A nurse is planning care for a client who is to receive a neuromuscular blocking agent. Which of the following items should the nurse plan to have at the client's bedside?

Bag-valve-mask device

Client's personal phone

Urinary catheter insertion tray

Central venous catheterization tray

Answer and Explanation

The Correct Answer is A

A. Bag-valve-mask device should always be at the bedside when administering a neuromuscular blocking agent because these medications cause paralysis of respiratory muscles, including the diaphragm. The client will require manual ventilation support if mechanical ventilation fails or is delayed to ensure adequate oxygenation.
B. Client's personal phone is not a priority item for immediate bedside safety. Although maintaining communication with loved ones is important for emotional well-being, the critical concern with neuromuscular blockade is airway management and respiratory support.
C. Urinary catheter insertion tray may eventually be necessary if the client is immobilized for a prolonged period, but it is not an immediate requirement when administering a paralytic agent. The priority remains ensuring airway patency and respiratory support.
D. Central venous catheterization tray is not required solely for administering a neuromuscular blocking agent. While some critically ill patients need central access, peripheral intravenous access is often sufficient for delivering the medication itself.

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Correct Answer is ["C","D","E"]

Explanation

A. Placing the client in a negative pressure room is not necessary because the client is suspected to have community-acquired pneumonia, which requires droplet precautions, not airborne precautions. Negative pressure rooms are reserved for diseases like tuberculosis, measles, or varicella, which are truly airborne infections.
B. Requesting a prescription for famotidine is not a priority because it is a gastrointestinal medication used for acid suppression or stress ulcer prophylaxis. The client’s presentation does not indicate gastrointestinal bleeding or acute GI issues requiring famotidine urgently.
C. Placing the client on supplemental oxygen is essential because the signs of respiratory distress, tachypnea, and low SpO₂ 90%-93%) require immediate intervention to maintain adequate oxygenation and prevent respiratory deterioration.
D. Obtaining a chest x-ray is a priority to confirm the diagnosis of pneumonia, assess the extent of lung involvement, and guide antibiotic and respiratory management. Radiographic imaging helps identify complications such as consolidation, pleural effusion, or worsening infection.
E. Requesting a prescription for dexamethasone is a priority intervention because steroids help control lung inflammation and reduce airway swelling, especially important for this client who has underlying asthma and signs of significant respiratory involvement.
F. Preparing the client for intubation is not immediately necessary because the client, although tachypneic, is able to maintain oxygen saturation above critical levels with supportive oxygen therapy. Intubation would be considered only if oxygenation worsens despite non-invasive measures.

Correct Answer is ["800"]

Explanation

Calculation:

Convert the client's weight from pounds (lbs) to kilograms (kg):

Conversion factor: 1 kg = 2.2 lbs
Formula: Weight in kg = Weight in lbs / 2.2 lbs/kg

= 88 lbs / 2.2 lbs/kg

= 40 kg

Calculate the micrograms of propofol per hour:

Ordered dose: 20 mcg/kg/hr
Client's weight in kg: 40 kg
Formula: Dosage per hour (mcg/hr) = Ordered dose (mcg/kg/hr) × Client's weight (kg)

= 20 mcg/kg/hr × 40 kg

= 800 mcg/hr

= 800 micrograms of propofol for the first hour.

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A nurse is planning care for a client who is to receive a neuromuscular blocking agent. Which of the following items should the nurse plan to have at the client's bedside?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in the emergency department is caring for a client who has an elevated temperature and reports fatigue and muscle aches. Exhibits Which 3 of the following actions should the nurse prioritize? (Select all that apply.)

Correct Answer is ["C","D","E"]

Explanation

A nurse is preparing to administer propofol to an intubated client who weighs 88 lbs. The propofol is ordered to start at 20 mcg/kg/hr and to titrate as ordered. How many micrograms will the client receive for the first hour? (Round to the nearest whole number.)

Correct Answer is ["800"]

Explanation

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