The healthcare provider prescribes the antibiotic surgical prophylaxis protocol for a client who weighs 90 kg. The protocol is cefazolin 2 grams/100 mL. 0.9% normal saline over 1 hour for clients weighing less than 285.5 pounds or cefazolin 3 grams/100 mL 0.9% normal saline over 90 minutes for clients weighing greater than 265.5 pounds. The nurse should program the pump to deliver how many mL/hr? (Enter number value only. If rounding is required, round to the nearest whole number.)

Answer and Explanation

The Correct Answer is ["100"]

Since the client weighs 90 kg, let’s first convert their weight to pounds to determine the appropriate cefazolin dosage:

Conversion factor: 1 kg = 2.205 pounds

Client weight (pounds) = 90 kg x 2.205 pounds/kg = 198.45 pounds (rounded to two decimals)

Now, comparing the client’s weight (198.45 pounds) to the weight threshold (265.5 pounds):

Client weight is less than the threshold (198.45 pounds < 265.5 pounds).

Therefore, the appropriate dosage is:

Cefazolin 2 grams/100 mL 0.9% normal saline over 1 hour.

The pump rate is determined by the total volume of the IV fluid and the infusion time.

We are not given the specific bag size, but typically these come in 100 mL or 500 mL volumes.

Assuming a 100 mL bag (which aligns with the concentration provided):

Total volume of IV bag: 100 mL

Infusion time: 1 hour

Calculation:

Pump rate (mL/hr) = Total volume (mL) / Infusion time (hr)

Pump rate (mL/hr) = 100 mL / 1 hour = 100 mL/hr

Therefore, the nurse should program the pump to deliver 100 mL/hr.

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Correct Answer is C

Explanation

A) Remove the patch and consult with the healthcare provider about the client’s pain resolution: While it’s essential to assess the need for continued pain management, removing the patch without replacing it could lead to inadequate pain control, especially if the client still requires opioid analgesia. Additionally, fentanyl patches are typically left in place for their prescribed duration, and removing them prematurely could disrupt the pain management plan.

B) Place the patch on the client's sh’ulder and leave both patches in place for 12 hours: Applying a new patch without removing the previous one could result in a higher-than-intended dose of fentanyl, increasing the risk of opioid toxicity. Leaving both patches in place simultaneously is not recommended.

C) Apply the new patch in a different location after removing the original patch: This is the correct action. Applying the new patch in a different location helps prevent skin irritation and ensures consistent drug absorption. Rotating patch sites according to the manufacturer's in’tructions is important for optimal medication delivery.

D) Administer an oral analgesic and evaluate its effectiveness before applying the new patch: While oral analgesics may provide temporary relief, they may not be as effective as transdermal fentanyl for managing chronic pain, especially if the client has been on a stable regimen of fentanyl patches. Additionally, delaying the application of the new patch could lead to inadequate pain control.

A. Sleeps soundly through the night. B. Exhibits fewer emotional outbursts. C. Improved ability to concentrate. D. Decreased episodes of incontinence,

Correct Answer is A

Explanation

A) Sleeps soundly through the night: Zolpidem is a sedative-hypnotic medication commonly prescribed for the short-term treatment of insomnia in older adults. The desired outcome of administering zolpidem is improved sleep quality, including the ability to sleep soundly through the night. Documenting that the client sleeps soundly through the night indicates that the medication has achieved its intended effect of promoting sleep.

B) Exhibits fewer emotional outbursts: While zolpidem may indirectly contribute to emotional stability by improving sleep quality, it is not primarily indicated for reducing emotional outbursts. Therefore, this documentation does not specifically reflect the desired outcome of zolpidem administration.

C) Improved ability to concentrate: Zolpidem’s primary effect is on sleep induction rather than concentration. While improved sleep may indirectly enhance concentration in some cases, this documentation does not directly relate to the intended outcome of zolpidem therapy.

D) Decreased episodes of incontinence: Zolpidem is not indicated for the treatment of urinary incontinence, so documenting a decrease in episodes of incontinence would not reflect the desired outcome of zolpidem administration.

Therefore, the most appropriate documentation indicating that the desired outcome has been achieved when administering zolpidem to an older client is that the client “sleeps soundly through the night.” This reflects the medication’s primary purpose of improving sleep quality and duration.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing to apply the client’s scheduled fentanyl transdermal patch. The nurse notes the previously applied patch is intact on the client’s upper back and the client reports no pain. Which action should the nurse take?

Correct Answer is C

Explanation

When administering zolpidem to an older client, which computer documentation indicates that the desired outcome has been achieved?

Correct Answer is A

Explanation

The loop diuretic furosemide is prescribed for a client with a history of heart failure (HF). Which foods should the nurse encourage this client to eat?

Before administering a laxative to a bedfast client, it is most important for the nurse to perform which assessment?

A client who is receiving pregabalin for fibromyalgia reports experiencing tremors in the hands. Which action should the nurse implement?

A peak and trough level was obtained from a client receiving an aminoglycoside IV every 8 hours. Which finding presents the highest risk for the client and should be reported immediately to the healthcare provider?

The nurse is providing discharge instructions for a client with metastatic cancer who is proscribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

Which instruction should the nurse include when teaching a client about self-administration of a bulk-forming laxative?

A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?