Vistaril 75 mg IM is ordered for anxiety. Available: 50 mg/mL. How many milliliters will the nurse administer?

1 mL

1.5 mL

2 mL

2.5 mL

Answer and Explanation

The Correct Answer is B

Choice A reason: 1 mL gives 50 mg; this underdoses the 75 mg order, reducing Vistaril’s sedative effect, risking inadequate anxiety relief for the patient.

Choice B reason: 1.5 mL is correct; 75 mg divided by 50 mg/mL equals 1.5 mL, delivering the precise IM dose for effective anxiolytic action safely.

Choice C reason: 2 mL provides 100 mg; this overdoses Vistaril, risking excessive sedation or hypotension, exceeding the ordered therapeutic amount unnecessarily.

Choice D reason: 2.5 mL yields 125 mg; this far exceeds 75 mg, amplifying side effects like drowsiness or respiratory depression, unsafe for anxiety management.

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Correct Answer is A

Explanation

Choice A reason: Blood indicates vascular entry; discarding prevents unintended IV delivery of an IM drug, avoiding rapid absorption risks and ensuring proper route administration.

Choice B reason: Giving with blood risks IV administration; IM drugs aren’t formulated for this, potentially causing embolism or toxicity, violating safety administration principles.

Choice C reason: Changing the needle leaves contaminated medication; blood-mixed drugs are unsafe, and this fails to address the compromised dose integrity fully.

Choice D reason: Omitting skips treatment needlessly; the issue is procedural, not the order, and restarting ensures the patient receives the intended therapy safely.

A. The patient will continually require higher doses of the drug for the same effect to be achieved. B. Tolerance occurs when the liver or kidneys are no longer able to metabolize the drug. C. The patient will require a stable dose of the medication until the drug is discontinued. D. Tolerance only develops when the patients do not take the medication as it is prescribed.

Correct Answer is A

Explanation

Choice A reason: Tolerance reflects receptor desensitization or enzyme induction; higher doses compensate for reduced drug efficacy, a common pharmacological adaptation.

Choice B reason: Organ failure affects metabolism, not tolerance; tolerance is a cellular response, not solely a failure of liver or kidney drug clearance mechanisms.

Choice C reason: Stable dosing contradicts tolerance; if tolerance develops, efficacy drops, necessitating dose increases, not maintenance, to achieve therapeutic levels.

Choice D reason: Non-adherence may alter response, but tolerance occurs with consistent use; it’s a physiological adaptation, not a result of misuse or skipping doses.

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Vistaril 75 mg IM is ordered for anxiety. Available: 50 mg/mL. How many milliliters will the nurse administer?

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