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A client with an acute stroke must receive Alteplase 0.9 mg/kg. The client weighs 220 pounds. How should the client receive? (Round to the nearest whole number, do not use trailing zeros)

Answer and Explanation

The Correct Answer is ["90"]

Given:

Ordered dose of Alteplase: 0.9 mg/kg

Client weight: 220 pounds

Step 1: Convert the client's weight from pounds to kilograms:

1 pound (lb) = 0.453592 kilograms (kg)

Client weight in kg = 220 lbs x 0.453592 kg/lb = 99.76824 kg

Step 2: Calculate the total dose of Alteplase:

Total dose (mg) = Ordered dose (mg/kg) xClient weight (kg)

Total dose (mg) = 0.9 mg/kg x 99.76824 kg

Total dose (mg) = 89.801416 mg

Step 3: Round to the nearest whole number:

Total dose (mg) ≈ 90 mg

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Correct Answer is ["A","B","E"]

Explanation

A) Assess the respiratory status hourly and as needed
It is essential for the nurse to frequently monitor and assess the respiratory status of a client on a ventilator, as changes can occur rapidly. Regular assessments allow the nurse to detect any early signs of respiratory distress, hypoxia, or ventilator malfunction. Hourly assessments are standard practice in the intensive care unit (ICU), and additional assessments may be necessary if there are concerns about the patient’s respiratory condition.

B) Ensure that a manual resuscitation bag is at the bedside
A manual resuscitation bag (Ambu bag) is a critical piece of emergency equipment that should always be available at the bedside of a patient on mechanical ventilation. In the event of ventilator failure, accidental extubation, or sudden respiratory distress, the nurse needs to be able to provide manual ventilation.
C) Check the patient's pulse oximetry once every shift
Although monitoring pulse oximetry is important in ICU patients on a ventilator, checking it only once per shift is insufficient. Continuous monitoring of oxygen saturation via pulse oximetry is a much more appropriate approach to ensure the patient is adequately oxygenated, especially when on a ventilator.

D) Adjust the ventilator settings based on the client’s level of consciousness
Adjusting the ventilator settings should be done by the healthcare provider or respiratory therapist, not the nurse, unless directed by the provider. While the patient's level of consciousness can influence their respiratory drive, the nurse does not have the authority or expertise to modify ventilator settings based on consciousness levels.

E) Collaborate frequently with the respiratory therapist
Collaboration with the respiratory therapist is essential for managing a patient on a ventilator. Respiratory therapists have specialized training in ventilator management and can assist with adjusting ventilator settings, monitoring the patient’s lung function, and troubleshooting ventilator malfunctions.

A. O- B. AB - C. A+ D. A- E. O+

Correct Answer is ["A","D"]

Explanation

A) O- (O negative):
A person with blood type A- can safely receive blood from a universal donor blood type, which is O-. This is because O- has no A, B, or Rh antigens on the surface of its red blood cells, making it compatible with any ABO blood group. The Rh negative status is also compatible, as the recipient is also Rh-negative.

B) AB- (AB negative):
A person with blood type A- cannot receive blood from someone with AB-. This is because the AB- blood type contains both A and B antigens on the surface of red blood cells, which could cause an immune reaction in a person with A- blood, whose immune system will react against the B antigen. Therefore, AB- is not compatible with A- blood.

C) A+ (A positive):
A person with A- blood cannot receive blood from an A+ donor, because the A+ blood contains the Rh positive antigen. If a person with A- blood receives Rh-positive blood, they will form antibodies against the Rh factor, leading to a hemolytic transfusion reaction. Therefore, A+ is not compatible with A- blood.

D) A- (A negative):
A person with A- blood can receive blood from another A- donor, because both share the A antigen and are Rh-negative. This is a perfect match and poses no risk of a transfusion reaction.

E) O+ (O positive):
A person with A- blood cannot receive blood from an O+ donor, because the O+ blood contains the Rh-positive antigen. This could cause an immune reaction in a person with A- blood, leading to the production of anti-Rh antibodies. Therefore, O+ is not compatible with A- blood.

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A client with an acute stroke must receive Alteplase 0.9 mg/kg. The client weighs 220 pounds. How should the client receive? (Round to the nearest whole number, do not use trailing zeros)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client Is in the intensive care unit on a ventilator. Which intervention(s) should the nurse implement? (SELECT ALL THAT APPLY)

Correct Answer is ["A","B","E"]

Explanation

The nurse is preparing to administer a unit of packed red blood cells (PRBC's) to a patient whose blood type is A- (negative). The nurse knows that this patient can receive transfusions from which blood types? (SELECT ALL THAT APPLY).

Correct Answer is ["A","D"]

Explanation

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