A nurse is preparing to administer vancomycin 50 mg PO daily divided into four equal doses. The amount available is vancomycin 125 mg capsules. How many capsules should the nurse administer with each dose?

(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A reason: A client who had a stroke and is to be admitted

Assigning a client who had a stroke and is to be admitted might not be the best choice for an RN floated from the maternal-newborn unit. Stroke patients often require specialized neurological assessments and interventions that the RN might not be familiar with. Additionally, the initial admission process can be complex and time-consuming, requiring familiarity with the specific protocols and procedures of the medical-surgical unit.

Choice B reason: A client who is one-day postoperative following a total abdominal hysterectomy

This is the most appropriate assignment for the RN floated from the maternal-newborn unit. The RN is likely to be familiar with postoperative care, especially related to abdominal surgeries, given their experience in the maternal-newborn unit. Postoperative care involves monitoring vital signs, managing pain, and ensuring proper wound care, all of which are within the RN’s skill set. This familiarity can help ensure the client receives competent and safe care.

Choice C reason: A client who has acute pancreatitis

Acute pancreatitis can be a complex condition requiring specialized knowledge of gastrointestinal issues and potential complications such as fluid and electrolyte imbalances, respiratory issues, and severe pain management. The RN from the maternal-newborn unit may not have the specific expertise needed to manage these complexities effectively.

Choice D reason: A client who has terminal end-stage renal disease

Caring for a client with terminal end-stage renal disease involves managing complex chronic conditions, including fluid balance, electrolyte management, and possibly dialysis. This requires specialized knowledge and skills that the RN from the maternal-newborn unit might not possess. Additionally, end-of-life care requires a specific set of competencies and experience that might not be within the RN’s usual scope of practice.

Choice A reason: Babinski’s sign

Babinski’s sign is a reflex action where the big toe moves upward or toward the top surface of the foot and the other toes fan out when the sole of the foot is stimulated. This sign is used to assess neurological function, particularly in the context of central nervous system disorders. It is not related to hypocalcemia, which is the likely cause of the tingling sensation in this scenario.

Choice B reason: Chvostek’s sign

Chvostek’s sign is a clinical indicator of hypocalcemia. It is elicited by tapping the facial nerve at the angle of the jaw, which causes twitching of the facial muscles. Hypocalcemia is a common complication following thyroidectomy due to potential damage or removal of the parathyroid glands, which regulate calcium levels. The tingling sensation reported by the client is a classic symptom of hypocalcemia, making Chvostek’s sign the most relevant assessment.

Choice C reason: Brudzinski’s sign

Brudzinski’s sign is used to assess for meningitis. It involves flexing the client’s neck and observing for involuntary flexion of the hips and knees. This sign is not related to hypocalcemia or the symptoms described by the client following thyroidectomy.

Choice D reason: Kernig’s sign

Kernig’s sign is another test for meningitis. It involves flexing the client’s hip and knee, then straightening the knee. Pain and resistance to straightening the knee indicate a positive Kernig’s sign. This sign is not relevant to the assessment of hypocalcemia or the symptoms described by the client.