A client is to receive one liter of normal saline intravenously over six hours. The tubing delivers 15 drops per milliliter.
How many drops per minute should a nurse regulate the infusion to deliver?
42.
84.
100.
166.
The Correct Answer is A
Step 1 is: Convert 1 liter to milliliters 1 L = 1000 mL
Step 2 is: Convert 6 hours to minutes 6 × 60 = 360 min
Step 3 is: Calculate drops per minute using tubing drop factor (1000 mL ÷ 360 min) × 15 gtt/mL = (2.77 mL/min) × 15 = 41.66 drops/min
Step 4 is: Round to the nearest whole number Final answer: 42 drops per minute
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A two-day postoperative client who has a large abdominal incision and says, “Something feels like it just popped open after I practiced my coughing”. This client may have a dehiscence or separation of the surgical wound, which is a serious complication that requires immediate attention.
The nurse should evaluate this client first and notify the surgeon.
Choice B is wrong because bile-colored fluid draining from a nasogastric tube is an expected finding after abdominal surgery and does not indicate an urgent problem.
The nurse should monitor the client’s fluid and electrolyte balance and provide antiemetics as needed.
Choice C is wrong because a three-day postoperative client who has an ileostomy and reports the need to have a bowel movement may have a paralytic ileus or a temporary cessation of bowel motility. This is a common postoperative complication that usually resolves within 72 hours.
The nurse should assess the client’s bowel sounds, abdominal distension, and ostomy output and encourage early mobilization and oral intake as tolerated.
Choice D is wrong because a three-day postoperative client who is receiving intravenous antibiotics for a wound infection may have a surgical site infection or an infection that occurs within 30 days of surgery. This is a preventable complication that can be managed with antibiotics, wound care, and infection control measures.
The nurse should monitor the client’s vital signs, wound appearance, and laboratory values and educate the client on signs and symptoms of infection.
Correct Answer is C
Explanation
The proper length of the needle to administer a subcutaneous injection depends on the amount of adipose tissue over the muscle.
The needle should be long enough to reach the subcutaneous layer but not so long that it penetrates the muscle. The needle gauge and length vary depending on the patient’s size and the injection site
Choice A is wrong because the age of the client does not determine the needle length.
However, age may affect the amount of adipose tissue and muscle mass, which are factors to consider when choosing a needle length.
Choice B is wrong because the viscosity of the solution does not determine the needle length. However, viscosity may affect the needle gauge, which is the diameter of the needle.
Thicker solutions may require larger gauge needles to allow easier flow.
Choice D is wrong because the quantity of the solution does not determine the needle length.
However, quantity may affect the syringe size, which is the volume of medication that can be held by the syringe.
The syringe size should match the prescribed dose as closely as possible to ensure accuracy and ease of measurement.
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