The nurse is preparing to administer enoxaparin (Lovenox) 135 mg subcutaneously. The medication is available in a cartridge labeled 150 mg/ml. How many ml should the nurse administer? (enter numeric value only. If rounding is required, round to the nearest tenth.)

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) 0.9 ml. To arrive at this answer, the nurse needs to calculate the dose based on the available concentration of enoxaparin (150 mg/ml) and the prescribed dose of 135 mg. To calculate the volume needed, the nurse can use the formula: Volume (ml) = Dose (mg) / Concentration (mg/ml) Substituting the values: Volume = 135 mg / 150 mg/ml Volume = 0.9 ml Therefore, the nurse should administer 0.9 ml of enoxaparin. Option B) 1 ml is incorrect because administering 1 ml would result in giving slightly more medication than the prescribed dose of 135 mg. Option C) 9 ml is significantly higher than the correct answer and would result in a substantial overdose, posing serious risks to the pediatric patient. Option D) 0 ml is incorrect as it implies not administering any medication, which would be incorrect when a dose of enoxaparin has been prescribed for the patient. Understanding medication calculations and dose conversions is crucial for nurses to ensure accurate and safe administration of medications, especially in pediatric patients where dosages need to be precise to prevent adverse effects. Nurses must be proficient in performing these calculations to deliver effective patient care.

Correct Answer: B

Rationale: In this scenario, option B, which involves sending wound drainage for culture and sensitivity, is the correct nursing intervention. This action is crucial to identify the causative organism, such as MRSA, and determine the most appropriate antibiotic for treatment. By obtaining cultures, the healthcare team can tailor the antibiotic therapy to target the specific pathogen, improving the chances of successful treatment and preventing antibiotic resistance. Option A, instituting contact precautions, is certainly important in cases of suspected MRSA to prevent the spread of infection. However, it is not the immediate nursing intervention required to address the client's condition. Monitoring the client's white blood cell count, as mentioned in option C, is relevant in assessing for signs of infection, but it is not the priority action when dealing with a client with draining skin lesions potentially caused by MRSA. Option D, administering broad-spectrum antibiotics before obtaining cultures, is not recommended because it can lead to inappropriate treatment and potential antibiotic resistance. Using broad-spectrum antibiotics without knowing the specific pathogen can be detrimental to the client and is not in line with evidence-based practice. For educational context, it is essential for nurses to understand the importance of obtaining cultures and sensitivities before initiating antibiotic therapy, especially in cases like MRSA infections where appropriate antibiotic selection is critical. This approach aligns with the principles of prudent antibiotic use, individualized patient care, and antimicrobial stewardship, all of which are crucial in combating antibiotic resistance.

Correct Answer: A

Rationale: In this question, the correct answer is A) 0.8 ml. To determine the correct dosage to administer, the nurse needs to calculate based on the concentration of the medication in the vial and the prescribed dose. Since each 1 ml of the solution contains 10,000 units of epoetin alfa, and the prescribed dose is 8,200 units, the nurse should administer 0.8 ml (8,200 units / 10,000 units/ml = 0.82 ml). Option B) 8 ml is incorrect because it does not consider the concentration of the medication in the vial. Option C) 0 ml is incorrect as the patient does require medication administration. Option D) 1 ml is incorrect as it would result in administering more medication than the prescribed dose. Educationally, this question highlights the importance of medication dosage calculations in nursing practice, especially in the context of pediatric patients with specific conditions like chronic kidney disease. Nurses must have a strong understanding of medication concentrations and prescribed doses to ensure accurate and safe administration, emphasizing the critical role of pharmacology knowledge in nursing care.

Correct Answer: A

Rationale: In this scenario, the nurse should report a potassium level of 6.5 mEq/L (mmol/L) to the healthcare provider immediately. In patients with chronic kidney disease (CKD), especially those who missed dialysis, hyperkalemia (high potassium levels) can occur. High potassium levels can lead to serious cardiac arrhythmias, which can be life-threatening. The symptoms of shortness of breath, weakness, and the elevated heart rate in this patient may be indicative of cardiac distress due to hyperkalemia. Option A (Potassium 6.5 mEq/L) is the correct answer because it reflects the critical value of hyperkalemia that requires immediate intervention. Option B (Potassium 6 mEq/L) is incorrect because it is still elevated but not as critical as 6.5 mEq/L. Options C (Potassium 0.5 mEq/L) and D (Potassium 1.5 mEq/L) are both extremely low potassium levels, indicating hypokalemia, which is not consistent with the clinical presentation of the patient and is not the immediate concern. Educationally, this question highlights the importance of recognizing critical laboratory values, understanding the implications of electrolyte imbalances in patients with CKD, and the need for prompt intervention to prevent serious complications in this population. Nurses must be vigilant in monitoring and managing electrolyte levels in patients with renal impairment to ensure optimal outcomes.

Correct Answer: A

Rationale: In the context of a client with chronic pancreatitis experiencing persistent gnawing abdominal pain, the most important assessment data for the nurse to obtain is eating patterns and dietary intake (Option A). This is crucial because in pancreatitis, the pancreas is inflamed and struggles to produce digestive enzymes, leading to malabsorption of nutrients. Certain foods can exacerbate pancreatitis symptoms, such as fatty or spicy foods. By assessing the client's eating patterns and dietary intake, the nurse can identify potential triggers for the abdominal pain and provide appropriate dietary recommendations to manage the pain and prevent further complications. Option B, level and amount of physical activity, while important in overall health management, is not directly related to managing abdominal pain in chronic pancreatitis. Option C, color and consistency of feces, is more indicative of pancreatic enzyme insufficiency, which may manifest as steatorrhea (fatty stools) but is not directly related to managing abdominal pain. Option D, presence and activity of bowel sounds, is more relevant in assessing gastrointestinal motility but may not directly address the underlying cause of the abdominal pain in chronic pancreatitis. Educationally, understanding the relationship between diet and pancreatitis symptoms is crucial for nurses caring for clients with this condition. By emphasizing the importance of assessing eating patterns and dietary intake, nurses can contribute significantly to symptom management and overall well-being of their clients with chronic pancreatitis.