Medication and Blood Products

A 6-day-old neonate in the newborn intensive care unit has been prescribed oxacillin for a suspected central line-associated bloodstream infection. The nurse receives the following order: oxacillin IV 50 mg/kg/day, divided q12h. The neonate weighs 2 lb. 11 oz and the pharmacy dispenses the medication in a concentration of 20 mg/mL. How many milliliters will the nurse administer for each dose? Round your answer to the nearest tenth decimal place.

The client presents to the emergency department following a blow to the abdomen during a baseball game. He is unresponsive with a blood pressure of 82/48 mmHg, heart rate of 118 bpm, a respiratory rate of 18, and an oxygen saturation of 95% on room air. The nurse anticipates taking which action first to treat this patient?

The nurse on the telemetry floor is reviewing EKG readings of the patients. The nurse notes one patient, who is taking digoxin, to have peaked T waves and a prolonged PR interval. The nurse contacts the provider to report concerns for which possible impending condition?

The patient with major depressive disorder has been prescribed a monoamine oxidase inhibitor (MAOI). The nurse has educated the patient on dietary restrictions that are required while taking an MAOI. Which statement by the patient indicates further teaching is required?

The adult patient with type 1 diabetes mellitus and Parkinson’s disease lives alone. Which patient statement would prompt the nurse to advocate for a delay in discharge from the hospital?

The nurse holds the transfusion and contacts the blood bank if which anemic patient is sent B negative packed red blood cells for transfusion?

The patient’s stool sample is positive for Entamoeba histolytica. The nurse plans education about which class of medication for this patient?

Which statement by a patient with type 1 diabetes mellitus indicates understanding of teaching about the recommended diet?

The patient receiving thyroid supplementation for hypothyroidism reports insomnia, fatigue, tachycardia, and headache. Which statement by the nurse is appropriate?

The patient receiving levothyroxine for hypothyroidism reports treatment failure after the third dose increase. The nurse anticipates the provider to order which test for this patient?

The neonate is diagnosed with purpura fulminans. Which order does the nurse anticipate first?

The nurse notes the patient is oozing blood from the IV site and has black, tarry stools. Which order will be most helpful for this patient?

The patient with von Willebrand disease has a fibrinogen level of 68 mg/dL. The nurse anticipates administering which blood product?

The patient with anemia has been prescribed a transfusion of packed red blood cells. The patient’s blood type is AB+ and the blood received from the blood bank is B-. Which action by the nurse is most appropriate?

The patient with increased intracranial pressure has been administered mannitol. Which patient symptom indicates the drug is having its intended effect?

The patient with malignant hypertension has suffered from a transient ischemic attack. He asks the nurse if he can continue taking his St. John’s wort for depression. Which answer by the nurse is most appropriate?

The nurse mistakenly gives the patient with malignant hypertension the wrong dose of antihypertensive medication, and the patient complains of several hours of dizziness. Which action by the nurse is most appropriate?

The nurse receives a telephone order from the healthcare provider for intravenous pain medication to be administered to a patient with cancer pain. Which statement is correct regarding this medication order?

The nurse attempts, but is unable, to contact the provider to clarify a prescription that is much higher than the normal dosage. Which action by the nurse is appropriate?

The nurse is supervising the care of a diabetic patient with stomach cancer. After surgery, the patient is placed on total parenteral nutrition (TPN). Which information does the nurse provide the nursing student about the TPN?

To which patient does the nurse most likely anticipate administering total parenteral nutrition (TPN)?

The nurse is caring for a patient receiving total parenteral nutrition (TPN). The nurse most closely assesses for which complication in this patient? 

The nurse is most vigilant for signs of which complication in a patient receiving total parenteral nutrition (TPN)?

The patient with chronic malnourishment is started on total parenteral nutrition (TPN). The nurse is vigilant for signs of which complication?

The patient has a 20 gauge IV in the left antecubital fossa and is receiving D5W at 150 mL/h. Upon assessment, the nurse notes the site is swollen and cool to the touch; there is no erythema. Which term does the nurse use to document this finding? 

The patient is pale and dizzy following a gunshot wound to the groin. Minimal bleeding is noted at the site. Vital signs are notable for a heart rate of 125 bpm and a blood pressure of 73/39 mm Hg. Two unsuccessful attempts have been made to establish an IV site. He loses consciousness. Which action does the nurse take next?

Which patient does the nurse assess first following shift change report?

The nurse is caring for a 62-year-old female who was recently diagnosed with glaucoma. The patient is given docusate. Which of the following is the primary reason for giving the patient a stool softener?

The 51-year-old male with major depressive disorder is ordered to receive trazodone 25 mg PO at bedtime. The nurse instructs the patient about which primary indication of trazodone for this patient? 

The 50-year-old patient receiving chemotherapy for breast cancer has developed a fungal bloodstream infection. Which intervention is the nurse’s first consideration?

The nurse is caring for a 60-year-old male with congenital spinal stenosis, who is diagnosed acute herniated disc. Which of the following conditions is most likely to occur as a result of the patient’s condition?

The patient with persistent shoulder pain with associated numbness of the hand is scheduled for a magnetic resonance imaging (MRI) scan. The patient tells the nurse, "I'm terrified of enclosed spaces. I just don't know if I'll survive this test." After relaying the patient's concerns to the provider, which response does the nurse expect from the provider? 

The patient with acquired immunodeficiency syndrome (AIDS) is receiving zidovudine (AZT). The nurse requests an order for which lab test to monitor adverse effects of the drug?

The nurse notes the patient being treated for chemical burns is hyperventilating. The nurse suspects which medication is the culprit of the patient's symptoms?

The nurse is supervising the student nurse passing medications on the medical surgical floor. The nurse allows the patient to continue after which verbalization to the patient? 

The nurse observes the affected eye of the patient with newly diagnosed Bell's palsy is not closing fully and performs which interventions? Select all that apply.

The patient is admitted with failure to thrive secondary to bulimia nervosa. The nurse anticipates administering which medication? 

The patient with chronic pain and generalized anxiety disorder has been prescribed alprazolam. Which medication, if also prescribed to the patient, prompts the nurse to clarify the order with the provider?

The nurse is assigned to care for a 45-year-old patient who presents with a three-day history of fever, sore throat, chills, and myalgia. On physical assessment, the nurse notes the patient has multiple erythematous macular areas surrounding bullous lesions, some of which have ruptured and desquamated. Past medical history is significant for a recently diagnosed seizure disorder, managed with lamotrigine. Which intervention will be performed first?

The patient who has taken phenytoin for the past 12 years for seizure disorder reports feeling something strange in the mouth. The nurse anticipates observing which condition? 

The nurse is assigned to a 55-year-old patient with Streptococcus viridans endocarditis who is receiving penicillin and amikacin. The nurse is vigilant for which adverse effect?

The nurse is assigned to a 45-year-old HIV-positive male patient who is admitted with a MRSA skin infection on his right arm secondary to intravenous drug use. The patient is prescribed intravenous vancomycin. Twenty minutes after starting the vancomycin infusion, the patient develops a mild erythematous macular rash on the face, trunk and extremities. Which action is performed first?

The nurse is caring for a 45-year-old patient undergoing treatment with doxorubicin for small cell lung cancer. The nurse focuses education on which adverse effects? Select all that apply.

The patient is being treated with intravenous quinidine for malaria that was contracted while in Africa. Several hours after administration of the medication, the patient develops palpitations and dizziness. Electrocardiogram shows tachycardia and twisting of the QRS complexes around an isoelectric line. Which best describes the most likely etiology of this patient’s arrhythmia?

The nurse is assigned to care for a patient who presents with fever, chills, lethargy, and sore throat. Past medical history is significant for schizophrenia diagnosed three months ago for which clozapine was prescribed. Which additional laboratory finding does the nurse expect to see in this patient?

The nurse is taking care of a patient who is prescribed chloramphenicol. After three days, the patient develops fatigue and dyspnea on exertion. Physical assessment reveals tachycardia, pallor and multiple petechiae on the trunk and extremities. The nurse anticipates which laboratory result(s)?

A new mother is discussing alcohol consumption while breastfeeding her baby. Which statement indicates a need for further teaching? 

The patient is prescribed phenytoin for treatment of a seizure disorder. The nurse instructs the patient about which adverse effect of treatment? 

The nurse is assigned to a 38-year-old patient who presents with polydipsia and polyuria. Past medical history is significant for bipolar disorder diagnosed two months ago, for which the patient was prescribed lithium. The nurse anticipates further testing will reveal which condition? 

The nurse is assigned to care for a 31-year-old male with a past medical history significant for long-standing diabetes mellitus and hypertension. Current medications are metformin, furosemide, and captopril. Laboratory tests reveal serum potassium of 3.2 mEq/L, so the patient is started on spironolactone. The nurse provides education about which side effect of therapy?