 1/2 tab. The nurse should administer digoxin tab PO daily.
Dimensional AnalysisSTEP 1: What is the unit of measurement the nurse should calculate? Tablet
STEP 2: What is the quantity of the dose available? 1 tablet
STEP 3: What is the dose available? Dose available = Have 0.25 mg
STEP 4: What is the dose the nurse should administer? Dose to administer= Desired 125 mcg
STEP 5: Should the nurse convert the units of measurement? Yes (mcg does not equal mg)
1 mg/1000 mcg = x mg/125 mcgX = 0.125 mgSTEP 6: Set up an equation and solve for X.
X = Quantity/Have x Conversion (Have)/Conversion(Desired) x Desired/
X tablet = 1 tablet/0.25 mg x 0.125 mg/
X
= 0.5
STEP 7: Round if necessary.
STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 0.25 mg/tab and the provider prescribed 0.125 mg, it makes sense to administer 1/2 tab. The nurse should administer digoxin tab PO daily.
InCorrect Rationale: Ratio and ProportionSTEP 1: What is the unit of measurement the nuse should calculate? tablet
STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 125 mcg
STEP 3: What is the dose available? Dose available
= Have 0.25
STEP 4: Should the nurse convert the units of measurement? Yes (mcg does not equal mg)
1 mg/1000 mcg = x mg/125 mcgX = 0. mgSTEP 5: What is the quantity of the dose available? 1 tablet
STEP 6: Set up an equation and solve for X.
Have/Quantity = Desired/X
0.25 mg/1 tablet
= 0.125 mg/X tablet
X = 0.5
STEP 7: Round if necessary.
STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 0. mg/tab and the provider prescribed 0.025 mg, it makes sense to administer 1/2 tab. The nurse should administer digoxin tab PO daily.
Desired Over HaveSTEP 1: What is the unit of measurement the nurse should calculate? Tablet
STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 125 mcg
STEP 3: What is the dose available? Dose available = Have 0.25 mg/tablet
STEP 4: Should the nurse convert the units of measurement? Yes (mcg does not
A. "To prevent dehydration, drink an additional liter of fluid during preparation time."
Rationale:
Dehydration does not occur with PEG. No additional fluid intake is necessary.
B. "Expect bowel movements to begin 3 hr following completion of solution."
Rationale: Bowel movements begin about 1 hr following the first dose.
C. "Abdominal bloating might occur."
Rationale: While PEG is well-tolerated, adverse effects include nausea, bloating, and abdominal discomfort.
D. "Drink 400 mL every hour until bowel movements are clear."
Rationale: The client should ingest the full solution by drinking 250 mL to 300 mL every 10 minutes over 2 to 3 hr.
- A nurse is preparing to administer amoxicillin 30 mg/kg/day divided equally every 12 hr to a toddler who weighs 32 lb (14.5 kg). Available is amoxicillin 200 mg/5 mL suspension. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
5.5 mL
Correct Rationale: Follow these steps for the preliminary conversions:STEP 1: What is the unit of measurement the nurse should calculate? mg
STEP 2: Set up an equation and solve for X.
mg x kg/day = X
30 mg X 14.5 kg/day = 435 mg
STEP 3: Round if necessary.
STEP 4: Reassess to determine whether the amount makes sense. If the prescription reads 30 mg/kg/day to divide equally every 12 hr and the toddler weighs 14.5 kg, it makes sense to give 435 mg/day or 218 mg every 12 hr.
Ratio and Proportion
STEP 1: What is the unit of measurement the nurse should calculate? mL
STEP 2: What is the dose the nurse should administer? Dose to administer = Desired 218 mg
STEP 3: What is the dose available? Dose available = Have 200 mg
STEP 4: Should the nurse convert the units of measurement? No
STEP 5: What is the quantity of the dose available? 5 mL
STEP 6: Set up an equation and solve for X.
Have/Quantity = Desired/X
200 mg/5 mL = 218 mg/X mL
X = 5.45 mL
STEP 7: Round if necessary.
5.45 = 5.5 mL
STEP 8: Reassess to determine whether the amount to give makes sense. If there is 200 mg/5 mL and the prescription reads 218 mg, it makes sense to give
5.5 mL. The nurse should administer amoxicillin oral solution 5.5 mL PO every 12 hr.
Desired Over Have
STEP 1: What is the unit of measurement the nurse should calculate? mL
STEP 2: What is the dose the nurse should administer? Dose to administer = Desired 218 mg
STEP 3: What is the dose available? Dose available = Have 200 mg
STEP 4: Should the nurse convert the units of measurement? No
STEP 5: What is the quantity of the dose available? 5 mL
STEP 6: Set up an equation and solve for X.
Desired X Quantity/Have = X
218 mg X 5 mL/ 200 mg = X
5.45 mL = X
STEP 7: Round if necessary.
Conversion (Have)/ Conversion (Desired) X Desired/
X mL = 5 mL/ 200 mg X 218 mg/
X = 5.45
STEP 7: Round if necessary. 5.45 = 5.5 mL
STEP 8: Reassess to determine whether the amount to give makes sense. If there is 200 mg/5 mL and the prescription reads 218 mg, it makes sense to give 5.5 mL. The nurse should administer amoxicillin 5.5 mL PO every 12 hr.
InCorrect Rationale: Follow these steps for the preliminary conversions:STEP 1: What is the unit of measurement the nurse should calculate? mg
STEP 2: Set up an equation and solve for X.
mg x kg/day = X
30 mg X 14.5 kg/day = 435 mg
STEP 3: Round if necessary.
STEP 4: Reassess to determine whether the amount makes sense. If the prescription reads 30 mg/kg/day to divide equally every 12 hr and the toddler weighs 14.5 kg, it makes sense to give 435 mg/day or 218 mg every 12 hr.
Ratio and Proportion
STEP 1: What is the unit of measurement the nurse should calculate? mL
STEP 2: What is the dose the nurse should administer? Dose to administer = Desired 218 mg
STEP 3: What is the dose available? Dose available = Have 200 mg
STEP 4: Should the nurse convert the units of measurement? No
STEP 5: What is the quantity of the dose available? 5 mL
STEP 6: Set up an equation and solve for X.
Have/Quantity = Desired/X
200 mg/5 mL = 218 mg/X mL
X = 5.45 mL
STEP 7: Round if necessary. 5.45 = 5.5 mL
STEP 8: Reassess to determine whether the amount to give makes sense. If there is 200 mg/5 mL and the prescription reads 218 mg, it makes sense to give 5.5 mL. The nurse should administer amoxicillin oral solution 5.5 mL PO every 12 hr.
Desired Over Have
STEP 1: What is the unit of measurement the nurse should calculate? mL
STEP 2: What is the dose the nurse should administer? Dose to administer = Desired 218 mg
STEP 3: What is the dose available? Dose available = Have 200 mg
STEP 4: Should the nurse convert the units of measurement? No
STEP 5: What is the quantity of the dose available? 5 mL
STEP 6: Set up an equation and solve for X.
Desired X Quantity/Have = X
218 mg X 5 mL/ 200 mg = X
5.45 mL = X
STEP 7: Round if necessary. 5.45 = 5.5 mL
STEP 8: Reassess to determine whether the amount to give makes sense. If there is 200 mg/5 mL and the prescription reads 218 mg, it makes sense to give 5.5 mL. The nurse should administer dexamethasone oral solution 5.5 mL PO every 12 hr.
Dimensional Analysis
STEP 1: What is the unit of measurement the nurse should calculate? mL
STEP 2: What Quantity of the dose is available? 5 mL
STEP 3: What is the dose available?
Dose available = Have 200 mg
STEP 4: What is the dose the nurse should administer? Dose to administer = Desired 218 mg
STEP 5: Should the nurse convert the units of measurement? No
STEP 6: Set up an equation and solve for
X.
X = Quantity/ Have X Conversion (Have)/ Conversion (Desired) X Desired/
X mL = 5 mL/ 200 mg X 218 mg/
X = 5.45
STEP 7: Round if necessary.
5.45 = 5.5 mL
STEP 8: Reassess to determine whether the amount to give makes sense. If there is 200 mg/5 mL and the prescription reads 218 mg, it makes sense to give 5.5 mL. The nurse should administer amoxicillin 5.5 mL PO every 12 hr.
- 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?
A. Offer the child a choice of taking the medication with juice or water.
Rationale: 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.
B. Tell the child it is candy.
Rationale:
The client should be told not to break, crush, or chew enteric-coated tablets.
C. "Crushing the medication would release all the medication at once, rather than over time."
Rationale: Crushing the pill will destroy the enteric coating, and the client should be advised against this,
but the enteric coating does not prevent the release of medication. Sustained release preparations disburse the medication over time.
D. "Crushing is unsafe, as it destroys the ingredients in the medication."
Rationale: Many medications can safely be crushed to make them easier to swallow. The client should check with his provider for information about which medications can be safely crushed.
- A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first?
A. Check the client's vital signs.
Rationale: It is possible that the client's nausea is secondary to digoxin toxicity. By obtaining vital signs, the nurse can assess for bradycardia, which is a symptom of digoxin toxicity. The nurse should withhold the medication and call the provider if the client's heart rate is less than 60 bpm.
B. Request a dietitian consult.
Rationale: While the dietitian might be able to assist the client with making appropriate food choices, this is not the first action the nurse should take.
C. Suggest that the client rests before eating the meal.
Rationale: While this intervention might be appropriate, this is not the first action the nurse should take.
D. Request an order for an antiemetic.
Rationale: While this intervention might relieve the client's nausea, this is not the first action the nurse should take.
- A nurse is caring for four clients for whom she has to administer oral medications in the morning. The nurse should administer which of the following medications before breakfast?
A. Alendronate
Rationale: The client must take alendronate first thing in the morning on an empty stomach and wait at least 30 minutes before eating, drinking, or taking other medications.
B. Digoxin
Rationale: Digoxin treats hearts failure and dysrhythmias. While it is important that the client get the morning dose in a timely manner, the nurse does not have to administer it before a meal.
C. Mycostatin mouthwash
Rationale: Any mouthwash or rinse is most effective after a meal.
disorder. The client should take the dose on time, but not necessarily before a meal.
- A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed?
A. Thyroid hormone assay
Rationale: Thyroid testing is important because long-term use of lithium may lead to thyroid dysfunction.
B. Liver function tests
Rationale: LFTs must be monitored before and during valproic acid therapy, not lithium therapy.
C. Erythrocyte sedimentation rate
Rationale: This is not a necessary test related to lithium therapy.
D. Brain natriuretic peptide
Rationale: Brain natriuretic peptide (BNP) is not a necessary test related to lithium therapy. The BNP is used to monitor heart failure.
- A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?
A. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level."
Rationale: The effects of heparin begin within minutes. This response does not accurately answer the client's question.
B. "A pharmacist is the person to answer that question."
Rationale: Contacting the pharmacist is not the appropriate answer for the nurse to give.
C. "Heparin does not dissolve clots. It stops new clots from forming."
Rationale: This statement accurately answers the client's question.
D. "The oral medication you will take after this IV will dissolve the clot."
Rationale: This is not a correct response. Warfarin, a PO medication that is often started after the client has been on heparin, does not dissolve clots.
- A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the client indicates an understanding of the teaching?
- A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?
A. "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic
level."
Rationale: Heparin and warfarin are both anticoagulants that decrease the clotting ability of the blood and help prevent thrombosis formation in the blood vessels. However, these medications work in different ways to achieve therapeutic coagulation and must be given together until therapeutic levels of anticoagulation can be achieved by warfarin alone, which is usually within 1 to 5 days. When the client's PT and INR are within therapeutic range, the heparin can be discontinued.
B. "I will call the provider to get a prescription for discontinuing the IV heparin today."
Rationale: Discontinuing the IV heparin is not indicated at this time.
C. "Both heparin and warfarin work together to dissolve the clots."
Rationale: Neither medication dissolves clots that have already formed.
D. "The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay."
Rationale: Neither medication increases the effects of the other.
- A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide?
A. Check the pulse after medication administration.
Rationale: Beclomethasone, an inhaled glucocorticoid, does not cause cardiac side effects.
B. Take the medication with meals.
Rationale: Oral, not inhaled, glucocorticoids should be administered with food.
C. Rinse the mouth after administration.
Rationale: Use of glucocorticoids by metered dose inhaler can allow a fungal overgrowth in the mouth.
Rinsing the mouth after administration can lessen the likelihood of this complication.
D. Limit caffeine intake.
Rationale: Caffeine does not interact with beclomethasone and is not contraindicated.
- A nurse is caring for a 2-year-old child who has seizures and is receiving phenytoin in suspension form. Which of the following actions should the nurse take before administering each dose?
A. Shake the container vigorously.
Phenytoin is a gastric irritant. It should be given with or immediately after a meal to decrease gastric upset.
C. Perform mouth care.
Rationale: Mouth care is not necessary prior to every dose.
D. Check the child's blood pressure.
Rationale: When giving the oral form of phenytoin, this action is not necessary.
- A nurse caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?
A. Asthma
Rationale: Propranolol, a beta-blocker, is contraindicated in clients who have asthma because it can cause bronchospasms. Propranolol blocks the sympathetic stimulation, which prevents smooth muscle relaxation.
B. Glaucoma
Rationale: Beta-blockers are contraindicated in clients who have cardiogenic shock, but are not contraindicated in a client who has glaucoma.
C. Depression
Rationale: Beta-blockers are contraindicated in clients who have AV heart block, but are not contraindicated in clients who have depression.
D. Migraines
Rationale: Beta-blockers are used for prophylactic treatment of migraine headaches.
- A nurse is teaching a client who has a new prescription for colchicine to treat gout. Which of the following instructions should the nurse include?
A. "Take this medication with food if nausea develops."
Rationale: The client should report manifestations of gastric toxicity such as nausea, vomiting, and diarrhea. The medication is discontinued for these effects.
B. "Monitor for muscle pain."
Rationale: This medication can cause rhabdomyolysis. The client should monitor and report muscle pain.
C. "Expect to have increased bruising."
Rationale: The client should report manifestations of thrombocytopenia such as bruising and bleeding, which are adverse effects of this medication.
