NCLEX with Greg

Rationale 50/100 x 5ml = 0.5 x 5 -= 2.5 ml.

For the question above, please select the correct answer

The nurse has just received a new patient from the ED, admitted with chronic alcohol abuse. The orders read 50 mg of Thiamine in 1 liter of Dextrose 5% 1/3 Normal Saline. The label on the Thiamine vial reads 100 mg/5 mL. How many milliliters of Thiamine would you withdraw from the vial as an additive to the above IV? 1) 2.5 ml 2) 1.75 ml 3) 2.75 ml 4) 2.0 ml

A client with crackles in the lungs is exhibiting signs of pulmonary fluid. Redness at the insertion site indicates infection, which can lead to peritonitis if untreated. The sign listed here, which is indicative of peritonitis, is cloudy dialysate drainage. When the dialysate is drained from the peritoneal cavity, it should not be cloudy. A significant peritoneal cavity infection may lead to scar tissue formation, eliminating the client’s ability to continue peritoneal dialysis. Prevention of infection is the highest priority when caring for this client.

A nurse is assessing a client who has been performing continuous ambulatory peritoneal dialysis for the last several weeks at home. Which of the signs and symptoms are indicative of the potential complication of peritonitis?

Starting a question with “why” can give the impression of an accusation. B and C give false reassurance. Instead, therapeutic communication techniques require the nurse to seek out information about the client’s feelings. Answer A is the most therapeutic, and it is an open-ended statement that encourages the client to elaborate.

A 42-year-old client tells you that he is sure that he will die during his surgery tomorrow because his dad died at the age of 39. What would be an appropriate response by the nurse?

When a nurse has been stuck by a used needle and has not completed the hepatitis B vaccination, he or she should receive both active and passive immunization. For postexposure prophylaxis, the hepatitis B virus vaccine and hepatitis B immune globulin (HBIG) are used. HBIG contains antibodies and confers temporary passive immunity.

The nurse who is stuck by a used needle but has not completed the hepatitis B immunization should receive:

Loss of electrolytes from the gastrointestinal tract through vomiting, diarrhea, or nasogastric suction is a common cause of potassium loss, resulting in hypokalemia. Hypermagnesemia does not result from excessive loss of gastrointestinal fluids. Common causes of hypernatremia are water loss (as in diabetes insipidus or osmotic diuresis) and excessive sodium intake. Common causes of hypocalcemia include chronic renal failure, elevated phosphorus concentration, and primary hypoparathyroidism.

Client who has been vomiting for 2 days has a nasogastric tube inserted. Nurse notes that over the past 10 hrs the tube drained 2 L of fluid. The nurse should plan to implement treatment that will prevent which of the following electrolyte imbalances?

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The first action is to increase the oxygen flow rate from 2 to 4 L/minute to help ensure adequate oxygenation for the client. Although it is important to notify the physician for additional orders and to obtain further assessment data, such as arterial blood gas measurements, it is a priority to support the client's cardiopulmonary system. It would be appropriate to reassure the client while these other interventions are occurring. (R)

For the question above, please select the correct answer

A client is admitted to the hospital with a diagnosis of suspected pulmonary embolism. Physician orders include the following: oxygen 2 to 4 L/minute per nasal cannula, oximetry at all times, and IV administration of 5% dextrose in water at 100 ml/hour. The client complains of increasing dyspnea and has a respiratory rate of 32 breaths/minute. What is the nurse's first response to this situation? 1) Increase the oxygen flow rate from 2 to 4 L/minute. 2) Call the physician immediately. 3) Provide reassurance to the client. 4) Obtain a sample for arterial blood gas analysis.

Salmeterol (Serevent) is a beta Agonist, a maintenance drug that the asthmatic client uses twice daily, every 12 hours. Albuterol (Proventil) is used as the "rescue inhaler" for bronchospasms. Serevent can be used to prevent exercise induced bronchospasms, but it should be taken 30 to 60 minutes before exercise. If the client is taking Serevent twice daily, it should not be used in additional doses before exercise; twice daily is the maximum dosage. Indications for Serevent include only asthma and bronchospasm induced by chronic obstructive pulmonary disease.

A client with asthma asks the nurse if she should use her salmeterol (Serevent) inhaler when she exercises and experiences wheezing and shortness of breath. The nurse's best response is which of the following?

By federal law, all clients entering a hospital or hospice program are offered the chance to make an advance directive, so that their wishes will be known and followed in an emergency. The directive is not a substitute for informed discussion with the physician. Worry about extraordinary means being taken can be discussed with the client later, but the client needs to be informed that the directive is a federal requirement to protect the client's autonomy.

A client asks the nurse why he was asked to complete an advance directive upon entering the hospital. The nurse's best response is which of the following?

ARDS frequently develops after a major insult to the body. The major diagnostic indicator is low arterial oxygen levels that are not responsive to the administration of high concentrations of oxygen. Early recognition of ARDS is important to increase the client's chances of recovery. The oxygen levels of clients with hospital-acquired pneumonia, hypovolemic shock, or asthma would be expected to improve with oxygen administration.