A client with neuroleptic malignant syndrome receives a prescription for dantrolene 1.5 mg/kg IV. The client weighs 132 pounds.

The label on the 250 mg vial reads, “Reconstitute with 5 mL sterile water for injection, USP. Reconstitution yields 50 mg/mL.”. How many mL should the nurse administer?

Answer and Explanation

The Correct Answer is ["1.8"]

The client weighs 132 pounds. To convert pounds to kilograms, divide the weight in pounds by

2.2. So, the client’s weight in kilograms is: Step 1: 132 pounds ÷ 2.2 = 60 kg The prescription for dantrolene is 1.5 mg/kg. To find out how many milligrams the client should receive, multiply the client’s weight in kilograms by the dosage in mg/kg: Step 2: 60 kg × 1.5 mg/kg = 90 mg The vial is reconstituted to yield a concentration of 50 mg/mL. To find out how many mL the nurse should administer, divide the total dosage in milligrams by the concentration in mg/mL: Step 3: 90 mg ÷ 50 mg/mL = 1.8 mL So, the nurse should administer 1.8 mL of dantrolene.

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Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A rationale
Using a cushion when sitting can provide comfort but does not directly address the client’s electrolyte imbalance, elevated blood pressure, or weight gain.
Choice B rationale

Offering a high protein diet can be beneficial for clients with hepatic failure to support liver regeneration and prevent malnutrition. However, it does not directly address the client’s immediate issues.
Choice C rationale
Providing only distilled water does not address the client’s electrolyte imbalance, elevated blood pressure, or weight gain. In fact, it could potentially exacerbate electrolyte imbalances.
Choice D rationale
Documenting abdominal girth can help monitor for fluid accumulation (ascites), a common complication of hepatic failure that can contribute to weight gain and elevated blood pressure.

A. Schedule a client and family conference to review the plan of care. B. Explain that living wills cannot be followed by emergency personnel. C. Check the client’s arm for a “Do Not Resuscitate” (DNR) bracelet. D. Seek clarification of the type of advance directive the client has.

Correct Answer is D

Explanation

Choice D rationale
Seeking clarification of the type of advance directive the client has is the most appropriate response. A living will typically outlines a person’s wishes for end-of-life care, but it may not specifically address emergency situations like cardiac arrest.

Choice A rationale
Scheduling a client and family conference to review the plan of care may be helpful, but it is not the immediate priority. The nurse first needs to understand the client’s wishes as outlined in their advance directive.

Choice B rationale
Explaining that living wills cannot be followed by emergency personnel is not entirely accurate. While it’s true that emergency personnel initiating resuscitative measures may not have immediate access to a person’s living will, in a hospital setting, a person’s known wishes should be respected as much as possible.

Choice C rationale

Checking the client’s arm for a “Do Not Resuscitate” (DNR) bracelet is not the most appropriate response. While some people may choose to wear such a bracelet, not all do. Furthermore, a DNR order is just one type of advance directive, and it’s important to clarify what specific directives the client has in place.

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Naxlex Comprehensive Predictor Exams

A client with hepatic failure has an electrolyte imbalance, elevated blood pressure, and a weight gain of 4.4 lbs (2 kg) in 24 hours. What intervention should the nurse include in the plan of care?

Correct Answer is D

Explanation

Correct Answer is D

Explanation

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The nurse identifies an electrolyte imbalance, elevated blood pressure, and a weight gain of 4.4 lbs (2 kg) in 24 hours in a client with hepatic failure. Which intervention should the nurse include in the plan of care?