Pharmacological and Parenteral Therapies

The 25-week-gestation neonate is ordered to receive ampicillin 100 mg/kg/day intravenously divided into doses every 12 hours immediately after birth. The neonate weighs 745 grams. The pharmacy dispenses ampicillin in a 5 mL vial that contains 125 mg. How many milliliters will the nurse administer with each dose? Round your answer to the nearest tenth decimal.

The 32-week-gestation, 1.9 kg neonate has been prescribed intravenous ampicillin for concerns for sepsis. The dose is 150 mg/kg/d divided into 2 doses administered over 15 minutes. The pharmacy dispenses the medication in a 5 mL vial that contains 250 mg of medication. At what rate will the nurse program the medication to infuse? Round your answer to the nearest tenth decimal.

The nurse is providing education to the patient who is starting warfarin for treatment of a deep vein thrombosis (DVT). Which statements are included in teaching? Select all that apply.

The nurse instructs the patient with diabetes mellitus to store prefilled insulin syringes in which location?

A child with “staring fits” is diagnosed with absence seizures. The nurse prepares patient education materials on which medication?

The nurse receives a call from the patient with type 2 diabetes who has nausea, vomiting, and is eating less. Which statement by the patient indicates that further education is needed?

The patient is undergoing placement of an antibiotic-impregnated central line catheter for vancomycin infusions. Which statements are true about this type of catheter? Select all that apply.

The nurse is assisting the physician with insertion of a central venous catheter into the patient's left internal jugular vein. Into which position does the nurse place the patient? 

The nurse must reconstitute a medication for intravenous administration. Using a syringe, the nurse draws up an appropriate amount of diluent. Which action does the nurse should take next?

The nurse anticipates administering which medication to the patient with osteomyelitis? 

The provider orders an infusion of 10mL/kg/hr for the patient who weighs 154 lbs. The nurse arranges the IV infusion pump to dispense which flow rate?

The nurse is caring for the patient with fever, chills, and a cough productive of green sputum. The chest X-ray shows a hazy opacity. The nurse checks the patient's medical history for sensitivity to which medication? 

The nurse is caring for the patient with intestinal obstruction who is receiving total parenteral nutrition (TPN). The nurse reviews which lab results to ensure the patient is tolerating the infusion? Select all that apply. 

The pediatric patient is hospitalized for fever, nausea, vomiting, and diarrhea. Capillary refill is >2 seconds. The nurse anticipates an order for which intravenous infusion?

The patient with angina and claudication with walking is prescribed isosorbide dinitrate (Isordil). The nurse bases medication teaching on which understanding of the drug's mechanism of action?

The nurse is preparing to insert a peripherally inserted central catheter (PICC) into the right upper extremity. The goal of the procedure is for the tip to terminate in which location?

The 7-year-old child with pica is brought to the emergency room (ER) with decreased level of consciousness after ingesting lead paint. His blood lead level (BLL) is determined to be 72 mcg/dL. The nurse prepares to administer which medication?

The nurse holds the dose of propranolol and contacts the provider for which vital sign?

The nurse is teaching the patient who has been prescribed propranolol. Which statement by the patient indicates an understanding of the teaching?

The nurse is providing medication instructions for iron supplements to a patient with anemia. Which information is included?

Which medication is used to treat epilepsy?

Which medication is a beta blocker?

Which medication is an anxiolytic?

A nurse reviews a patient’s medication list and recognizes an antibiotic. Which medication does the nurse recognize as an antibiotic?

Which medication is a hypoglycemic agent?

Which medication is a member of the biologic pharmacologic class?

The 35-year-old woman is interested in starting hormonal birth control. Which characteristic, if found in the patient's medical record, indicates the patient requires an alternative form of contraceptive?

Which comorbidities increase the risk for refeeding syndrome in the chronically ill patient who is started on total parenteral nutrition (TPN)? Select all that apply.

The patient has come to the emergency department by ambulance for presumed heroin overdose. The nurse expects the patient to have received which medication in the field?

An acutely intoxicated child is brought to the ED because his parents suspect he has consumed antifreeze. The nurse anticipates administering which medication?

The patient with a severe peanut allergy was inadvertently exposed to peanuts at work. Dyspnea persists despite the patient using the epinephrine autoinjector and emergency medical services was contacted. Which concentration of epinephrine does the first responder prepare for intramuscular injection?

Which symptoms, if present in the patient receiving a blood transfusion, indicate the patient is experiencing an acute hemolytic transfusion reaction? Select all that apply.

The female patient’s hypertension is controlled with reduced sodium intake and enalapril and has no other health problems. Abdominal weight gain is noted at the patient’s regular checkup and a human chorionic gonadotropin test is positive. Further testing reveals the patient is 32 weeks pregnant. Which assessment is most important for the safety of the fetus in relation to the enalapril?

The patient has been prescribed enalapril and spironolactone for the treatment of hypertension. The nurse is providing medication education to the patient regarding diet. Which food, if selected by the patient, indicates a need for further teaching?

The nurse prepares the nursing student for the administration of which short-acting cardiovascular drug that can be used to help maintain the patient’s ventricular function after cardiac surgery?

The nurse anticipates administering which medications to the patient with meningitis? Select all that apply.

The nurse is planning care for the patient receiving adalimumab. Which nursing intervention does the nurse utilize to prevent complications of the medication?

The nonverbal patient is improving in the intensive care unit following a motor vehicle accident; as such, the continuous hydromorphone infusion is being weaned according to a schedule. The nurse provides education to the patient’s guardian about which signs and symptoms that the pain medicine is being weaned too quickly? Select all that apply.

The 14-year-old patient was admitted following surgical reduction of an open femur fracture. The patient, who has reported good pain control with the patient-controlled analgesia (PCA) pump, is sleeping peacefully. During hourly rounding, the nurse observes the parent press the button to administer the bolus of pain medication. Which action by the nurse is appropriate?

The patient is receiving alefacept. Which finding indicates the patient is having the desired response to therapy?

The nurse advocates for the use of secukinumab in which patient?

The patient receiving patient-controlled analgesia (PCA) with morphine is found to be sleeping deeply and minimally responsive. Which action does the nurse take first?

The LPN/LVN informs the supervising RN, “I didn’t realize until after administering the medication, but I was supposed to give the patient a half tablet of levothyroxine; I gave him a whole tablet.” Which action does the nurse take first?

The nurse is setting up a patient-controlled analgesia (PCA) for the infusion of hydromorphone. Which drugs does the nurse have readily available? Select all that apply.

The nurse is planning care for the patient who will undergo hip replacement surgery in a month. When is the best time to provide teaching about the use of a patient-controlled analgesia (PCA) pump?

The 3.2 kg patient with persistent pulmonary hypertension of the newborn (PPHN) has the following order: Infuse norepinephrine 0.05 mcg/kg/min IV and titrate q15 minutes by 0.05 mcg/kg/min to maintain mean arterial pressure between 45 and 55 mm Hg. Overnight, the norepinephrine had been titrated to 0.25 mcg/kg/min for persistent hypotension. At 0900, the MAP rose to 62 mm Hg and the nurse decreased the infusion from 0.25 mcg/kg/min to 0.20 mcg/kg/min. At 0905, the patient’s blood pressure fell to 42 mm Hg. Which action does the nurse take first?

The patient has experienced an extravasation of norepinephrine in the right forearm. It is cool to the touch, firm, and pale. Distal to peripheral pulses are not well felt and the fingertips are dusky. Which order does the nurse clarify with the provider?

The nurse assesses the peripheral IV site of the patient who is receiving norepinephrine, which was started for profound, life-threatening hypotension and finds the hand to be firm to the touch, cool, and pale. Which action does the nurse take?

The asymptomatic patient tested positive for Neisseria gonorrhoeae during routine screening for sexually transmitted infections (STI). The nurse anticipates administering which medications? Select all that apply.

The 32-weeks-pregnant woman who presents with genital lesions is diagnosed with herpes simplex virus-2. The nurse prepares a patient information handout for which medication for this patient?