Order: 1.5 L of 0.9 % NS over 20 hours.

Calculate milliliters per hour.

(ROUND TO WHOLE NUMBER & LABEL CORRECTLY TO RECEIVE CREDIT)

Step 1 is to locate the medication label. It is stated that Label #4 contains SoluMedrol.

Step 2 is to identify the concentration of SoluMedrol on Label #4. Assuming Label #4 indicates SoluMedrol 125 mg/2 mL (This is a common concentration; specific label details are not provided in the prompt, so a typical concentration is assumed for calculation purposes).

Step 3 is to calculate the volume to be administered. Volume (mL) = (Ordered dose ÷ Available concentration). Volume (mL) = (75 mg ÷ 125 mg/2 mL). Volume (mL) = (75 mg ÷ 125 mg) × 2 mL. Volume (mL) = 0.6 × 2 mL. Volume (mL) = 1.2 mL. The nurse will administer 1.2 mL.

Choice A rationale

Immediately before menstruation, hormonal fluctuations, particularly increased estrogen levels, can lead to breast swelling and tenderness. This physiological engorgement can obscure subtle lumps or changes, making accurate palpation difficult and potentially leading to false positives or missed abnormalities during self-examination, thereby reducing its efficacy.

Choice B rationale

Days 4-7 of the menstrual cycle, specifically post-menstruation, are optimal for breast self-examination because hormonal influences are at their lowest point. Estrogen and progesterone levels are minimal, resulting in the least breast tenderness and swelling. This makes breast tissue softer and less nodular, facilitating the detection of any new or subtle changes.

Choice C rationale

During ovulation, estrogen levels are elevated, which can cause some degree of breast fullness and tenderness due to glandular changes. This hormonal influence can make it more challenging to distinguish normal breast tissue from suspicious lumps, potentially leading to inaccurate findings and reducing the sensitivity of the self-examination process.

Choice D rationale

While consistency is important, simply choosing any same day of the month without regard to the menstrual cycle can lead to less effective examinations. Hormonal fluctuations throughout the cycle significantly impact breast tissue consistency. A fixed day may coincide with breast swelling or tenderness, hindering accurate assessment and potentially masking abnormalities, thereby reducing detection rates.