HESI Dosage Calculations Practice Exam, Hesi Pharmacology Review Already Passe

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HESI Dosage Calculations Practice Exam, Hesi Pharmacology Review Already Passed A client with cardiogenic shock weighs 220 lb and is receiving dopamine at the rate of 3 mcg/kg/minute. The solution... strength available is dopamine 400 mg in 250 ml of D5W. The nurse should set the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Correct Answer-11.3 First, convert pounds to kg, 220 lb : X = 2.2 lb : 1 kg = 100 kg. Next, calculate the dosage per minute, 3 mcg/kg/min x 100 kg = 300 mcg/min. Convert mcg/min to mcg/hour, 300 mcg/min x 60 min=18,000 mcg/hour. Convert mcg/hr to mg/hour, 18,000 mcg/hr = 18.0 mg/hour. Calculate the rate, 400 mg : 250 ml = 18 mg : X ml 400X = 4500 X = 11.25 = 11.3 ml. So, 18 mg/11.3 ml should be infused at 11.3 ml/hour. A client with hypertension who weighs 72.4 kg is receiving an infusion of nitroprusside (Nipride) 50 mg in D5W 250 ml at 75 ml/hour. How many mcg/kg/minute is the client receiving? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Correct Answer-3.5 Calculate the mg/hour infusing, 50 mg : 250 ml = X : 75 ml 250X = 3750 and X = 15 mg/hour. Next, convert mg/hr to mcg/hour, 15 mg/hour = 1 mg / 1000 mcg = 15,000 mcg/hour, then divide by 60 min = 250 mcg/minute. Lastly, 250 mcg/72.4 kg/min = 3.45 = 3.5 mcg/kg/minute.A client who weighs 70 kg is receiving a dopamine solution of 800 mg/500 ml normal saline at 5 ml/hour. How many mcg/kg/minute is the client receiving? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Correct Answer-1.9 To change ml/hour to mcg/kg/minute, use the formula: desired rate (5 ml/hour) / volume available (500 ml) x dose available (800 mg) = 8 mg/hour. Next, convert milligrams/hour to mcg/kg/minute: mg (8) x 1000 / kg (70) / 60 minutes = 1.904 = 1.9 mcg/kg/minute. A client is receiving an IV solution of sodium chloride 0.9% (Normal Saline) 250 ml with amiodarone (Cordarone) 1 gram at 17 ml/hour. How many mg/minute of amiodarone is infusing? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Correct Answer-Convert grams to mg, 1 gram equals 1,000 mg. Using ratio and proportion - 1,000 mg : 250 ml :: X mg : 1ml 250X= 1,000 so X = 4 mg/ml is the solution concentration of amiodarone. The infusion rate (ml/hour) x concentration (mg/ml) divided by 60 minutes/hour 17 ml/hour x 4 mg/ml = 68/60 = 1.13 = 1.1 mg/minute. A client who weighs 176 pounds is receiving an IV infusion with esmolol hydrochloride (Brevibloc) at 48 ml/hour. The IV solution is labeled with the concentration of Brevibloc 10 mg/ml. How many mcg/kg/minute is the client receiving? (Enter numeric value only.) Correct Answer-100 Convert pounds to kg by dividing 176 pounds by 2.2 pounds = 80 kg. Convert the IV concentration from mg to mcg. 1 mg : 1000 mcg :: 10 mg : 10,000 mcg. Infusion rate (48 ml/hour) x concentration (10,000 mcg/ml) divided by 60 minutes/hour x 80 kg = 48 x 10,000 divided by 60 x 80 = 480,000 / 4800 = 100 mcg/kg/minute.The nurse is preparing the change-of-shift report for a client who has a 265 ml secondary infusion that was started 2 hours ago at a rate of 85 ml/hour via an infusion pump. The nurse should report that how many ml remain to be infused by the on-coming nurse? (Enter numeric value only.) Correct Answer-95 85 ml x 2 hours = 170 ml has infused. 265 ml (total amount to be infused) - 170 ml (amount infused) = 95 ml remain to be infused. A male client receives a prescription for ondansetron hydrochloride (Zofran) 4 mg IV to prevent postoperative nausea after an inguinal hernia repair. The medication is available in 2 mg/ml. How many ml should the nurse administer? (Enter numeric value only.) Correct Answer-2 Use ratio and proportion, 4 mg : X ml = 2 mg : 1 ml 2X = 4 X = 2 The nurse is preparing to administer Hepatitis B Vaccine, Recombinant (Energix-B) 5 mcg IM to a schoolaged child. The vaccine is labeled, 10 mcg/ml. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth). Correct Answer-1 or 0.5 Use ratio and proportion, 5 mcg : X ml :: 10 mcg : 1ml 10X = 5 X = 0.5 ml A client's daily PO prescription for aripiprazole (Abilify) is increased from 15 mg to 30 mg. The medication is available in 15 mg tablets, and the client already received one tablet today. How manyadditional tablets should the nurse administer so the client receives the total newly prescribed dose for the day? (Enter numeric value only.) Correct Answer-1 30 mg (total dose) - 15 mg (dose already administered) = 15 mg that still needs to be administered. Using the Desired/Have formula: 15 mg/15 mg = 1 tablet At the end of the shift, the nurse is recording the fluid balance for a client receiving a continuous gastrostomy tube (GT) feeding. Based on the client's records, how many ml should the nurse record for the total fluid balance (intake - output) for the shift that started at 0700 and ended at 1900? (Enter numeric value only.) (Click on each image asset for additional information.) Correct Answer-695 The tube feeding is administered at 75 ml/hour for 11 hours (0700 - 1800) and then turned off for one hour because the residual is greater than 200 ml. 11 hours x 75 ml/hr = 825 ml. Three doses of 20 ml of medication are administered, with 10 ml of water used to flush the GT before and after each dose. 20 ml x 3 doses = 60 ml; 10 ml (flush) x 2 x 3 doses = 60 ml; so 825 ml + 60 ml + 60 ml = 945 ml. 250 ml of residual is removed and not replaced. 945 ml - 250 ml = 695 ml total fluid balance (Intake - output). The nurse is administering a 250 milliliter (ml) intravenous solution to be infused over 2 hours. How many ml/hour should the nurse program the infusion pump? (Enter numeric value only.) Correct Answer-125 250 ml : 2 hours = X ml : 1 hour 250 = 2X X = 250 divided by 2 = 125 ml/hrThe nurse is preparing to administer 0.25 mg of bumetanide (Bumex) IV. The medication is available in a vial labeled 1 mg/4 ml. How many ml of medication should the nurse administer? (Enter numeric value only.) Correct Answer-1 Using the Desired/Have x Volume formula: Desired = 0.25 mg Have = 1 mg Volume = 4 ml 0.25 mg/1 mg x 4 ml = 1 ml A client with hypertension receives a prescription for carteolol (Cartel) 7.5 mg PO daily. The drug is available in 2.5 mg tablets. How many tablets should the nurse administer? (Enter numeric value only.) Correct Answer-3 Using D/H: 7.5 mg / 2.5 mg = 3 tablets The healthcare provider prescribes trimethoprim-sulfamethoxazole (Bactrim-DS Oral Suspension) 120 mg BID for a child with bronchitis. The Bactrim bottle is labeled 200 mg/5ml. How many ml should the nurse administer at each dose? (Enter numeric value only.) Correct Answer-3 Using the formula D/H x Q, 120/200 x 5 = 3 ml A 180-pound adult male is admitted to the Emergency Center after receiving thermal burns to 60 percent of his body. Using the Parkland formula of 4 ml/kg/24 hours, the client should receive how many ml of fluid during the first 24 hours? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Correct Answer-19632Using the Parkland formula, the client's fluid requirements for the first 24 hours after injury: 4 ml lactated Ringer's solution x Body weight (in kilograms) x Percent burn. Convert 180 pounds to kg = 180 / 2.2 = 81.8 kg 4 ml x 81.8 kg x 60 = 19632 ml over the first 24 hours. The healthcare provider prescribes acetazolamide (Diamox) 600 mg/m2/day divided into 3 doses. The nurse calculates the child's body surface area (BSA) as 0.7 m2. How many mg should the child receive per dose? (Enter numeric value only.) Correct Answer-140 Using the child's BSA, 0.7 m2, calculate the mg/dose, 600 mg x 0.7 m2 = 420 mg/day/3 doses = 140 mg/dose A loading dose of acetylcysteine (Mucomyst) 8 grams, which is available as a 20% solution (200 mg acetylcysteine per ml) is prescribed by nasogastric tube for a client with acetaminophen toxicity. How many ml of diluent should be added to the medication to obtain a 1:4 concentration? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Correct Answer-120 8 grams = 8,000 mg prescribed dose. Using the formula, D/H x Q, 8,000 mg / 200 mg x 1 ml = 40 ml of the 20% solution. Dilute the 40 ml to a 1:4 concentration for administration using ratio and proportion, 1 : 4 solution :: 40 ml : X X= 160 ml total volume to administer. Subtract total volume of 160 ml - 40 ml of 20% concentration = 120 ml diluent is added to obtain a 1:4 concentration. A child who weighs 55 pounds receives a prescription for atovaquone with proguanil (Malarone Pediatric) 125 mg/50 mg PO daily. A drug reference states that children 11 to 20 kg should receive 1pediatric tablet daily; 21 to 30 kg should receive 2 pediatric tablets daily; 31 to 40 kg should receive 3 pediatric tablets daily; and greater than 40 kg should receive 1 adult tablet daily with food. The drug is available as atovaquone 62.5 mg/proguanil 25 mg pediatric tablets. How many tablets should the nurse administer? Correct Answer-2 Calculate each drug component dose, using the formula, D/H 125 mg / 62.5 mg (atovaquone) = 2 combined with 50 mg / 25 mg (proguanil) = 2. The child should receive 2 tablets. A client receives a prescription for azithromycin (Zithromax) 500 mg PO x 3 days. Azithromycin is available as 250 mg scored tablets. How many tablets should the nurse administer per dose? (Enter numeric value only. Correct Answer-2 Using the formula, D/H 500 mg/250 mg = 2 tablets A child who is scheduled for a kidney transplant receives a prescription for basiliximab (Simulect) 20 mg IV 2 hours prior to surgery. The medication is available in a 20 mg vial that is reconstituted by adding 5 ml sterile water for injection, and administered in a 50 ml bag of normal saline over 30 minutes. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. Correct Answer-110 After reconstituting the medication vial, the nurse adds the 5 ml of medication to the 50 ml of sterile water to result in a 55 ml volume to infuse in 30 minutes. Using the formula, Volume/Time = 55 ml / 0.5 hours = 110 ml/hourA client with a gastrostomy tube (GT) receives a prescription for Osmolite® 1/2 strength enteral formula at 80 ml/hour. To prepare a 4 hour solution, the nurse should dilute the full-strength formula with how many ml of water? (Enter numeric value only.) Correct Answer-160 Determine the total volume needed at 80 ml/hour x 4 hours = 320 ml. Use the formula, Desired strength/strength on Hand x Volume = 50/100 x 320 = 160 ml of Osmolite® enteral formula, which must be diluted to half strength. Or use ratio and proportion, Desired strength (1/2 = 1 part : 2 parts) :: Volume of full strength : Total Desire volume 1 : 2 :: X : 320 ml 2X = 320, and X = 160 ml of Osmolite® enteral formula, full strength 320 ml total volume - 160 ml of full-strength formula = 160 ml of water to create 1/2 strength or 50% concentration. The nurse notes that a client is receiving an oxytocin (Pitocin) infusion via a pump that is programmed to deliver 30 ml/hour. The available solution is Ringer's Lactated 1,000 ml with Pitocin 20 units. How many milliunits/minute is the client receiving? (Enter numeric value only.) Correct Answer-10 Convert units to milliunits, 20 x 1,000 = 20,000 units. Using D/H x Q = 30 ml/hour X/20,000 units x 1,000 ml = 30 ml/hour (60 minutes) X/20 =30/60, reduce X/2 = 1/2, and 2X = 20, so X = 10 milliunits/minute OR 20/1,000 = 0.02 1000 : 0.02 :: 30 : X = 0.6 :: 1,000X X = 600 and 600/60 = 10 milliunits/minute. A client is receiving Heparin Sodium 25,000 Units in 5% Dextrose Injection 500 ml IV at 1,000 unit/hour per protocol for acute coronary syndrome (ACS). The client's partial thromboplastin time (PTT) is 76 seconds. Based on the ACS protocol, the infusion should be decreased by 100 units/hour for a PTT between 71 to 80 seconds. The nurse should program the pump to deliver how many ml/hour? (Enter numeric value only.) Correct Answer-18Adjust the infusion to 900 units/hour (1,000 units/hour minus 100 units/hour per protocol). Using the formula, D/H x Q, 900 units/1 hour divided by 25,000 units x 500 ml = 90/5= 18 ml/hour. The healthcare provider prescribes oxytocin (Pitocin) 0.5 milliunits/minute for a client in labor. One liter Ringer's Lactate with 10 units of oxytocin (Pitocin) is infusing. The nurse should program the infusion pump at how many ml/hour? (Enter numeric value only.) Correct Answer-3 Using the formula, D/H x Q, 0.5 milliunits / 10,000 milliunits x 1000 ml = 0.05 ml/minute. Multiply by 60 minutes = 3 ml/hour. Docusate sodium (Colace) 0.3 grams is prescribed for a client who has frequent constipation. Each capsule contains 100 mg. How many capsules should the nurse administer? Correct Answer-3 Using the known equivalent, 1 gram = 1000 mg, the nurse should first convert the dose to the same unit of measurement, which is 0.3 gram = 300 milligram. Using the formula, Desired / Available x 1 capsule = 300/100 x 1 = 3 capsules. A client who has a sinus infection is receiving a prescription for amoxicillin/clavulanate potassium (Augmentin) 500 mg PO q8 hours. The available form is 250 mg amoxicillin/125mg clavulanate tablets. How many tablets should the nurse administer for each dose? (Enter numeric value only.) Correct Answer-2 Using Desired/Available formula: 500 mg/250 mg x 1 tablet = 2The healthcare provider prescribes acetaminophen elixir (Tylenol elixir) 600 mg PO q6 hours for an adult client experiencing pain associated with maxillofacial surgery. The bottle is labeled 500 mg/15 ml. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Correct Answer-18 Using the formula D/H x Q: 600 mg/500mg x 15 ml = 18 ml A client who has AIDS is receiving octreotide (Sandostatin) 1,200 mcg by subcutaneous injection every day for symptoms of diarrhea. Octreotide is available for injection in 1 mg/ml vials. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Correct Answer-1 or 1.2 First, to convert micrograms to milligrams, divide the number of micrograms by 1000: 1,200/1000 = 1.2 mg. Using the Desired/Have available formula: 1.2 mg/1 mg x 1 ml = 1.2 ml. A client is receiving dantrolene sodium (Dantrium) PO for malignant hyperthermia. The maximum safe dose is 8 mg/kg/day in 4 divided doses. The client currently weighs 48.5 kg. What is the maximum safe dose the nurse should administer? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Correct Answer-97 Determine the maximum number of mg this client should receive in a day: 48.5 kg x 8 mg/kg/day = 388 mg/day. Next determine how many mg the nurse should deliver each dose: 388 mg/4 doses = 97 mg.A child with a urinary tract infection is receiving Cephalexin (Keflex) 100 mg suspension PO QID. Keflex oral suspension is labeled 125 mg in 5 ml. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Correct Answer-4 Using the formula Desired/Have available x Quantity: 100/125 x 5 = 500/125 = 4 ml The healthcare provider prescribes a continuous intravenous infusion of dextrose 5% and 0.45% sodium chloride with KCl 20 mEq/1000 ml to be delivered over 8 hours. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Correct Answer-125 Using the formula volume/time: 1000 ml/8 hours = 125 ml/hour A client receives a prescription for an intravenous infusion 0.45% sodium chloride 500 ml to be infused over 6 hours. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Correct Answer-83 Calculate using Volume/Time: 500 ml/6 hours = 83.3 ml/hour A client returns to the nursing unit from surgery with a prescription for Lactated Ringer's solution 1,000 ml to be infused over 10 hours. The IV administration set delivers 60 gtts/ml. The nurse should regulate the infusion to deliver how many gtts/minute? Correct Answer-100First convert hours to minutes: 10 hrs x 60 = 600 minutes. Using the formula Volume/Time x drop factor: 1000 ml /600 minutes = 1.66666 x 60 = 100 gtts minute. An IV infusion of dextrose 5% in normal saline with oxytocin (Pitocin) 20 units in 1,000 ml is prescribed for a client to control postpartum bleeding. The solution is to be administered at a rate of 2 mu/minute. The nurse should program the infusion pump to administer how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Correct Answer-6 First calculate the number of units/hour. 0.002 units/minute x 60 minutes = 0.12 units/hour. Next calculate the number of ml/hour needed to administer 0.12 units/hour. 20 units : 1,000 ml :: 0.12 units : X 20/0.12 :: 1,000/X 20X : 120 X = 6 The healthcare provider prescribes an IV solution of 5% dextrose in water with magnesium sulfate 4 gram/50 ml to be infused over 30 minutes for a client with preeclampsia. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Correct Answer-100 To calculate the rate of infusion for ml/hour: 50 ml: 30 minutes :: X ml : 60 minutes 50 ml / X ml :: 30 min / 60 min 3000 = 30X X = 100 ml/hour A client who has a gastrostomy feeding tube is receiving 3/4 strength Ensure 240 ml every 6 hours. Full strength Ensure is available in a 240 ml can. The nurse should use how many ml of Ensure to prepare the feeding? (Enter numeric value only. If needed, round to the nearest whole number.) Correct Answer-180240 ml Ensure : 1 :: X ml Ensure : 0.75 240/X : 1 / 0.75 X = 240 x 0.75 = 180 ml Ensure + 60 ml water = 240 ml 0.9% normal saline with inamrinone (Inocor) 0.1 grams/100 ml is prescribed for a client with heart failure. The medication is to be delivered at a rate of 400 mcg/minute. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Correct Answer-24 First calculate the number of mcg/hour: 400 mcg x 60 minutes = 24000 mcg/hour. Next calculate the number of ml/hour needed to administer 24,000 mcg/hour: 100,000 mcg: 100ml :: 24,000 mcg : X 100,000/24,000 :: 100/X 100,000X = 2,400,000 X = 24 ml/hour. A client experiencing cardiogenic shock receives a prescription for an IV infusion of 0.9% normal saline with milrinone (Primacor) 10 mg in 100 ml at a rate of 46 mcg/minute. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Correct Answer-28 First calculate the number of mcg/hour: 46 mcg x 60 minutes = 2760 mcg/hour. Next calculate the number of ml/hour needed to administer 2760 mcg/hour: 10,000 mcg : 100 ml :: 2760 mcg : X 10,000 / 2760 :: 100 / X 10,000X = 276000 X = 27.6 (rounded to) 28 ml/hour. A client with septic shock receives a prescription for dextrose 5% in water with dopamine (Intropin) 0.6 grams/250 ml at a rate of 5 mcg/kg/minute. The client's weight is 148 lbs. The nurse should set the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Correct Answer-8First convert the weight into kilograms: 148 pounds/2.2 kg = 67 kg. Next calculate the number of mcg/kg/minute: 5 x 67 x 1 minute = 335 mcg/min. Calculate the number of mcg/hour: 335 x 60 minutes = 20,100 mcg/hour. Now calculate the number of ml/hour needed to administer 20,100 mcg/hour: 600,000 mcg : 250 ml :: 20,100 mcg : X ml 600,000/20100 :: 250/X 600,000X = 5,02500 X = 8.375 (rounded to) 8 ml/hour. A client with type 2 diabetes is receiving metformin (Glucophage) 1 gram PO twice daily. The medication is available in 500 mg tablets. How many tablets should the nurse administer? (Enter numeric value only.) Correct Answer-2 Using the known equivalent, 1 gram = 1000 mg, the nurse should first convert the dose to the same unit of measurement, which is 1 gram = 1000 mg. Using the formula, Desired / Available x 1 tablets: 1000 mg / 500 mg x 1 = 2 tablets A client with Mycobacterium avium complex (MAC) is receiving an infusion of 5 % dextrose in water with amikacin (Amikin) 0.572 grams/100 ml every 12 hours. The nurse prepares the dose of amikacin using a vial labeled, 250 mg/ml. How many ml should the nurse add to the infusion? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Correct Answer-2.3 First convert gram to milligram: 1 gm = 1000mg .572 gram x 1000 = 572 mg. Next use the formula D/H x Q: 572/250 x 1 = 2.288 (rounded to) 2.3 ml.A client with pericardial effusion has phrenic nerve compression resulting in recurrent hiccups. The healthcare provider prescribes metoclopramide (Reglan) liquid 10 mg PO q 6 hours. Reglan is available as 5 mg/5 ml. A measuring device marked in teaspoons is being used. How many teaspoons should the nurse administer? Correct Answer-2 First, using the formula, Desired dose/dose on Hand x Quantity of volume on hand (D/H x Q), 10 mg / 5 mg x 5ml = 10 ml. Next using the known conversion of 5 ml = 1 tsp: 5 ml : 1 tsp :: 10 ml : X 5 / 10 : 1 / X 5X = 10 X = 2 A client is receiving alprazolam (Xanax) 0.75 mg PO BID for anxiety. Alprazolam is available in 0.5 mg scored tablets. How many tablets should the nurse administer? (Enter numeric value only.) Correct Answer-1.5 Using the conversion of 1 gram = 1000 mg: 0.1 gram = 100 mg 100 mg = 1 capsule A client with multiple sclerosis is prescribed Dantrolene (Dantrium) 0.1 grams PO BID for spasticity. Dantrolene is available in 100 mg capsules. How many capsules should the nurse administer? (Enter numeric value only.) Correct Answer-1 Using the conversion of 1 gram = 1000 mg: 0.1 gram = 100 mg 100 mg = 1 capsule A client has a prescription for inamrinone (Inocor) 0.75 mg/kg IV bolus to be delivered over 3 minutes. The client weighs 80 kg. Inamrinone is available for injection 100 mg/20 ml. How many ml of inamrinoneshould the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Correct Answer-12 First calculate the mg/kg dosage needed: 0.75 mg x 80 kg = 60 mg needed. Then calculate Desired / Have x ml 60 mg / 100 mg x 20 ml = 12 ml. A client who had mitral valve replacement surgery receives a prescription for dextrose 5% in water with 0.5 grams of dobutamine in 250 ml for IV infusion at a rate of 5 mcg/kg/minute. The client weighs 75 kg. The nurse should program the infusion pump to deliver how many ml/hr? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Correct Answer-11.3 First calculate the number of mcg/kg/minute: 5 x 75 = 375 mcg/minute. Calculate the number of mcg/hour: 375 x 60 minutes = 22,500 mcg/hour. Next calculate the number of ml/hour needed to administer 22,500 mcg/hour: 500,000 mcg : 250 ml :: 22,500 mcg/ X ml 500,000X = 5,625,000 X = 11.25 (rounded to 11.3 ml/hour). A healthcare provider prescribes a continuous infusion of 0.9% sodium chloride with pancuronium (Pavulon) 25 mg/250 ml at a rate of 0.1 mg/kg/hr for a client with coronary artery bypass grafting. The client weighs 78 kg. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest tenth. Correct Answer-78 First calculate the number of mg the client will receive in 1 hour: 0.1 mg x 78 kg = 7.8 mg/hour. Next calculate the number of ml containing 7.8 mg of medication: 25 mg : 250 ml :: 7.8 mg : X 25 mg/ 7.8 mg :: 250 ml/X 25X = 1950 X = 78 ml/hour.A client scheduled for surgery is to receive an IV infusion of 0.9% sodium chloride with prochlorperazine edisylate (Compazine) 10 mg/50 ml over 30 minutes. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only.) Correct Answer-100 Calculate: 50 ml : 30 minutes :: X ml : 60 minutes 50/X :: 30/60 3000 = 15X X = 100 ml The healthcare provider prescribes an IV infusion of 0.9% sodium chloride with 40 mEq KCl/500 ml to infuse over 3 hours for a client with hypokalemia. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Correct Answer-167 To determine ml/hour: 500 ml : 3 hours :: as X ml : 1 hour 500/X :: 3/1 500 = 3X X = 166.66 (rounds to)= 167 ml/hour. The healthcare provider prescribes a continuous infusion of 5% dextrose in 0.45% sodium chloride at 85 ml/hour. The IV administration set delivers 10 gtt/ml. The nurse should regulate the drop rate to deliver how many gtts/minute? (Enter numeric value only. If rounding is required, round to the nearest whole number.) Correct Answer-14 Volume/Time (minutes) x drop factor (gtt/ml) = 85 ml/ 60 minutes x 10 gtt/ml = 14.16 = 14 gtt/minute1) A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client? Correct Answer-3. calcitonin (Miacalcin) 2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which best food item? 1. Milk 2. Water 3. Apple juice 4. Orange juice Correct Answer-4. Orange juice 3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication? 1. Tinnitus 2. Diarrhea 3. Constipation 4. Decreased respirations Correct Answer-1. Tinnitus 4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied: 1. Immediately before swimming2. 15 minutes before exposure to the sun 3. Immediately before exposure to the sun 4. At least 30 minutes before exposure to the sun Correct Answer-4. At least 30 minutes before exposure to the sun 5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action? 1. Notifying the registered nurse 2. Discontinuing the medication 3. Informing the client that this is normal 4. Applying a thinner film than prescribed to the burn site Correct Answer-3. Informing the client that this is normal 6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which of the following indicates that a systemic effect has occurred? 1.Hyperventilation 2.Elevated blood pressure 3.Local pain at the burn site 4.Local rash at the burn site Correct Answer-1.Hyperventilation 7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed?1. Platelet count 2. Triglyceride level 3. Complete blood count 4. White blood cell count Correct Answer-2. Triglyceride level 8.) A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is taking which medication? 1. Vitamin A 2. Digoxin (Lanoxin) 3. Furosemide (Lasix) 4. Phenytoin (Dilantin) Correct Answer-1. Vitamin A 9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor for the potential for increased systemic absorption of the medication if the medication were being applied to which of the following body areas? 1. Back 2. Axilla 3. Soles of the feet 4. Palms of the hands Correct Answer-2. Axilla10.) The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for: 1. Acne 2. Eczema 3. Hair loss 4. Herpes simplex Correct Answer-1. Acne 11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a partialthickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatments? 1. "The medication is an antibacterial." 2. "The medication will help heal the burn." 3. "The medication will permanently stain my skin." 4. "The medication should be applied directly to the wound." Correct Answer-3. "The medication will permanently stain my skin." 12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. During an inspection of the site, the nurse notes redness and swelling and that the rate of infusion of the medication has slowed. The nurse should take which appropriate action?1. Notify the registered nurse. 2. Administer pain medication to reduce the discomfort. 3. Apply ice and maintain the infusion rate, as prescribed. 4. Elevate the extremity of the IV site, and slow the infusion. Correct Answer-1. Notify the registered nurse. 13.) The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed? 1. Echocardiography 2. Electrocardiography 3. Cervical radiography 4. Pulmonary function studies Correct Answer-4. Pulmonary function studies 14.) The client with acute myelocytic leukemia is being treated with busulfan (Myleran). Which laboratory value would the nurse specifically monitor during treatment with this medication? 1. Clotting time 2. Uric acid level 3. Potassium level 4. Blood glucose level Correct Answer-2. Uric acid level15.) The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse who is assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication? 1. Alopecia 2. Chest pain 3. Pulmonary fibrosis 4. Orthostatic hypotension Correct Answer-4. Orthostatic hypotension 16.) The clinic nurse is reviewing a teaching plan for the client receiving an antineoplastic medication. When implementing the plan, the nurse tells the client: 1. To take aspirin (acetylsalicylic acid) as needed for headache 2. Drink beverages containing alcohol in moderate amounts each evening 3. Consult with health care providers (HCPs) before receiving immunizations 4. That it is not necessary to consult HCPs before receiving a flu vaccine at the local health fair Correct Answer-3. Consult with health care providers (HCPs) before receiving immunizations 17.) The client with ovarian cancer is being treated with vincristine (Oncovin). The nurse monitors the client, knowing that which of the following indicates a side effect specific to this medication? 1. Diarrhea 2. Hair loss 3. Chest pain4. Numbness and tingling in the fingers and toes Correct Answer-4. Numbness and tingling in the fingers and toes 18.) The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client's history? 1. Pancreatitis 2. Diabetes mellitus 3. Myocardial infarction 4. Chronic obstructive pulmonary disease Correct Answer-1. Pancreatitis 19.) Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse understands that the primary action of this medication is to: 1. Increase DNA and RNA synthesis. 2. Promote the biosynthesis of nucleic acids. 3. Increase estrogen concentration and estrogen response. 4. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors. Correct Answer-4. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors. 20.) The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?1. Glucose level 2. Calcium level 3. Potassium level 4. Prothrombin time Correct Answer-2. Calcium level 21.) A nurse is assisting with caring for a client with cancer who is receiving cisplatin. Select the adverse effects that the nurse monitors for that are associated with this medication. Select all that apply. 1. Tinnitus 2. Ototoxicity 3. Hyperkalemia 4. Hypercalcemia 5. Nephrotoxicity 6. Hypomagnesemia 1. Tinnitus 2. Ototoxicity 5. Nephrotoxicity 6. Hypomagnesemia Correct Answer-1. Tinnitus 2. Ototoxicity 5. Nephrotoxicity 6. Hypomagnesemia22.) A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to: 1. Treat thyroid storm. 2. Prevent cardiac irritability. 3. Treat hypocalcemic tetany. 4. Stimulate the release of parathyroid hormone. Correct Answer-3. Treat hypocalcemic tetany. 23.) A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge? 1. Keep insulin vials refrigerated at all times. 2. Rotate the insulin injection sites systematically. 3. Increase the amount of insulin before unusual exercise. 4. Monitor the urine acetone level to determine the insulin dosage. Correct Answer-2. Rotate the insulin injection sites systematically. 24.) A nurse is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the same syringe. Which of the following actions, if performed by the client, indicates the need for further teaching? 1. Withdraws the NPH insulin first 2. Withdraws the regular insulin first 3. Injects air into NPH insulin vial first4. Injects an amount of air equal to the desired dose of insulin into the vial Correct Answer-1. Withdraws the NPH insulin first 25.) A home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse tells the client to: 1. Freeze the insulin. 2. Refrigerate the insulin. 3. Store the insulin in a dark, dry place. 4. Keep the insulin at room temperature. 2 Correct Answer-2. Refrigerate the insulin. 26.) Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. A nurse reinforces instructions for the client and tells the client to avoid which of the following while taking this medication? 1. Alcohol 2. Organ meats 3. Whole-grain cereals 4. Carbonated beverages1. Correct Answer-1. Alcohol 27.) Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client's medical record and would question the prescription if which of the following is noted in the client's history? 1. Neuralgia2. Insomnia 3. Use of nitroglycerin 4. Use of multivitamins Correct Answer-3. Use of nitroglycerin 28.) The health care provider (HCP) prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. The nurse knows that which of the following is the appropriate intervention? 1. The medication is administered within 60 minutes before the morning and evening meal. 2. The medication is withheld and the HCP is called to question the prescription for the client. 3. The client is monitored for gastrointestinal side effects after administration of the medication. 4. The insulin is withdrawn from the Penlet into an insulin syringe to prepare for administration. Correct Answer-2. The medication is withheld and the HCP is called to question the prescription for the client. 29.) A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions for the client and tells the client that the most likely time for a hypoglycemic reaction to occur is: 1. 2 to 4 hours after administration 2. 4 to 12 hours after administration 3. 16 to 18 hours after administration 4. 18 to 24 hours after administration Correct Answer-2. 4 to 12 hours after administration 30.) A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia? 1. Prednisone 2. Phenelzine (Nardil) 3. Atenolol (Tenormin) 4. Allopurinol (Zyloprim) 1. Correct Answer-1. Prednisone 31.) A community health nurse visits a client at home. Prednisone 10 mg orally daily has been prescribed for the client and the nurse reinforces teaching for the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary? 1. "I can take aspirin or my antihistamine if I need it." 2. "I need to take the medication every day at the same time." 3. "I need to avoid coffee, tea, cola, and chocolate in my diet." 4. "If I gain more than 5 pounds a week, I will call my doctor." Correct Answer-1. "I can take aspirin or my antihistamine if I need it." 32.) Desmopressin acetate (DDAVP) is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response? 1. Decreased urinary output 2. Decreased blood pressure 3. Decreased peripheral edema4. Decreased blood glucose level Correct Answer-1. Decreased urinary output 33.) The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should reinforce which instructions to the client? Select all that apply. 1. Diarrhea can occur secondary to the metformin. 2. The repaglinide is not taken if a meal is skipped. 3. The repaglinide is taken 30 minutes before eating. 4. Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes. 5. Metformin increases hepatic glucose production to prevent hypoglycemia associated with repaglinide. 6. Muscle pain is an expected side effect of metformin and may be treated with acetaminophen (Tylenol). Correct Answer-1. Diarrhea can occur secondary to the metformin. 2. The repaglinide is not taken if a meal is skipped. 3. The repaglinide is taken 30 minutes before eating. 4. Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes. 34.) A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). The nurse assisting in caring for the client should take which action to monitor the effectiveness of treatment? 1. Monitoring the leukocyte count for 2 days after the infusion 2. Checking the frequency and consistency of bowel movements3. Checking serum liver enzyme levels before and after the infusion 4. Carrying out a Hematest on gastric fluids after the infusion is completed Correct Answer-2. Checking the frequency and consistency of bowel movements 35.) The client has a PRN prescription for loperamide hydrochloride (Imodium). The nurse understands that this medication is used for which condition? 1. Constipation 2. Abdominal pain 3. An ep [Show More]

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