A client weighing 198 lbs is prescribed Dopamine hydrochloride IV at 2 mcg/kg/minute to promote renal perfusion.

The pharmacy provides a pre-mixed bag of dopamine containing 400 mg in 250 mL dextrose 5% in water (D5W). An IV pump that provides a precision infusion rate to a tenth of a mL is available.

How many mL/hour should the IV pump be set to deliver? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

Answer and Explanation

The Correct Answer is ["6.8"]

Step 1: Convert the client’s weight from lbs to kg. 1 kg is approximately 2.2 lbs. So, 198 lbs ÷

2.2 = 90 kg (rounded to the nearest whole number).

Step 2: Calculate the total mcg of Dopamine needed per minute. The prescription is for 2 mcg/kg/minute. So, 90 kg × 2 mcg/kg/minute = 180 mcg/minute.

Step 3: Convert the total mcg of Dopamine in the bag to mcg/mL. The bag contains 400 mg of Dopamine in 250 mL. 1 mg is equal to 1000 mcg. So, 400 mg × 1000 = 400,000 mcg. Therefore, the concentration is 400,000 mcg ÷ 250 mL = 1600 mcg/mL.

Step 4: Calculate the mL of Dopamine needed per minute. So, 180 mcg/minute ÷ 1600 mcg/mL

= 0.1125 mL/minute.

Step 5: Convert mL/minute to mL/hour. There are 60 minutes in an hour. So, 0.1125 mL/minute × 60 = 6.75 mL/hour. The IV pump should be set to deliver 6.8 mL/hour (rounded to the nearest tenth).

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Correct Answer is A

Explanation

Choice A rationale

The unlicensed assistive personnel (UAP) is providing care to a client with influenza, a respiratory illness that can be transmitted through droplets when the client coughs or sneezes. Therefore, it is crucial for the UAP to wear a face mask while in close contact with the client to prevent the transmission of the virus. This is in line with the standard precautions for infection control, which recommend the use of personal protective equipment (PPE) such as gloves, gowns, and masks when providing care to clients with infectious diseases.
Choice B rationale
Reassigning the UAP to another client and assuming full care of the client is not the most appropriate action in this situation. While it is the nurse’s responsibility to ensure that the UAP is competent and understands the care needs of the client, it is not necessary to reassign the UAP unless there are specific concerns about their ability to provide safe and effective care.
Choice C rationale
While it is important for the UAP to alert the nurse of any changes in the client’s respiratory status, this is not the most immediate action that the nurse should take in this situation. The priority is to ensure that the UAP is wearing appropriate PPE to prevent the transmission of influenza.
Choice D rationale
A fitted respirator mask is typically used when caring for clients with airborne diseases, such as tuberculosis. Influenza is primarily spread through droplets, so a regular face mask is usually sufficient for protection.

A. Malignancy B. Bacterial infection C. Viral infection D. Lymphangitis .

Correct Answer is A

Explanation

Choice A rationale
A large, non-tender, hardened lymph node without overlying tissue inflammation could indicate malignancy. Lymph nodes may become enlarged or hard due to the presence of cancer cells.
Choice B rationale

While bacterial infections can cause lymph node enlargement, they typically also cause tenderness and overlying skin changes, such as redness or warmth.
Choice C rationale
Viral infections can cause generalized lymph node enlargement, but the nodes are usually tender and not hard.
Choice D rationale
Lymphangitis, or inflammation of the lymphatic channels, typically presents with red streaks on the skin, fever, and tenderness.

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Naxlex Comprehensive Predictor Exams

A client with influenza requires assistance in transferring to the bedside commode. The nurse observes the unlicensed assistive personnel (UAP) donning gloves and a gown to assist the client. What action should the nurse take?

Correct Answer is A

Explanation

An adult patient visits the clinic expressing concern about a lump that appeared on their neck about a week ago. Upon examination, the nurse finds a large, non-tender, hardened left subclavian lymph node without any overlying tissue inflammation. What could these findings indicate?

Correct Answer is A

Explanation

The nurse is collecting a heel-stick blood specimen for a neonatal screen, which includes thyroxine (T4) and thyroid- stimulating hormone (TSH) levels, prior to discharging a 2-day-old patient. When the parents ask why these tests are being conducted, which explanation should the nurse provide?

The nurse uses the Modified Caregiver Strain Index (MCSI) and determines that the daughter is under significant stress caused by the assumption of her mother’s care.

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The client is a 26-year-old female who fell from an apartment balcony. She was transported to the hospital via ambulance. The client enters the emergency room on a stretcher and is met in the trauma bay by the nurse. What two actions should the nurse take first during the primary survey?