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A nurse is preparing to administer heparin at 1,000 units/hr via continuous IV infusion to a client who had a coronary artery bypass graft. Available is heparin 25,000 units in dextrose 5% in water in 250 mL. The nurse should set the IV pump to deliver how many mL/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 ["10"]

The formula to calculate the IV flow rate is:

mL/hr =

(Desired dose (units/hr)×Total volume (mL))/ Available dose

Substituting the given values:

(1,000×250)/25000

= 250,000/25,000

= 10ml/hr

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Have the client hold their breath during the examination. This is not recommended, as slow, deep breathing helps the client relax and reduces discomfort.
B. Ensure that the client's bladder is full. The bladder should be emptied before the exam to enhance comfort and allow better access for the provider.
C. Instruct the client to bear down when the speculum is inserted. This helps relax the pelvic muscles and makes insertion easier, reducing discomfort.
D. Place the client in modified Sims' position. The lithotomy position is the correct positioning for a pelvic examination, not modified Sims'.

A. The client has been in the restraints for 4 hr. B. The client can explain the reasons for their behavior. C. The client is able to calmly follow commands." D. The client reports that the restraints are too tight.

Correct Answer is C

Explanation

A. The client has been in the restraints for 4 hr. This is incorrect because the duration of restraint use is determined by the client's behavior and safety, not a set time frame. Restraints should be discontinued as soon as they are no longer necessary.
B. The client can explain the reasons for their behavior. This is incorrect because insight into behavior does not necessarily indicate that the client is no longer a danger to themselves or others.
C. The client is able to calmly follow commands. This is correct because the primary indication for removing restraints is when the client demonstrates self-control and the ability to follow directions, reducing the risk of harm.
D. The client reports that the restraints are too tight. This is incorrect because a complaint of tight restraints indicates a need for reassessment and possible adjustment, but not necessarily discontinuation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing a client for a pelvic examination. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is assessing a client who is in mechanical restraints after hitting a staff member. Which of the following findings indicates that the nurse should discontinue the restraints?

Correct Answer is C

Explanation

A nurse observes two assistive personnel (AP) discussing a client's information in the facility cafeteria. Which of the following actions should the nurse take?

A nurse is providing change-of-shift report about a client to an oncoming nurse. Which of the following information should the nurse include?

A nurse is teaching a client who has a new prescription for tetracycline. Which of the following information should the nurse include in the teaching?

A nurse is teaching a class of newly licensed nurses about infectious diseases that nurses are required to report to the health department. Which of the following diseases should the nurse include in the teaching?

A nurse manager is reviewing medical records to recommend clients for discharge following a local mass casualty event. Which of the following clients should the nurse recommend for discharge?

A nurse is admitting a client to the medical-surgical unit. The Patient Self-Determination Act requires the nurse to perform which of the following actions during the admission process?

A nurse is teaching a client who has GERD about appropriate dietary choices. Which of the following food choices by the client indicates an understanding of the teaching?

A nurse is caring for a client who is preoperative for cataract removal. Which of the following statements by the client indicates an understanding of the procedure?