A nurse is preparing to administer morphine sulfate 2 mg IV bolus. Available is morphine sulfate 10 mg/mL How many mL should the nurse administer per dose?

(Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer: B. Position the sterile drape leaving the perineum exposed.

Rationales

A. Lubricate the catheter with water-soluble gel.
Lubrication is important to reduce urethral trauma, but this is not the first step once the sterile field is prepared. It comes after draping and cleansing, just before catheter insertion.

B. Position the sterile drape leaving the perineum exposed.
This is the first action after donning sterile gloves and preparing the field. Draping maintains a sterile environment and provides access to the insertion site. Ensuring sterility from the beginning is critical for preventing catheter-associated infections.

C. Cleanse the client’s meatus with antiseptic solution.
Cleansing the meatus is done after draping to reduce the risk of introducing microorganisms during catheter insertion. Although essential, it is not the very first step once the sterile procedure begins.

D. Attach a prefilled syringe to the catheter inflation hub.
The balloon should not be prepared or inflated until after the catheter has been inserted and urine return is observed. Attaching the syringe too early may risk accidental inflation outside the bladder.

A. Clubbing of the fingers: Clubbing of the fingers is a common finding in clients with advanced emphysema. It is characterized by bulbous enlargement of the fingertips and nail changes, including increased curvature and softening of the nail beds. Clubbing results from chronic hypoxia and tissue oxygen deprivation, which leads to vascular changes and tissue proliferation in the fingertips.
B. Deep respirations: Deep respirations are not typically associated with emphysema. Instead, clients with emphysema often exhibit shallow, rapid respirations due to decreased lung elasticity and air trapping, which impair effective ventilation. As a compensatory mechanism, clients may adopt a pursed-lip breathing pattern to facilitate expiration and reduce airway collapse.
C. Bradycardia: Bradycardia is not a characteristic finding in clients with emphysema. Instead, clients with emphysema commonly experience tachycardia, which is a compensatory response to hypoxia and increased work of breathing. Tachycardia helps maintain cardiac output and tissue perfusion in the setting of impaired gas exchange.
D. Barrel chest: Barrel chest is a classic physical finding in clients with emphysema. It results from hyperinflation of the lungs and loss of lung elasticity, leading to a permanent increase in the anteroposterior diameter of the chest. This change in chest shape contributes to the characteristic appearance of a rounded, barrel-like chest.
E. Dyspnea: Dyspnea, or shortness of breath, is a hallmark symptom of emphysema. Clients with emphysema often experience dyspnea, especially with exertion, due to air trapping, decreased lung function, and impaired gas exchange. Dyspnea can significantly impact the client's quality of life and functional status, requiring careful management and symptom relief interventions.