A nurse is reviewing the medication orders for a client who has heart failure. Which of the following prescriptions should the nurse clarify with the provider

Digoxin 25 mcg/kg via IV bolus every 8 hr x 2 doses

Dobutamine 15 mcg/kg via continuous IV infusion

Bumetanide 0.1 mg/kg via IV bolus every 12 hr

Dextrose 5% in 0.45% sodium chloride with 20 mEq KCl via continuous V Infusion at 50 mL/hr

Answer and Explanation

The Correct Answer is A

A) Digoxin 25 mcg/kg via IV bolus every 8 hr x 2 doses: This prescription should be clarified. Digoxin is typically prescribed in micrograms (mcg), but the dose of 25 mcg/kg is very high and could lead to toxicity. For a client with heart failure, the usual dosage for digoxin is 0.125–0.25 mg daily, not 25 mcg/kg per dose, which is excessive and potentially dangerous. Therefore, this order should be clarified with the provider.

B) Dobutamine 15 mcg/kg via continuous IV infusion: This is an appropriate dose for dobutamine, which is commonly used in heart failure for its inotropic effects. Dobutamine is typically dosed between 2–20 mcg/kg/min for continuous IV infusion, so 15 mcg/kg/min is within a safe range.

C) Bumetanide 0.1 mg/kg via IV bolus every 12 hr: Bumetanide is a loop diuretic used in heart failure, and the prescribed dose of 0.1 mg/kg every 12 hours is an appropriate dosing regimen for this medication. It is within the typical dosing range, and the interval is also reasonable for managing fluid overload in heart failure.

D) Dextrose 5% in 0.45% sodium chloride with 20 mEq KCl via continuous IV infusion at 50 mL/hr: This IV fluid prescription is generally appropriate. The combination of dextrose and sodium chloride with potassium is commonly used to maintain hydration and electrolyte balance in clients, particularly in the context of heart failure management. The infusion rate of 50 mL/hr is a typical rate for continuous IV infusions.

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Correct Answer is ["1.3"]

Explanation

Order: Cefotaxime 100 mg/kg IV bolus, divided into equal doses every 8 hours

Toddler Weight: 26.4 lb

Available Solution: Cefotaxime injection 300 mg/mL

Desired Dose: mL per dose

Step 1: Convert Toddler Weight to Kilograms (kg)

1 kg = 2.2 lbs

Toddler Weight in kg: 26.4 lbs / 2.2 lbs/kg = 12 kg

Step 2: Calculate the Total Daily Dose

Ordered Dose: 100 mg/kg

Toddler Weight: 12 kg

Total Daily Dose: 100 mg/kg x 12 kg = 1200 mg

Step 3: Determine the Number of Doses per Day

Doses are given every 8 hours.

Hours in a Day: 24 hours

Number of Doses: 24 hours / 8 hours/dose = 3 doses

Step 4: Calculate the Dose per Administration

Total Daily Dose: 1200 mg

Number of Doses: 3

Dose per Administration: 1200 mg / 3 doses = 400 mg/dose

Step 5: Calculate the Volume to Administer per Dose

Dose per Administration: 400 mg

Concentration: 300 mg/mL

Volume to Administer: 400 mg / 300 mg/mL = 1.333 mL

Step 6: Round to the Nearest Tenth

The calculated volume is 1.333 mL.

Rounded to the nearest tenth: 1.3 mL

Answer: 1.3 mL

Correct Answer is ["60"]

Explanation

Understanding the Problem

Order: Lidocaine 4 mg/min

Available Solution: Lidocaine 1 g in 250 mL of D5W

Desired Rate: mL/hr

Step 1: Convert Grams (g) to Milligrams (mg)

1 g = 1000 mg

Available Lidocaine: 1 g x 1000 mg/g = 1000 mg

Step 2: Determine the Concentration of the Lidocaine Solution

Available Lidocaine: 1000 mg

Solution Volume: 250 mL

Concentration: 1000 mg / 250 mL = 4 mg/mL

Step 3: Calculate the Infusion Rate in mL/min

Ordered Dose: 4 mg/min

Concentration: 4 mg/mL

Infusion Rate: 4 mg/min / 4 mg/mL = 1 mL/min

Step 4: Convert Infusion Rate to mL/hr

Infusion Rate: 1 mL/min

Minutes in an Hour: 60 min

Infusion Rate in mL/hr: 1 mL/min x 60 min/hr = 60 mL/hr

Step 5: Round to the Nearest Whole Number

The calculated rate is 60 mL/hr, which is already a whole number.

Final Answer: 60 mL/hr

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A nurse is reviewing the medication orders for a client who has heart failure. Which of the following prescriptions should the nurse clarify with the provider

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["1.3"]

Explanation

Correct Answer is ["60"]

Explanation

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