A nurse is reviewing the medication orders for a client who has heart failure. Which of the following prescriptions should the nurse clarify with the provider

Digoxin 25 mcg/kg via IV bolus every 8 hr x 2 doses

Dobutamine 15 mcg/kg via continuous IV infusion

Bumetanide 0.1 mg/kg via IV bolus every 12 hr

Dextrose 5% in 0.45% sodium chloride with 20 mEq KCl via continuous V Infusion at 50 mL/hr

Answer and Explanation

The Correct Answer is A

A) Digoxin 25 mcg/kg via IV bolus every 8 hr x 2 doses: This prescription should be clarified. Digoxin is typically prescribed in micrograms (mcg), but the dose of 25 mcg/kg is very high and could lead to toxicity. For a client with heart failure, the usual dosage for digoxin is 0.125–0.25 mg daily, not 25 mcg/kg per dose, which is excessive and potentially dangerous. Therefore, this order should be clarified with the provider.

B) Dobutamine 15 mcg/kg via continuous IV infusion: This is an appropriate dose for dobutamine, which is commonly used in heart failure for its inotropic effects. Dobutamine is typically dosed between 2–20 mcg/kg/min for continuous IV infusion, so 15 mcg/kg/min is within a safe range.

C) Bumetanide 0.1 mg/kg via IV bolus every 12 hr: Bumetanide is a loop diuretic used in heart failure, and the prescribed dose of 0.1 mg/kg every 12 hours is an appropriate dosing regimen for this medication. It is within the typical dosing range, and the interval is also reasonable for managing fluid overload in heart failure.

D) Dextrose 5% in 0.45% sodium chloride with 20 mEq KCl via continuous IV infusion at 50 mL/hr: This IV fluid prescription is generally appropriate. The combination of dextrose and sodium chloride with potassium is commonly used to maintain hydration and electrolyte balance in clients, particularly in the context of heart failure management. The infusion rate of 50 mL/hr is a typical rate for continuous IV infusions.

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Correct Answer is ["1.5"]

Explanation

Understanding the Problem

Order: Midazolam 0.03 mg/kg IM

Client Weight: 110 lbs

Available Solution: Midazolam 1 mg/mL

Desired Dose: mL to administer

Step 1: Convert Client Weight to Kilograms (kg)

1 kg = 2.2 lbs

Client Weight in kg: 110 lbs / 2.2 lbs/kg = 50 kg

Step 2: Calculate the Total Dose

Ordered Dose: 0.03 mg/kg

Client Weight: 50 kg

Total Dose: 0.03 mg/kg x 50 kg = 1.5 mg

Step 3: Calculate the Volume to Administer

Total Dose: 1.5 mg

Concentration: 1 mg/mL

Volume: 1.5 mg / 1 mg/mL = 1.5 mL

Step 4: Round to the Nearest Tenth

The calculated volume is 1.5 mL, which is already to the nearest tenth.

Answer: 1.5 mL

Correct Answer is ["30"]

Explanation

Understanding the Problem

Order: Potassium gluconate 40 mEq PO

Available Solution: Potassium gluconate liquid 20 mEq/15 mL

Desired Dose: mL to administer

Step 1: Set Up the Calculation

We need to find the volume (in mL) that contains the ordered dose (40 mEq). We can do this by setting up a proportion or using the formula:

Volume (mL) = (Ordered Dose (mEq) / Concentration (mEq/mL))

Step 2: Determine the Concentration

Available Concentration: 20 mEq / 15 mL

Step 3: Perform the Calculation

Ordered Dose: 40 mEq

Concentration: 20 mEq / 15 mL

Volume: (40 mEq) / (20 mEq / 15 mL) = (40 mEq X 15 mL) / 20 mEq

We can simplify this by dividing 40 by 20:

Volume: (2 X 15 mL) = 30 mL

Step 4: Round to the Nearest Whole Number

The result is 30 mL, which is already a whole number.

Answer: 30 mL

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A nurse is reviewing the medication orders for a client who has heart failure. Which of the following prescriptions should the nurse clarify with the provider

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer midazolam 0.03 mg/kg IM to a client who weighs 110 lb. Available is midazolam 1 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["1.5"]

Explanation

A nurse is preparing to administer potassium glucose 40 mEq PO. Available is potassium gluconate liquid 20 mEq/15 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.)

Correct Answer is ["30"]

Explanation

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