The physician orders vancomycin 500 mg in 250 mL of D5W IVPB daily to infuse over 2 hours. Tubing drop factor is 15 gtts/mL. Calculate the flow rate in drops per minute.

31 gtts/min

62 gtts/min

125 gtts/min

250 gtts/min

Answer and Explanation

The Correct Answer is B

Choice A reason: 31 gtts/min assumes 250 mL over 4 hours with 15 gtts/mL; this halves the rate, underdelivering vancomycin, risking subtherapeutic levels and ineffective bacterial killing over the prescribed 2-hour infusion time.

Choice B reason: 62 gtts/min is correct; 250 mL over 2 hours is 125 mL/hr, times 15 gtts/mL equals 1875 gtts total, divided by 120 minutes yields 62 gtts/min, ensuring proper antibiotic delivery.

Choice C reason: 125 gtts/min doubles the rate; 250 mL in 1 hour with 15 gtts/mL is too fast, risking vancomycin toxicity, including renal damage, and exceeding safe infusion guidelines for IVPB.

Choice D reason: 250 gtts/min assumes 250 mL in 30 minutes; this dangerously rapid rate could cause vancomycin-induced red man syndrome or cardiovascular overload, far beyond the ordered 2-hour infusion duration.

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Correct Answer is A

Explanation

Choice A reason: Withholding and rechecking ensures safety; a color change signals a potential error, and verifying the MAR against orders prevents administering the wrong drug.

Choice B reason: Assuming a change is risky; without confirmation, administering an unverified drug could harm the patient if it’s not the intended prescription.

Choice C reason: Administering then checking later endangers the patient; a wrong drug could cause adverse effects, and delayed verification violates safety protocols.

Choice D reason: Describing and giving without verification is unsafe; the red tablet may not match the order, risking incorrect treatment or allergic reactions.

A. That it will make him feel better right away. B. That the medication is candy and tastes good. C. In a confident manner what the medication is for and how it will be given. D. Firmly that the drug is important to take as soon as possible.

Correct Answer is C

Explanation

Choice A reason: Promising instant relief is misleading; most drugs take time, and false expectations may erode trust, reducing cooperation in a toddler’s care.

Choice B reason: Calling it candy is unethical; it risks future candy confusion with drugs, potentially leading to accidental ingestion, unsafe for a 3-year-old.

Choice C reason: Confident explanation suits a toddler’s understanding; it builds trust, reduces fear, and ensures cooperation by clearly stating purpose and process age-appropriately.

Choice D reason: Firm insistence may scare a toddler; without explanation, it lacks reassurance, potentially increasing resistance and distress during medication administration.

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The physician orders vancomycin 500 mg in 250 mL of D5W IVPB daily to infuse over 2 hours. Tubing drop factor is 15 gtts/mL. Calculate the flow rate in drops per minute.

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Naxlex Comprehensive Predictor Exams

After the nurse hands a client a medication, the client says, "What is this red tablet for? I have always taken a yellow pill." What is the most appropriate action for the nurse to take?

Correct Answer is A

Explanation

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Correct Answer is C

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