The physician gives orders to infuse 1 unit (250 mL) of packed red blood cells over 4 hours. Calculate the flow rate in milliliters per hour.

62.5 mL/hr

125 mL/hr

250 mL/hr

500 mL/hr

Answer and Explanation

The Correct Answer is A

Choice A reason: Flow rate is volume divided by time; 250 mL over 4 hours equals 62.5 mL/hr, ensuring safe transfusion pacing to avoid fluid overload or hemolysis.

Choice B reason: 125 mL/hr assumes 250 mL over 2 hours; this doubles the ordered rate, risking circulatory overload and transfusion reactions in a standard protocol.

Choice C reason: 250 mL/hr infuses the unit in 1 hour; this rapid rate exceeds safe limits, potentially causing hypertension or pulmonary edema in vulnerable patients.

Choice D reason: 500 mL/hr is far too fast, implying 250 mL in 30 minutes; this dangerous speed could trigger severe hemolytic reactions or cardiovascular collapse.

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Correct Answer is A

Explanation

Choice A reason: Narcotics are controlled substances requiring strict accountability; two nurses—one ending and one starting the shift—verify counts to ensure accuracy and prevent diversion per regulatory standards.

Choice B reason: The head nurse and pharmacist may oversee inventory, but shift change counts involve direct caregivers for real-time accuracy, not administrative staff, ensuring immediate responsibility and oversight.

Choice C reason: Involving all nurses from both shifts is impractical and unnecessary; it dilutes accountability and increases error risk, as only two are needed to confirm the count efficiently.

Choice D reason: Pharmacy technicians lack authority over unit narcotics, and the charge nurse alone doesn’t suffice; two nurses ensure a witnessed, reliable count per hospital policy and law.

A. In the medication room B. Outside the door to the patient’s room C. At the medication cart D. At the patient’s bedside

Correct Answer is D

Explanation

Choice A reason: Removing in the medication room risks mix-ups; tablets could be dropped or misidentified before reaching the patient, compromising the three-check safety protocol.

Choice B reason: Outside the door is premature; without the patient present, verification against the MAR is incomplete, increasing error risk before final identity confirmation.

Choice C reason: At the cart is too early; medication stays packaged until bedside to ensure the right patient, right drug match, reducing handling errors or contamination.

Choice D reason: Bedside removal allows final MAR check with patient ID; it ensures accuracy, prevents mix-ups, and aligns with safety standards for administering oral medications.

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The physician gives orders to infuse 1 unit (250 mL) of packed red blood cells over 4 hours. Calculate the flow rate in milliliters per hour.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The graduate nurse is aware that the count of the unit's narcotics and controlled substances at the change of shifts should involve:

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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