Clinicals and Dosage

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Sample questions from Clinicals and Dosage

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 68-year-old client on a medical unit has heart failure, new pink frothy sputum, respiratory rate 32/min, and oxygen saturation 84% on room air. Blood pressure is 168/94 mm Hg. Which action should the nurse take first?

   • A.Administer the scheduled oral furosemide.
   • B.Position the client upright and apply oxygen while activating the rapid response team.
   • C.Obtain a daily weight using the standing scale.
   • D.Restrict oral fluids and document intake.

   Rationale: Severe hypoxemia and pink frothy sputum suggest acute pulmonary edema, requiring immediate oxygenation support and emergency assistance. Oral furosemide has a slower onset and does not replace immediate stabilization. Standing for a weight increases exertion, and fluid restriction will not rapidly reverse respiratory compromise. On priority questions, address an immediate breathing threat before routine monitoring or longer-term management.

2. 2.A 46-year-old client in an outpatient clinic reports postoperative pain rated 5/10. Acetaminophen 650 mg orally is prescribed, and 325 mg tablets are available. The client has no liver disease and has received no acetaminophen today. How many tablets should the nurse administer?

   • A.1 tablet
   • B.1.5 tablets
   • C.2 tablets
   • D.3 tablets

   Rationale: Divide the prescribed 650 mg by the available 325 mg per tablet to obtain 2 tablets. One tablet supplies only 325 mg, and 1.5 tablets supplies 487.5 mg. Three tablets supplies 975 mg and exceeds the prescribed single dose. Always verify the total daily acetaminophen exposure, including combination products.

3. 3.A 4-year-old child weighing 18 kg is treated in urgent care for acute otitis media. The prescription is amoxicillin 45 mg/kg/dose orally every 12 hours, and the suspension contains 400 mg/5 mL. How many milliliters should the nurse administer per dose? Round to the nearest tenth.

   • A.5.1 mL
   • B.10.1 mL
   • C.20.3 mL
   • D.2.3 mL

   Rationale: The prescribed dose is 18 kg x 45 mg/kg = 810 mg, and 810 mg x 5 mL/400 mg = 10.125 mL, rounded to 10.1 mL. Giving 5.1 mL incorrectly divides a per-dose prescription into two doses. Giving 20.3 mL doubles the dose, while 2.3 mL does not reflect the prescribed weight-based amount. Distinguish mg/kg/dose from mg/kg/day before calculating a pediatric medication volume.

4. 4.A 59-year-old client in the emergency department has dehydration, blood pressure 96/60 mm Hg, and pulse 108/min. The provider prescribes 1,000 mL of 0.9% sodium chloride over 8 hours. At what rate should the nurse program the infusion pump?

   • A.80 mL/hr
   • B.100 mL/hr
   • C.150 mL/hr
   • D.125 mL/hr

   Answer and rationale are in the full material.

5. 5.A 34-year-old client in an ambulatory infusion center is prescribed 500 mL of lactated Ringer's solution over 4 hours. The gravity tubing delivers 15 gtt/mL. How many drops per minute should the nurse regulate? Round to the nearest whole drop.

   • A.21 gtt/min
   • B.31 gtt/min
   • C.42 gtt/min
   • D.125 gtt/min

   Answer and rationale are in the full material.