The healthcare provider (HCP) prescribes penicillin G benzathine 1,800,000 units intramuscularly (IM) for a client with a bacterial infection. The prefilled syringe is labeled, "Penicillin G benzathine 1,200,000 units/2 mL." How many mL should the nurse administer to this client? (Enter numerical value only, rounded to the nearest whole number.)

Answer and Explanation

The Correct Answer is ["3"]

To calculate the volume needed, use the ratio:
1,200,000 units / 2 mL = 600,000 units per mL.
To deliver 1,800,000 units:
1,800,000 ÷ 600,000 = 3 mL.

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Correct Answer is A

Explanation

Choice A reason: Huff coughing is a technique that helps mobilize and clear secretions without causing airway collapse. It is especially effective for clients with weak cough reflexes or obstructive lung conditions. Coaching the client through this method promotes airway clearance and improves ventilation.

Choice B reason: Nebulizer treatments may be helpful if the client has bronchospasm or thick secretions, but they are not the first-line intervention after repositioning for ineffective cough. They require a provider’s order and are more appropriate when pharmacologic therapy is indicated.

Choice C reason: Humidification can help loosen secretions over time, but it is not an immediate action to improve coughing effectiveness. It supports long-term airway maintenance rather than acute clearance.

Choice D reason: Pulse oximetry assesses oxygenation but does not directly address the mechanical issue of ineffective coughing. It is useful for monitoring but not a therapeutic intervention in this context.

A. Educate the client on signs and symptoms of narcotic dependency. B. Give maximum dosage when score reaches 10. C. Alternate IV and IM analgesic medications. D. Administer opioid and non-opioid medication simultaneously.

Correct Answer is D

Explanation

Choice A reason: Education on narcotic dependency is important but not the priority when the client is experiencing severe pain. Immediate relief is the focus.
Choice B reason: Waiting until pain reaches a score of 10 before giving maximum dosage is inappropriate and may lead to unnecessary suffering. Pain should be managed proactively.
Choice C reason: Alternating IV and IM routes may be useful in some contexts but does not enhance analgesic efficacy or address multimodal pain pathways.
Choice D reason: Combining opioid and non-opioid medications targets different pain mechanisms, improves pain control, and may reduce opioid requirements. This is the most effective and evidence-based approach for managing severe cancer pain.

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Naxlex Comprehensive Predictor Exams

After positioning the client upright, which action should the nurse take to assist with ineffective coughing?

Correct Answer is A

Explanation

A client with stage IV bone cancer is admitted to the hospital for pain control. The client verbalizes continuous, severe pain rated 8 on a 0 to 10 scale. Which intervention should the nurse implement?

Correct Answer is D

Explanation

A client is recovering from an episode of urinary tract calculi. During discharge teaching, the client asks about dietary restrictions. In discussing fluid intake, the nurse should include which type of fluid limitation?

A client with heart failure (HF) is receiving IV fluids at 125 mL/hour. The nurse observes an increase in jugular vein distention (JVD) and pedal edema. Which additional assessment should the nurse make before reporting to the healthcare provider (HCP)?

A nurse is caring for a client with diabetes insipidus (DI). Which data warrants the most immediate intervention by the nurse? Reference Range: Sodium [136 to 145 mEq/L (136 to 145 mmol/L)]

The nurse is caring for a client with acute kidney injury (AKI). Which assessment finding warrants immediate intervention?

Ten hours after successful thrombolysis for ST elevation myocardial infarction (STEMI), a client is receiving lidocaine and heparin infusions. Which assessment(s) should the nurse monitor regularly during the reperfusion period? Select all that apply.

The nurse is assessing a client who is one day postoperative from a parathyroidectomy and finds that the client is experiencing tenderness. After notifying the healthcare provider (HCP), the nurse should prepare for which procedure?

A male client who fractured his right femur from a fall at home is placed in Buck’s skin traction while awaiting surgery. When the client informs the nurse of the need to urinate, which intervention should the nurse implement?