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The healthcare provider prescribes enoxaparin sodium 80 mg SUBQ three times daily. The nurse is preparing a preloaded 1 mL syringe labeled “Enoxaparin sodium injection, USP 60 mg/0.6 mL.”

How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

Answer and Explanation

The Correct Answer is ["0.8"]

Calculation Steps

Step 1: Identify the concentration of the medication in the syringe.

The syringe is labeled “Enoxaparin sodium injection, USP 60 mg/0.6 mL.”

Step 2: Calculate the amount of medication per mL.

60 mg ÷ 0.6 mL = 100 mg/mL

Result = 100 mg/mL

Step 3: Determine the prescribed dose.

The prescribed dose is 80 mg.

Step 4: Calculate the volume to administer.

80 mg ÷ 100 mg/mL = 0.8 mL

Result = 0.8 mL

Therefore, the nurse should administer 0.8 mL.

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Correct Answer is C

Explanation

Choice A reason:

Placing the new patch on the client’s shoulder and leaving both patches in place for 12 hours is not recommended. Fentanyl patches are designed to be used one at a time, and overlapping patches can lead to an overdose due to excessive absorption of the medication1. The standard practice is to remove the old patch before applying a new one.

Choice B reason:

Removing the patch and consulting with the healthcare provider about the client’s pain resolution is a cautious approach. However, it is not necessary to consult the healthcare provider if the client denies pain and the patch is due for replacement. The nurse should follow the standard protocol for patch replacement.

Choice C reason:

Applying the new patch in a different location after removing the original patch is the correct action. This ensures that the medication is delivered effectively while preventing skin irritation and potential overdose. The new patch should be placed on a different area of intact skin to allow the previous site to recover.

Choice D reason:

Administering an oral analgesic and evaluating its effectiveness before applying the new patch is not appropriate in this scenario. The client is already receiving pain management through the transdermal patch, and additional oral analgesics are not necessary unless there is breakthrough pain. The focus should be on proper patch replacement

A. Decreased night vision. B. Increased sensitivity to light. C. Increased frequency of lacrimation. D. Diminished color perception.

Correct Answer is A

Explanation

Choice A reason:

Decreased night vision is a significant concern for clients receiving miotics for open-angle glaucoma. Miotics, such as pilocarpine, work by constricting the pupil (miosis), which can reduce the amount of light entering the eye. This effect is particularly problematic in low-light conditions, leading to decreased night vision and increasing the risk of injury due to poor visibility

Choice B reason:

Increased sensitivity to light, also known as photophobia, can occur with the use of miotics, but it is not the primary concern related to the risk of injury. While photophobia can cause discomfort and avoidance of bright environments, it does not directly contribute to the risk of injury as significantly as decreased night vision.

Choice C reason:

Increased frequency of lacrimation (tearing) can be a side effect of miotics, but it is not a major factor in the risk of injury. Excessive tearing can cause discomfort and blurred vision temporarily, but it does not pose a significant risk for injury compared to decreased night vision.

Choice D reason:

Diminished color perception is not a common side effect of miotics. Miotics primarily affect the pupil size and accommodation, rather than color vision. Therefore, this choice is not relevant to the risk of injury associated with the use of miotics.

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Naxlex Comprehensive Predictor Exams

When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client’s upper back and the client denies pain. Which action should the nurse take?

Correct Answer is C

Explanation

A client is receiving miotics for the treatment of open-angle glaucoma. The nurse determines that a priority nursing problem is the risk for injury. This nursing problem is based on which etiology?

Correct Answer is A

Explanation

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