D441 (ZOO1) MDC pharm OA1 (HESI Dosage Calculation and pharmacology)

35. The nurse is preparing a client’s dose of an IM analgesic in a single syringe. The prescription is hydromorphone 4 mg and hydroxyzine 25 mg. The hydromorphone ampule is labeled 10 mg/mL, and the hydroxyzine is labeled 50 mg/mL. How many mL in total should the nurse administer?

• A. 0.4 mL
• B. 0.5 mL
• C. 0.9 mL
• D. 1.0 mL

36. The healthcare provider prescribes ampicillin 140 mg intravenously (IV) every 8 hours for a child with meningitis. The vial is labeled, ‘Ampicillin 250 mg for reconstitution with 8.3 mL sterile normal saline for injection to yield a total solution concentration of 30 mg/mL.’ How many mL should the nurse administer?

• A. 3.7 mL
• B. 4.0 mL
• C. 4.7 mL
• D. 5.0 mL

37. The healthcare provider prescribes cytovene 375 mg every 12 hours to infuse over 90 minutes. The pharmacy delivers cytovene 375 mg in a 150 mL IV bag. How many mL/hour should the nurse program the infusion pump?

• A. 75 mL/hr
• B. 90 mL/hr
• C. 100 mL/hr
• D. 150 mL/hr

38. The nurse is administering an intradermal (ID) injection to a client. Which action should the nurse take?

• A. Select upper arm as the injection site.
• B. Ensure bevel of the needle is pointing up.
• C. Hold the syringe perpendicular to the skin.
• D. Massage the site gently after injection.

39. After a seven day treatment with an IV antibiotic, the healthcare provider discharges a client from the hospital and writes a prescription for an oral antibiotic. While providing discharge instructions, the nurse notes that the dosage for the oral antibiotic is significantly higher than the IV antibiotic. Which resource should the nurse use first in resolving the situation?

• A. Medication reference guide.
• B. Healthcare provider.
• C. Nursing unit charge nurse.
• D. Hospital pharmacist.

40. A client has a prescription for heparin 1,000 units IV STAT. Several pre-filled syringes of low molecular weight heparin are available in the client’s medication drawer. Which action should the nurse implement?

• A. Advise the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately.
• B. Dilute the available heparin in 250 mL of normal saline solution prior to IV administration.
• C. Calculate and administer the equivalent dose of the available low molecular weight heparin.
• D. Request a prescription to change the route of administration and use the available heparin.

41. The nurse is administering sevelamer during lunch to a client with chronic kidney disease (CKD). The client asks the nurse to bring the medication later. The nurse should describe which action of sevelamer as an explanation for taking it with meals?

• A. Promotes stomach emptying and prevents gastric reflux.
• B. Binds with phosphorus in foods and prevents absorption.
• C. Buffers hydrochloric acid and prevents gastric erosion.
• D. Prevents indigestion associated with ingestion of spicy foods.

42. A client scheduled for coronary artery bypass surgery (CABG) is to receive an IV infusion of cefazolin 1 gram in 50 mL 0.9% sodium chloride over 30 minutes. How many mL/hour should the nurse program the infusion pump to deliver?

• A. 50 mL/hr
• B. 75 mL/hr
• C. 100 mL/hr
• D. 120 mL/hr

43. A client diagnosed with primary open angle glaucoma received a prescription for miotic eye drops. Which instruction should the nurse plan to include in this client’s teaching?

• A. ‘Squeeze your eye closed after administering the drops.’
• B. ‘Do not allow the dropper bottle to touch the eye.’
• C. ‘Wash your hands after each administration of eye drops.’
• D. ‘Administer the medication directly on the cornea.’

44. Two months after taking nitrofurantoin for a bacterial infection, a client reports the onset of severe, watery diarrhea to the home health nurse. How should the nurse respond?

• A. Determine if the full course of the initial prescription of medication was taken.
• B. Advise that the infection has returned and additional medication will be needed.
• C. Offer instructions about the use of an over-the-counter (OTC) antidiarrheal medication.
• D. Explain that the diarrhea may be an adverse effect that requires further evaluation.

45. A child who weighs 44 pounds with otitis media receives a prescription for azithromycin 10 mg/kg once, then 10 mg/kg daily for 4 days. The medication is available in a solution containing 200 mg/5 mL. How many mL should the nurse administer on the first day of the treatment regimen?

• A. 2.5 mL
• B. 5 mL
• C. 7.5 mL
• D. 10 mL

46. A client receives a prescription for ciprofloxacin 400 mg intravenously (IV) every 12 hours, which is to be infused over an hour. The IV bag contains ciprofloxacin 400 mg in dextrose 5% in water (DW) 200 mL. How many mL/hr should the nurse program the infusion pump to deliver?

• A. 100 mL/hr
• B. 150 mL/hr
• C. 200 mL/hr
• D. 250 mL/hr

47. A client is receiving one liter of D5W 0.45% normal saline IV every 8 hours by gravity infusion. The IV tubing has a drip factor of 12 gtt/mL. How many drops per minute should the nurse regulate the IV to deliver?

• A. 20 gtt/min
• B. 25 gtt/min
• C. 30 gtt/min
• D. 35 gtt/min

48. The client is receiving fentanyl transdermal patch 25 mcg/hr. Which nursing intervention is most important for the nurse to initiate?

• A. Auscultate the client’s bowel sounds.
• B. Assess the client’s level of consciousness (LOC).
• C. Record the client’s urinary output.
• D. Observe the client’s mucous membranes.

49. A client is receiving D5W at 125 mL/hour and a secondary infusion of pantoprazole 40 mg IV daily. The pharmacy provides a 110 mL premixed solution of pantoprazole to be infused over 15 minutes. How many mL per hour should the nurse program the secondary infusion?

• A. 220 mL/hr
• B. 330 mL/hr
• C. 440 mL/hr
• D. 550 mL/hr

50. Which nursing action has the highest priority when administering a dose of codeine with acetaminophen to a client?

• A. Administer a stool softener/laxative at the same time as the analgesic.
• B. Tell the client to notify the nurse if the pain is not relieved.
• C. Advise the client that the medication should start to work in about 30 minutes.
• D. Instruct the client to request assistance when ambulating to the bathroom.

51. A male client receives a scopolamine transdermal patch 2 hours before surgery. Four hours after surgery, the client tells the nurse that he is experiencing pain and asks why the patch is not working. Which action should the nurse take?

• A. Check for correct placement of the patch behind the client’s ear.
• B. Advise the client that the effects of the medication have worn off.
• C. Explain that the medication is not given to prevent pain.
• D. Offer to apply a new transdermal patch to relieve the pain.

52. A client with allergic rhinitis is taking the over-the-counter antihistamine diphenhydramine HCL. Which instruction is most important for the nurse to provide this client?

• A. Do not take the medication more than once every 8 hours.
• B. Take the medication with food to prevent gastric upset.
• C. Use sugarless candy or gum to help prevent a dry mouth.
• D. Avoid driving, since this medication causes drowsiness.
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