Order: 500 mg PO. Available: 250 mg tablets.
How many tablets will the nurse administer?
2 tablets.
1 tablet.
1.5 tablets.
0.5 tablets.
The Correct Answer is A
Choice A rationale
Administering 2 tablets is the correct action because the ordered dose is 500 mg and each available tablet contains 250 mg. By providing two of these tablets, the nurse delivers the exact amount prescribed. This calculation is a basic nursing competency used to ensure medication safety. Giving the correct number of tablets prevents underdosing, which would result in subtherapeutic levels of the medication, and overdosing, which could lead to toxicity or adverse reactions for the patient.
Choice B rationale
Administering 1 tablet would only provide 250 mg of the medication, which is exactly half of the 500 mg dose that was ordered by the healthcare provider. Providing only one tablet would result in a medication error categorized as underdosing. This would fail to meet the therapeutic needs of the patient and could lead to a worsening of the condition being treated, as the drug concentration in the bloodstream would not reach the necessary level for effectiveness.
Choice C rationale
Administering 1.5 tablets would provide a total dose of 375 mg, as 250 mg multiplied by 1.5 equals 375 mg. This amount is still 125 mg short of the required 500 mg dose. While closer than a single tablet, it remains an incorrect dosage that would not fulfill the prescriber's order. Nursing practice requires precise calculation to ensure that the patient receives the specific amount of active ingredient necessary to produce the desired physiological response without error.
Choice D rationale
Administering 0.5 tablets would only provide 125 mg of the medication, which is significantly less than the 500 mg dose required for the patient. Such a small amount would be entirely insufficient for treating the patient's condition. In clinical practice, the nurse must always verify the dose on hand against the dose ordered. Using a half tablet in this scenario would be a clear mathematical error and a violation of the rights of medication administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
Choice A rationale
Apoptosis is the process of programmed cell death used to remove damaged cells without causing an inflammatory response. In this clinical scenario, the client is exhibiting signs of an active, escalating infection and systemic inflammation rather than a controlled apoptotic process. The presence of a high white blood cell count of 16,200/mm and 10 percent bands suggests an acute shift toward necrosis and systemic activation rather than localized apoptotic pathways intended to limit damage.
Choice B rationale
Systemic inflammatory response syndrome involves the massive release of cytokines like tumor necrosis factor and interleukins into the bloodstream. These mediators cause widespread peripheral vasodilation to increase blood flow to tissues, but this results in a drop in blood pressure. The normal blood pressure varies, but a downward trend from a baseline of 120/80 mmHg toward hypotension indicates that these systemic cytokines are causing vascular relaxation and a significant decrease in systemic vascular resistance.
Choice C rationale
Inflammatory mediators increase the size of the gaps between endothelial cells in the capillaries. This allows protein-rich fluid to leak from the intravascular space into the interstitial space, known as third spacing. This process reduces the effective circulating blood volume, contributing to the client's declining blood pressure and localized edema. Normal capillary function maintains fluid balance, but during systemic inflammation, this permeability becomes global, leading to potential organ dysfunction and further hemodynamic instability in the client.
Choice D rationale
In the early stages of systemic inflammation and distributive shock, the systemic vascular resistance actually decreases due to vasodilation. The body typically attempts to compensate by increasing cardiac output via an increased heart rate to maintain perfusion. A decrease in cardiac output usually occurs later if the heart muscle becomes depressed by inflammatory toxins. The current assessment of trending down blood pressure is primarily driven by low resistance and fluid loss, not by an increase in resistance.
Choice E rationale
Neutrophils are the first responders to bacterial invasion and puncture wounds. They migrate to the injury site through chemotaxis and undergo degranulation to release antimicrobial enzymes. The client's white blood cell count of 16,200/mm is above the normal range of 5,000 to 10,000/mm, and the 10 percent bands indicate a left shift. This signifies that the bone marrow is releasing immature neutrophils to keep up with the significant demand of the escalating infection. .
Correct Answer is C
Explanation
Choice C rationale
Normal negative feedback loops involve the end-product (cortisol) inhibiting the production of the stimulating hormone (ACTH). In a functioning system, high cortisol levels would signal the pituitary to stop producing ACTH. However, a pituitary adenoma is an autonomous tumor that does not respond to these inhibitory signals. Therefore, the persistence of high ACTH levels despite the presence of high circulating cortisol (normal: 5 to 23 mcg/dL) clearly demonstrates that the negative feedback mechanism is disrupted and no longer regulating hormone secretion.
Choice A rationale
Fluctuating cortisol levels with normal ACTH levels suggest that the pituitary-adrenal axis is still somewhat responsive to physiological rhythms or that the primary issue may not be at the pituitary level. In the case of an ACTH-secreting adenoma, one would expect both values to be consistently abnormal or poorly regulated. Normal ACTH ranges (typically 10 to 60 pg/mL) in the presence of fluctuating cortisol do not provide the definitive evidence of feedback loop failure that a non-suppressible ACTH value provides.
Choice B rationale
This finding would actually demonstrate that the negative feedback loop is still intact. If elevated cortisol levels were successful in suppressing ACTH secretion, it would indicate that the pituitary gland is still capable of sensing and responding to the concentrations of adrenal hormones in the blood. In Cushing disease caused by a pituitary adenoma, the hallmark is that the tumor continues to secrete ACTH even when cortisol levels are excessively high, proving the loss of normal regulatory control.
Choice D rationale
Decreased cortisol levels despite elevated ACTH would typically indicate primary adrenal insufficiency, such as Addison disease, rather than a pituitary adenoma. In this scenario, the pituitary is functioning correctly by increasing ACTH to stimulate the failing adrenal glands, but the adrenals are unable to produce cortisol. This represents a functioning feedback loop attempting to maintain homeostasis, rather than the disruption of feedback seen when a pituitary tumor ignores high hormone levels and continues to overproduce ACTH. .
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