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A nurse is preparing to administer 12 L of lactated Ringer’s IV to infuse over 24 hr. Half of the fluid is to be administered in the first 8 hr. The nurse should set the IV pump to deliver how many mL/hr during the first 8 hr?
(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Answer and Explanation

The Correct Answer is ["750"]

To calculate the infusion rate for the first 8 hours, we can use the following formula:

Infusion rate (mL/hr) = (Volume to be infused / Time for infusion)

First, we need to find the volume to be infused in the first 8 hours:

Volume for the first 8 hours = Total volume / 2 = 12 L / 2 = 6 L = 6000 mL

Now we can calculate the infusion rate for the first 8 hours:

Infusion rate = 6000 mL / 8 hr = 750 mL/hr

Therefore, the nurse should set the IV pump to deliver 750 mL/hr during the first 8 hours.

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Correct Answer is B

Explanation

Choice A reason: This choice is incorrect because there is no need to recheck the heart rate in one hour before giving the digoxin. The client's apical heart rate is within the normal range (60 to 100 beats per minute) and does not indicate bradycardia (slow heart rate), which is a sign of digoxin toxicity. The nurse should check the apical heart rate for one full minute before giving the digoxin and withhold the dose if the heart rate is below 60 beats per minute.

Choice B reason: This choice is correct because the client's digoxin level is within the therapeutic range (0.5 to 2.0 ng/mL) and does not indicate digoxin toxicity or underdosing. The client's vital signs and labs are also stable and do not indicate any adverse effects of digoxin. Digoxin is a cardiac glycoside that improves the contractility and efficiency of the heart and helps to control the heart rate and rhythm in clients with heart failure. The nurse should give the digoxin as ordered and monitor the client's response and digoxin level.

Choice C reason: This choice is incorrect because there is no indication for a chest x-ray for this client. A chest x-ray is a diagnostic test that can show the size and shape of the heart and lungs and detect any abnormalities, such as fluid accumulation, infection, or tumors. The client's symptoms and labs do not suggest any pulmonary complications or worsening of heart failure that would require a chest x-ray. The nurse should follow the provider's orders and protocols for chest x-ray indications.

Choice D reason: This choice is incorrect because there is no reason to hold the digoxin and call the MD for this client. The client's digoxin level is not too high or too low and does not require dose adjustment or discontinuation. The client's vital signs and labs are also normal and do not indicate any signs of digoxin toxicity or adverse effects. Holding the digoxin could cause the client's heart failure to worsen or cause arrhythmias. The nurse should only hold the digoxin and call the MD if the client has signs of digoxin toxicity, such as nausea, vomiting, visual disturbances, confusion, or bradycardia. .

Correct Answer is ["83"]

Explanation

To calculate the IV flow rate in drops per minute, we can use the following formula:

IV flow rate (gtt/min) = (Volume to be infused in mL drop factor) / Time in minutes

Given:

Volume to be infused = 250 mL

Drop factor = 10 gtt/mL

Time = 30 minutes

Using the formula:

IV flow rate = (250 mL 10 gtt/mL) / 30 min

IV flow rate ≈ (2500 gtt) / 30 min

IV flow rate ≈ 83.33 gtt/min

Rounding to the nearest whole number, the nurse should set the manual IV flow rate to deliver 83 gtt/min.

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Naxlex Comprehensive Predictor Exams

A patient is being treated for heart failure. Labs: Sodium 146 meq/L, Potassium 4.2 mmol/L, Hemoglobin 10.5 gm/dL, White Blood Cells 12.2, digoxin level 0.8 ng/mL VS: BP 118/66, apical heart rate 68, O2 96% on 2L nasal cannula, temperature 98.4°F What will the nurse do with the digoxin order?

Correct Answer is B

Explanation

Correct Answer is ["83"]

Explanation

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