A client is to receive a continuous Heparin infusion at s00 units per hour. Pharmacy supplies Heparin in a concentration of 25,000 units per 250mL of NSS.

Calculate the rate at which the nurse should set the infusion pump.

Answer and Explanation

The Correct Answer is ["5"]

Step 1: Determine the concentration of Heparin in units per mL. 25,000 units ÷ 250 mL = 100 units per mL Result: 100

Step 2: Determine the rate in mL per hour needed to deliver 500 units per hour. 500 units ÷ 100 units per mL = 5 mL per hour Result: 5 mL per hour

The nurse should set the infusion pump to deliver at a rate of 5 mL per hour.

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Correct Answer is C

Explanation

Choice A Reason: Childhood Depression

Childhood depression is characterized by persistent sadness, irritability, and a lack of interest in activities. While it can lead to behavioral issues, it does not typically include the aggressive and antisocial behaviors described in the scenario. The symptoms of childhood depression include changes in sleep patterns, appetite, and energy levels, but these do not align with the client’s history of running away and abusive behavior towards parents.

Choice B Reason: Oppositional Defiant Disorder (ODD)

ODD is marked by a pattern of angry, irritable mood, argumentative, defiant behavior, or vindictiveness. While children with ODD may be defiant and hostile towards authority figures, the behaviors described in the scenario, such as running away and engaging in illegal activities like prostitution, are more severe and align more closely with Conduct Disorder. ODD does not typically involve the violation of societal norms to the extent seen in this case.

Choice C Reason: Conduct Disorder

Conduct Disorder is characterized by a repetitive and persistent pattern of behavior that violates the rights of others or major age-appropriate societal norms or rules. This includes aggressive behavior towards people and animals, destruction of property, deceitfulness or theft, and serious violations of rules. The client’s history of running away, abusive behavior towards parents, and involvement in illegal activities like prostitution strongly suggests Conduct Disorder. This diagnosis is supported by the presence of multiple behavioral issues that are severe and pervasive.

Choice D Reason: Autism Spectrum Disorder (ASD)

ASD is a developmental disorder that affects communication and behavior. Individuals with ASD may have difficulty with social interactions, exhibit repetitive behaviors, and have restricted interests. While ASD can sometimes be associated with challenging behaviors, it does not typically include the antisocial and aggressive behaviors described in the scenario. The client’s history of running away and abusive behavior is not characteristic of ASD.

A. Denial B. Separation-individuation C. Reaction formation D. Splitting

Correct Answer is D

Explanation

The correct answer is d. Splitting.

Choice A Reason: Denial

Denial is a defense mechanism where an individual refuses to accept reality or facts, blocking external events from awareness. While denial can be present in various mental health conditions, it does not specifically explain the client’s sudden shift from idealizing to devaluing the nurse.

Choice B Reason: Separation-individuation

Separation-individuation refers to a developmental process where an individual differentiates themselves from others, particularly caregivers, and develops a sense of self. This concept is more relevant to early childhood development and does not directly explain the client’s behavior in this context.

Choice C Reason: Reaction formation

Reaction formation is a defense mechanism where an individual expresses feelings or behaviors that are opposite to their true feelings or desires. While this can occur in borderline personality disorder, it does not fully capture the client’s extreme shift in perception from positive to negative.

Choice D Reason: Splitting

Splitting is a hallmark characteristic of borderline personality disorder. It involves viewing people or situations in black-and-white terms, as either all good or all bad, with no middle ground. The client’s outburst, shifting from idealizing the nurse to seeing them as hateful, is a classic example of splitting. This defense mechanism helps individuals with borderline personality disorder manage their intense emotions and fears of abandonment.

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A client is to receive a continuous Heparin infusion at s00 units per hour. Pharmacy supplies Heparin in a concentration of 25,000 units per 250mL of NSS. Calculate the rate at which the nurse should set the infusion pump.

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Naxlex Comprehensive Predictor Exams

A fifteen-year-old was referred to the adolescent mental health clinic after being arrested for prostitution. The client’s parents reported that they have run away several times and are abusive towards them. The nurse should anticipate that the diagnosis will be:

Correct Answer is C

Explanation

The nurse has recently set limits for a client with borderline personality disorder. The client yells at the nurse, “You used to care about me. I thought you were wonderful. Now I can see that I was mistaken. You are hateful.” This outburst can be assessed as:

Correct Answer is D

Explanation

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A client is to receive a continuous Heparin infusion at s00 units per hour. Pharmacy supplies Heparin in a concentration of 25,000 units per 250mL of NSS.

Calculate the rate at which the nurse should set the infusion pump.