Which equipment should the nurse use to most accurately measure a 2 mL dose of viscous liquid solution to be administered orally?
3 mL syringe.
One ounce medicine cup.
Tuberculin syringe.
3 mL syringe and a sterile needle.
The Correct Answer is A
Choice a reason: A 3 mL syringe is the most accurate device for measuring a 2 mL dose of a viscous liquid solution due to its design and gradation precision. Syringes provide clearly marked measurement lines, allowing for highly accurate dosing, especially for amounts as small as 2 mL. For viscous liquids, the controlled plunger mechanism of a syringe ensures smooth and consistent measurement and delivery. This is critical in nursing practice, as even slight deviations in medication dosing can lead to therapeutic failures or adverse effects. Additionally, syringes are designed to handle a variety of liquid viscosities, reducing the likelihood of measurement errors caused by sticking or uneven flow. By eliminating the need for visual estimation common with other tools, the syringe minimizes user error and enhances patient safety. The 3 mL capacity ensures the nurse can measure the exact dose without overloading or underutilizing the equipment, maintaining both precision and ease of use.
Choice b reason: A one-ounce medicine cup is less accurate for measuring a 2 mL dose due to its relatively larger size and less precise measurement gradations. Medicine cups are typically designed for measuring larger volumes, such as 5 mL, 15 mL, or more, and are not ideal for small doses. The wide surface area and less detailed markings make it difficult to accurately align the liquid level to the desired measurement, especially for small amounts like 2 mL. This can result in over- or under-dosing, which is particularly problematic when administering potent medications. Additionally, the open design of medicine cups may make pouring viscous liquids challenging, as the liquid may stick to the sides of the cup, leading to further inaccuracies. While convenient for larger doses or liquid mixtures, the medicine cup does not offer the precision required for small, specific dosages in clinical practice.
Choice c reason: A tuberculin syringe, which has a capacity of 1 mL, is specifically designed for administering very small doses, such as subcutaneous or intradermal injections. Using it for a 2 mL dose is impractical and could lead to dosing errors. The nurse would need to fill the syringe twice to administer the full 2 mL, increasing the risk of cumulative measurement inaccuracies. This approach is also time-consuming and may lead to wastage of the medication, as viscous liquids can leave residue inside the syringe, further complicating the dose calculation. Additionally, the markings on a tuberculin syringe are optimized for fractions of a milliliter, not for whole milliliter increments, making it unsuitable for measuring a 2 mL dose. Using this tool for a dose beyond its designed capacity contradicts best practices in nursing, which emphasize using equipment tailored to the specific requirements of the medication and patient.
Choice d reason: Using a 3 mL syringe with a sterile needle is unnecessary and not recommended for administering an oral medication. While the 3 mL syringe itself is suitable for measuring a 2 mL dose, the inclusion of a sterile needle is irrelevant and introduces an additional risk of improper administration. Oral medications are not meant to be injected, and the presence of a needle could lead to accidental use or injury. Furthermore, sterile needles are specifically intended for invasive procedures, such as intramuscular or intravenous injections, and their inclusion in an oral medication protocol is not only superfluous but also contraindicated. The presence of the needle complicates the preparation process without providing any benefit, detracting from the simplicity and efficiency of administering the medication orally. In nursing practice, ensuring that the equipment matches the route of administration is crucial to patient safety and protocol adherence.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Giving positive feedback to the PN and documenting the skill competency is not the appropriate action to take. The PN did not demonstrate proper sterile technique, as he touched the outside of the sterile glove package and the sterile sponges with his bare hands, contaminating them.
Choice B reason: Explaining to the PN that the sterile sponges are not needed for the procedure is not the relevant action to take. The PN may have been following the instructions of the healthcare provider, who may have requested the sponges for the procedure. The issue is not the need for the sponges, but the way the PN handled them.
Choice C reason: Reminding the PN to wash his hands before applying the sterile gloves is not the sufficient action to take. Washing the hands is an important step in maintaining infection control, but it does not correct the mistake the PN made by touching the sterile items with his bare hands.
Choice D reason: Asking the PN to remove the gloves and sponges and start over with a new set is the best action to take. It ensures that the PN follows the correct sterile technique and does not compromise the safety of the client or the procedure. It also provides an opportunity for the charge nurse to teach the PN how to avoid contamination.
Correct Answer is B
Explanation
Choice A reason: Applying lubricant to the cannula tubing is not the best intervention as it may cause irritation or infection of the nasal mucosa. The nurse should use water-soluble gel or saline spray to moisten the nasal passages if needed.
Choice B reason: Placing padding around the cannula tubing is the best intervention as it prevents friction and pressure on the skin. The nurse should use soft materials such as gauze or foam to cushion the tubing and check the skin integrity frequently.
Choice C reason: Decreasing the flow rate to 1 L/minute is not an appropriate intervention as it may compromise the client's oxygenation. The nurse should maintain the prescribed flow rate and monitor the client's vital signs and oxygen saturation.
Choice D reason: Discontinuing the use of the nasal cannula is not an option as it may endanger the client's life. The nurse should continue the oxygen therapy as ordered and provide comfort measures and education to the client.
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