A nurse is caring for a client who is 2 hr postoperative following orthopedic surgery and reports pain as 10 on a scale of 0 to 10. Which of the following prescriptions should the nurse expect to administer?
Ketorolac 30 mg IV
Oxycodone 10 mg PO
Acetaminophen 1,000 mg PO
Fentanyl 12.5 mcg/hr transdermal
The Correct Answer is A
A. Ketorolac 30 mg IV: Ketorolac is a NSAID that can be administered intravenously for postoperative pain relief. Since the client is only 2 hours postoperative and reports severe pain (10/10), this prescription is appropriate for managing acute pain effectively.
B. Oxycodone 10 mg PO: Oxycodone is an opioid but it is taken orally, which may not be appropriate in the immediate postoperative period when the client is still recovering from anesthesia and may have nausea or difficulty swallowing.
C. Acetaminophen 1,000 mg PO: Acetaminophen is an appropriate medication for mild to moderate pain, but given the client's severe pain (10/10), a stronger analgesic such as an NSAID (ketorolac) or opioid would likely be prescribed in this situation.
D. Fentanyl 12.5 mcg/hr transdermal: Fentanyl transdermal patches are used for long-term, chronic pain management and are not suitable for immediate postoperative pain. The onset of action is slow, and it would not provide adequate pain relief in the immediate postoperative period.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Hgb 11.5 g/dL (12 to 16 g/dL): While this hemoglobin level is slightly below normal, it is not an immediate priority compared to other more concerning values. Anemia could be addressed later with appropriate interventions but is not life-threatening in this case.
B. Creatinine 3.2 mg/dL (0.5 to 1.1 mg/dL): A creatinine level of 3.2 mg/dL is significantly elevated and indicates possible kidney dysfunction or acute kidney injury. Gentamicin is known to be nephrotoxic, and this level requires prompt attention to prevent further renal damage.
C. Sodium 146 mEq/L (136 to 145 mEq/L): Sodium levels are only slightly elevated and do not represent an immediate concern unless the client has symptoms of hypernatremia (e.g., confusion, seizures). While monitoring is required, it is not as urgent as the creatinine.
D. WBC count 12,000/mm3 (5,000 to 10,000/mm3): A WBC count of 12,000/mm3 is mildly elevated, which could suggest an infection or inflammation. However, this is not the priority compared to the kidney function, which could be compromised by gentamicin therapy.
Correct Answer is ["30"]
Explanation
Calculation:
- Determine the concentration of the available lidocaine solution in milligrams per milliliter (mg/mL).
Available concentration = Total medication (mg) / Total volume (mL)
= 400 mg / 100 mL
= 4 mg/mL.
- Convert the desired dose from milligrams per minute (mg/min) to milligrams per hour (mg/hr).
1 hr = 60 min
Desired dose in mg/hr = 2 mg/min × 60 min/hr
= 120 mg/hr.
- Calculate the IV pump rate in milliliters per hour (mL/hr).
IV pump rate (mL/hr) = Desired dose (mg/hr) / Available concentration (mg/mL)
= 120 mg/hr / 4 mg/mL
= 30 mL/hr.
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