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A client receives a prescription for penicillin G 1,000,000 units intramuscular (IM) daily. The medication is available in 1,200,000 units/2 mL syringe. How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

Answer and Explanation

The Correct Answer is ["1.7"]

To find out how many mL the nurse should administer:

We can set up a proportion to solve for the unknown.

Given:

The prescription is for 1,000,000 units of penicillin G.

The available medication is 1,200,000 units/2 mL.

We can set up the proportion as follows:

1,000,000 units/ x mL = 1,200,000 units/2 mL

Solving for x gives us the volume in mL that the nurse should administer.

Cross-multiplying and solving for x:

X = 1,000,000 units×2 mL/1,200,000 units

After performing the calculation, we find that x equals 1.67 mL.

So, the nurse should administer 1.7 mL (rounded to the nearest tenth) of the medication.

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Correct Answer is B

Explanation

Answer: B. Administer a second dose of naloxone.

Rationale:

A) Prepare to assist with chest tube insertion:
Chest tube insertion is not relevant in this situation. A chest tube is typically used for conditions like pneumothorax or pleural effusion, not opioid-induced respiratory depression. The immediate concern here is the opioid overdose and the need for further naloxone administration to reverse the opioid effects, not the placement of a chest tube.

B) Administer a second dose of naloxone:
Administering a second dose of naloxone is the most appropriate action. Naloxone is a short-acting opioid antagonist, and its effects can wear off before the opioids have fully cleared from the client’s system. Given that the client’s respiratory rate is severely depressed and the oxygen saturation is dangerously low, another dose of naloxone is necessary to reverse the opioid's effects and restore adequate breathing. Immediate action is required to prevent further hypoxia.

C) Determine Glasgow Coma Scale score:
While assessing the client’s level of consciousness using the Glasgow Coma Scale (GCS) is important, it is not the immediate priority in this situation. The client’s low respiratory rate and oxygen saturation indicate a critical need for immediate treatment to improve ventilation and oxygenation. Administering naloxone should take precedence over neurological assessment.

D) Initiate cardiopulmonary resuscitation (CPR):
While the client’s respiratory depression is severe, initiating CPR may not yet be necessary if the client still has a pulse. Administering naloxone can potentially reverse the respiratory depression and prevent the need for CPR. If the client's condition continues to decline despite naloxone administration, CPR may become necessary later, but the first step is to administer a second dose of naloxone to restore breathing.

A. When using the discus, have the client breathe out rapidly into the mouthpiece. B. Explain that the client should not use the discus more than twice daily. C. Offer the discus to the client for use during an acute asthma attack. D. Clients using the discus may experience decreased blood pressure.

Correct Answer is B

Explanation

A) When using the discus, have the client breathe out rapidly into the mouthpiece: This instruction is incorrect because with dry powder inhalers (DPIs) like the fluticasone propionate and salmeterol discus, clients should exhale slowly and completely before inhaling the medication. Breathing out rapidly may cause the medication to be dispersed ineffectively, reducing its therapeutic benefit. By exhaling slowly, clients ensure better delivery of the medication to their lungs, maximizing its effectiveness in controlling asthma symptoms.
B) Explain that the client should not use the discus more than twice daily: This is the correct answer. Fluticasone propionate and salmeterol combination inhalers are typically used on a scheduled basis to maintain asthma control. Overuse of these medications can lead to increased risk of side effects, such as oral thrush or hoarseness from the steroid component (fluticasone propionate), or increased heart rate from the long-acting beta agonist (salmeterol). Moreover, exceeding the prescribed dose may not provide additional benefits in controlling asthma symptoms and can indicate inadequate control, necessitating a review of the treatment plan by the healthcare provider.
C) Offer the discus to the client for use during an acute asthma attack: Using a combination inhaler during an acute asthma attack is not appropriate. During acute exacerbations, clients should use short-acting bronchodilators (e.g., albuterol) for quick relief of symptoms. Combination inhalers like fluticasone propionate and salmeterol are intended for long-term maintenance therapy to prevent asthma symptoms, not for acute symptom relief.
D) Clients using the discus may experience decreased blood pressure: This statement is incorrect. Fluticasone propionate and salmeterol combination inhalers are not known to cause decreased blood pressure as a side effect. However, salmeterol, being a long-acting beta agonist, can potentially cause an increase in heart rate, especially when used excessively, but this is not related to blood pressure changes. It's essential to focus on the appropriate use and dosing schedule of the medication to achieve optimal asthma control and minimize adverse effects.

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A client receives a prescription for penicillin G 1,000,000 units intramuscular (IM) daily. The medication is available in 1,200,000 units/2 mL syringe. How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

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Naxlex Comprehensive Predictor Exams

The nurse administers naloxone to a client with opioid-induced respiratory depression. One hour later, nursing assessment reveals that the client has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unable to be aroused. Which action should the nurse implement?

Correct Answer is B

Explanation

Rationale:

To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client's caregivers?

Correct Answer is B

Explanation

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