Nursing Elites

1. The healthcare provider prescribes Amoxicillin 500mg PO every 8hrs for a child who weighs 22 pounds. The available suspension is labeled Amoxicillin Suspension 250mg/5ml. The recommended maximum dose is 50mg/kg/24hr. How many mL should the nurse administer in a single dose based on the child’s weight?

• A. 10mL
• B. 15mL
• C. 7.5mL
• D. 5mL

Correct answer: A

Rationale: To calculate the dose for the child weighing 22 pounds, first convert the weight to kg: 22 lbs ÷ 2.2 = 10 kg. The maximum dose based on weight would be 10 kg × 50 mg/kg/24hr = 500 mg/24hr. Since the medication is prescribed every 8 hours, the dose for each administration would be 500 mg ÷ 3 doses = 166.67 mg. As the available suspension is 250mg/5ml, the nurse should administer 166.67 mg ÷ 250 mg/mL = 0.67 mL per dose. However, since it's not practical to administer a fraction of a milliliter, the nurse should round up to the nearest appropriate dose, which is 10mL.

2. During a prenatal visit, the LPN/LVN discusses with a client the effects of smoking on the fetus. When compared with nonsmokers, mothers who smoke during pregnancy tend to produce infants who have

• A. lower Apgar scores.
• B. lower birth weights.
• C. respiratory distress.
• D. a higher rate of congenital anomalies.

Correct answer: B

Rationale: When mothers smoke during pregnancy, it is associated with intrauterine growth restriction, which leads to lower birth weights in infants. Maternal smoking can restrict the flow of oxygen and nutrients to the fetus, affecting its growth and development. This can result in babies being born with lower birth weights, which can have various health implications for the newborn. Choices A, C, and D are incorrect as smoking during pregnancy is primarily linked to intrauterine growth restriction and lower birth weights in infants, rather than lower Apgar scores, respiratory distress, or a higher rate of congenital anomalies.

3. The nurse is caring for a female client, a primigravida with preeclampsia. Findings include +2 proteinuria, BP 172/112 mmHg, facial and hand swelling, complaints of blurry vision and a severe frontal headache. Which medication should the nurse anticipate for this client?

• A. Clonidine hydrochloride
• B. Carbamazepine
• C. Furosemide
• D. Magnesium sulfate

Correct answer: D

Rationale: In the scenario presented, the client is exhibiting signs and symptoms of severe preeclampsia, including hypertension, proteinuria, facial and hand swelling, visual disturbances, and a severe headache. The medication of choice for preventing seizures in preeclampsia is magnesium sulfate. This drug helps to prevent and control seizures in clients with preeclampsia, making it the most appropriate option for this client. Clonidine hydrochloride (Choice A) is an antihypertensive medication used for managing hypertension but is not the first-line treatment for preeclampsia. Carbamazepine (Choice B) is an anticonvulsant used for seizure disorders like epilepsy and is not indicated for preeclampsia. Furosemide (Choice C) is a diuretic used to manage fluid retention but is not the drug of choice for treating preeclampsia.

4. A 16-year-old gravida 1, para 0 client has just been admitted to the hospital with a diagnosis of eclampsia. She is not presently convulsing. Which intervention should the nurse plan to include in the client's nursing care plan?

• A. Assess temperature every hour.
• B. Allow liberal family visitation.
• C. Monitor blood pressure, pulse, and respirations every 4 hours.
• D. Keep an airway at the bedside.

Correct answer: D

Rationale: In the case of eclampsia, the priority intervention is to keep an airway at the bedside. Eclampsia is associated with a high risk of convulsions, and having an airway readily available is crucial for prompt intervention in the event of seizures. Assessing temperature, allowing family visitation, and monitoring vital signs are important aspects of care but ensuring airway patency takes precedence in this situation to manage potential complications and ensure the client's safety.

5. Which physical assessment data should the nurse consider a normal finding for a primigravida client who is 12 hours postpartum?

• A. Unilateral lower leg pain.
• B. Saturating two perineal pads per hour.
• C. Pulse rate of 56 bpm.
• D. Soft, spongy fundus.

Correct answer: C

Rationale: A pulse rate of 56 bpm is a normal finding for a primigravida client who is 12 hours postpartum. Bradycardia (pulse rate 50-70 bpm) can be a normal postpartum occurrence due to increased stroke volume and decreased cardiac output after delivery. Unilateral lower leg pain and saturating two perineal pads per hour are not normal findings and require further assessment. A soft, spongy fundus could indicate uterine atony, which is abnormal postpartum.

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