A nurse is preparing to administer methylprednisolone sodium succinate 30 mg/kg via intermittent IV bolus to a client who weighs 169 lb. Available is methylprednisolone sodium succinate 125 mg/mL. How many mL should the nurse administer?
(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 ["18"]

To calculate the dose of methylprednisolone sodium succinate that the nurse should administer, we can follow these steps:

Convert the client's weight from pounds to kilograms:

169 lb ÷ 2.2 = 76.82 kg (rounded to two decimal places)

Calculate the dose of methylprednisolone sodium succinate:

30 mg/kg × 76.82 kg = 2,304.6 mg

Determine the volume of methylprednisolone sodium succinate needed using the available concentration:

2,304.6 mg ÷ 125 mg/mL = 18.437 mL

Rounding to the nearest whole number, the nurse should administer 18 mL of methylprednisolone sodium succinate via intermittent IV bolus.

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Correct Answer is C

Explanation

Choice A reason: This is incorrect because fentanyl 25 mcg/hr transdermal patch is a common and appropriate dose for chronic pain management. Fentanyl is a potent opioid analgesic that delivers a steady amount of medication through the skin over 72 hours.

Choice B reason: This is incorrect because meloxicam 15 mg PO daily is a standard and safe dose for treating inflammation and pain caused by arthritis. Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) that reduces the production of prostaglandins, which are involved in inflammation.

Choice C reason: This is correct because regular insulin 8 units subcutaneous before meals is a vague and potentially dangerous prescription. Regular insulin is a short-acting insulin that lowers blood glucose levels by facilitating the uptake of glucose into the cells. The dose of insulin should be individualized based on the client's blood glucose level, carbohydrate intake, and activity level. The nurse should contact the provider for clarification on how to adjust the dose according to the client's needs.

Choice D reason: This is incorrect because docusate sodium 200 mg PO at bedtime is a usual and effective dose for preventing constipation. Docusate sodium is a stool softener that works by increasing the amount of water in the stool, making it easier to pass.

A. Elimination B. Metabolism C. Distribution D. Absorption

Correct Answer is A

Explanation

Choice A reason: Elimination is the process of removing a drug from the body, usually through the kidneys or the liver. Acute renal failure is a condition where the kidneys suddenly lose their ability to filter waste products and excess fluid from the blood. This can impair the elimination of drugs that are mainly excreted by the kidneys, leading to increased drug levels and potential toxicity. The nurse should monitor the patient's renal function and adjust the dose of drugs that are renally eliminated.

Choice B reason: Metabolism is the process of transforming a drug into one or more metabolites, usually by enzymes in the liver. Acute renal failure does not directly affect the metabolism of drugs, unless it causes liver damage or alters the blood flow to the liver. The nurse should monitor the patient's liver function and the levels of drugs that are metabolized by the liver.

Choice C reason: Distribution is the process of transferring a drug from the blood to the tissues and organs of the body. Acute renal failure can affect the distribution of drugs that are bound to plasma proteins, such as albumin. When the kidneys are damaged, they may leak protein into the urine, causing hypoalbuminemia (low levels of albumin in the blood). This can increase the amount of free or unbound drug in the blood, which may enhance the drug's effect or cause adverse reactions. The nurse should monitor the patient's serum albumin level and the effects of drugs that are highly protein bound.

Choice D reason: Absorption is the process of moving a drug from the site of administration to the bloodstream. Acute renal failure does not directly affect the absorption of drugs, unless it causes changes in the gastrointestinal tract, such as edema, bleeding, or motility disorders. The nurse should monitor the patient's gastrointestinal function and the bioavailability of drugs that are administered orally.

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is A

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