A nurse is caring for a client who has a pulmonary embolism and has a new prescription for enoxaparin 1.5 mg/kg/dose subcutaneously every 12 hours. The client weighs 245 lbs. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
The Correct Answer is ["167 "]
To calculate the dose of enoxaparin, follow these steps:
1) Convert the client's weight from pounds to kilograms:
245 lbs / 2.2046 (kg/lb) = 111.13 kg (rounded to the nearest whole number, it's 111 kg).
2) Multiply the weight in kilograms by the prescribed dose per kilogram:
111 kg x 1.5 mg/kg = 166.5 mg.
Round the answer to the nearest whole number, so the nurse should administer 167 mg per dose of enoxaparin every 12 hours to the client with a pulmonary embolism.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is C
Explanation
Choice A Reason: This is incorrect because a client who is post-CABG and has high cholesterol is not in immediate danger, as atorvastatin is a long-term medication that lowers cholesterol and prevents cardiovascular complications.
Choice B Reason: This is incorrect because a client who has pneumonia and a slightly elevated WBC count is not in immediate danger, as piperacillin is an antibiotic that treats bacterial infections.
Choice C Reason: This is correct because a client who has renal failure and a high serum potassium level is in immediate danger, as sodium polystyrene sulfonate is an emergency medication that lowers potassium and prevents cardiac arrhythmias.
Choice D Reason: This is incorrect because a client who has anemia and a mild hemoglobin deficiency is not in immediate danger, as epoetin alfa is a long-term medication that stimulates red blood cell production and improves oxygen delivery.
Correct Answer is B
Explanation
Choice A Reason: This choice is incorrect because oral hypoglycemic medications are not effective for treating DKA. Oral hypoglycemic medications are drugs that lower the blood glucose level by stimulating insulin secretion or increasing insulin sensitivity. They may be used for clients who have type 2 diabetes mellitus, but they do not work for clients who have type 1 diabetes mellitus or DKA.
Choice B Reason: This choice is correct because 0.9% sodium chloride IV bolus is an effective treatment for DKA. 0.9% sodium chloride is an isotonic solution that contains the same concentration of solutes as blood plasma. It may be used for clients who have fluid loss, dehydration, or shock. In DKA, the body breaks down fat for energy due to insulin deficiency or resistance, resulting in high levels of ketones and acids in the blood. This causes osmotic diuresis, dehydration, electrolyte imbalance, and metabolic acidosis. Therefore, administering 0.9% sodium chloride IV bolus can help to restore fluid volume and correct electrolyte imbalance.
Choice C Reason: This choice is incorrect because dextrose 5% in 0.45% sodium chloride is not indicated for treating DKA. Dextrose 5% in 0.45% sodium chloride is a hypertonic solution that contains more solutes than blood plasma. It may be used for clients who have hyponatremia, cerebral edema, or malnutrition, but it can worsen hyperglycemia and osmotic diuresis in clients who have DKA.
Choice D Reason: This choice is incorrect because glucocorticoid medications are not indicated for treating DKA. Glucocorticoid medications are drugs that mimic the effects of cortisol, a hormone that regulates stress response and inflammation. They may be used for clients who have allergic reactions, asthma, or autoimmune diseases, but they can increase blood glucose levels and inhibit insulin action in clients who have DKA.
