How many drops per minute should the nurse set for the infusion? The patient has been prescribed 1 liter of 0.9% sodium chloride, USP to be administered intravenously (IV) over a period of 4 hours.
The IV administration set delivers 10 drops/mL. If rounding is required, round to the nearest whole number.
The Correct Answer is ["42"]
Step 1: Convert the volume from liters to milliliters. 1 liter = 1000 mL. Step 2: Convert the time from hours to minutes. 4 hours = 240 minutes.
Step 3: Calculate the rate in mL per minute. Rate = Volume ÷ Time = 1000 mL ÷ 240 min = 4.17 mL/min.
Step 4: Calculate the drops per minute. Drops per minute = Rate × Drop factor = 4.17 mL/min
× 10 gtt/mL = 41.7 gtt/min.
Step 5: Round off the result to the nearest whole number. 41.7 gtt/min rounds off to 42 gtt/min.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
While maintaining elevated positioning of the dependent joints on the affected side can be helpful in certain conditions such as edema or injury, it is not the immediate intervention needed for a client presenting with sudden, severe facial numbness, uneven smile with facial droop to the right side, and a hand grasp strength that is weaker on the right than the left.
Choice B rationale
Verifying prescribed laboratory tests including prothrombin time and platelet count is important in assessing the client’s coagulation status. However, it is not the immediate intervention needed in this situation.
Choice C rationale
The client’s symptoms are suggestive of a stroke. In such cases, immediate medical intervention is crucial. Starting two large-bore IV catheters and reviewing inclusion criteria for IV fibrinolytic therapy is an appropriate immediate intervention.
Choice D rationale
Administering aspirin can be beneficial in preventing further clot formation and platelet clumping in clients at risk of a stroke. However, it is not the immediate intervention needed in this situation.
Correct Answer is A
Explanation
Choice A rationale
Heberden’s nodes are bony swellings that develop at the end joints (distal interphalangeal joints) of fingers, particularly the fingers closest to the nails. They are a characteristic feature of osteoarthritis, a degenerative joint disease. Osteoarthritis causes the protective cartilage in the joints to wear down over time, leading to the development of these bony growths, which can be painful and limit joint movement. Therefore, discussing strategies for managing chronic pain with the patient is the most appropriate action for the nurse to take.
Choice B rationale
While checking the patient’s radial pulses and capillary refill time is a part of a comprehensive physical assessment, it is not directly related to the management of Heberden’s nodes or osteoarthritis.
Choice C rationale
Although Heberden’s nodes are a sign of osteoarthritis, they are not typically an emergency that requires immediate notification of the healthcare provider. They are a common finding in individuals with osteoarthritis and are usually managed with conservative measures such as pain management and physical therapy.
Choice D rationale
Reviewing the patient’s dietary intake of high-protein foods is not directly related to the management of Heberden’s nodes or osteoarthritis. While a balanced diet is important for overall health, it does not specifically address the pain and limited joint movement associated with Heberden’s nodes.
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