LATEST FUNDAMENTAL PN HESI SPECIALTY V2

LATEST FUNDAMENTAL PN HESI SPECIALTY V2 1. The prescriber wrote for a 40-kg child to receive 25 mg of medication 4 times a day. The therapeutic range is 5 to 10 mg/kg/day. What is the nurse’s priority? a. Change the dose to one that is within range. b. Administer the medication because it is within the therapeutic range. Notify the health care provider that the prescribed dose is in the toxic range. Notify the health care provider that the prescribed dose is below the therapeutic range. ANS: D The dosage range is 200 to 400 mg a day (5 × 40 = 200 and 10 × 40 = 400). The prescribed dose is 100 mg/day (4 × 25 = 100), which is below therapeutic range. The nurse should notify the health care provider first and ask for clarification on the order. The dose is not above the therapeutic range and is not at a toxic level. The nurse should never alter an order without the prescriber’s approval and consent. 2. The supervising nurse is observing several different nurses. Which action will cause the supervising nurse to intervene? a. A nurse administers a vaccine without aspirating. A nurse gives an IV medication through a 22-gauge IV needle without b. blood return. A nurse draws up the NPH insulin first when mixing a short-acting and intermediate-acting insulin. A nurse calls the health care provider for a patient with nasogastric suction and orders for oral meds. ANS: C The supervising nurse must intervene with the nurse who is drawing up the NPH insulin first; if regular and intermediate-acting (NPH) insulin is ordered, prepare the regular insulin first to prevent the regular insulin from becoming contaminated with the intermediate-acting insulin. All the other actions are appropriate and do not need follow-up. The CDC no longer recommends aspiration when administering immunizations to reduce discomfort. In some cases, especially with a smaller gauge (22) IV needle, blood return is not aspirated, even if the IV is patent. If the IV site shows no signs of infiltration and IV fluid is infusing without difficulty, proceed with IV push slowly. Oral meds are contraindicated in patients with nasogastric suction. 3. A nurse is caring for a patient who is receiving pain medication through a 1 saline lock. After obtaining a good blood return when the nurse is flushing the patient’s peripheral IV, the patient reports pain. Upon assessment, the nurse notices a red streak that is warm and tender to the touch. What is the nurse’s initial action? a. Do not administer the pain medication. b. Administer the pain medication slowly. c. Apply a warm compress to the site.