A nurse is preparing to administer vancomycin 50 mg PO daily divided into four equal doses. The amount available is vancomycin 125 mg capsules. How many capsules should the nurse administer with each dose?

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

Choice A reason: Palpate the client’s pedal pulses

Palpating the client’s pedal pulses assesses the blood flow to the lower extremities but does not provide information about the client’s muscle strength. This action is important for evaluating circulation but is not relevant for determining strength.

Choice B reason: Ask the client how strong she feels today

Asking the client how strong she feels today provides subjective information about the client’s perception of her strength. While this can be useful, it does not offer an objective measure of muscle strength. Objective assessments are more reliable for determining the client’s actual strength.

Choice C reason: Ask the client to touch her finger to her nose

Asking the client to touch her finger to her nose assesses coordination and fine motor skills rather than muscle strength. This test is often used to evaluate neurological function but does not provide information about the strength of the muscles needed for ambulation.

Choice D reason: Ask the client to push her feet against the nurse’s palms

Asking the client to push her feet against the nurse’s palms is an effective way to assess the strength of the lower extremities. This action provides an objective measure of the client’s muscle strength, which is crucial for determining her ability to ambulate safely. This test helps the nurse evaluate whether the client has sufficient strength to stand and walk.

Choice A reason: Reinforce discharge teaching to clients

While reinforcing discharge teaching is important, it is not the immediate priority during a disaster situation with limited staff. The focus should be on addressing urgent and life-threatening needs first. Discharge teaching can be addressed once the immediate crisis is managed and resources are more available.

Choice B reason: Instruct the assistive personnel (AP) to focus on clients’ ADLs

Instructing assistive personnel to focus on clients’ activities of daily living (ADLs) is important for maintaining basic care, but it is not the highest priority in a disaster situation. The primary focus should be on preventing life-threatening emergencies and ensuring the safety of all clients.

Choice C reason: Stock additional unit supplies

Stocking additional unit supplies is a proactive measure, but it is not the immediate priority during a disaster with limited staff. Ensuring that clients are safe and that life-threatening emergencies are prevented takes precedence over restocking supplies.

Choice D reason: Focus on providing care that prevents life-threatening emergencies

Focusing on providing care that prevents life-threatening emergencies is the highest priority in a disaster situation. With limited staff, it is crucial to prioritize interventions that ensure the immediate safety and well-being of clients. This includes monitoring for and addressing any critical changes in clients’ conditions and providing necessary emergency care.