All practice questions

A healthcare provider prescribes a continuous intravenous (IV) infusion of aminophylline at a rate of $0.5 \text{ mg/kg/hr}$ for a client experiencing a severe exacerbation of asthma. The client weighs $75 \text{ kg}$. The pharmacy supplies an IV bag containing aminophylline $500 \text{ mg}$ in $250 \text{ mL}$ of $0.9\% \text{ sodium chloride}$. At what rate, in $\text{mL/hr}$, should the nurse set the IV infusion pump? Record your answer rounding to the nearest tenth.

A nurse in the cardiovascular intensive care unit is caring for a client with acute decompensated heart failure. The client weighs $209\text{ lbs}$.

The client is receiving a continuous intravenous infusion of dobutamine. The standard hospital mixture contains $500\text{ mg}$ of dobutamine in $250\text{ mL}$ of $5\%$ dextrose in water (D5W). The infusion pump is currently running at $17.1\text{ mL/hr}$.

The provider's order reads: 'Titrate dobutamine by $1.5\text{ mcg/kg/min}$ every $15\text{ minutes}$ to achieve a cardiac index $\geq 2.2\text{ L/min/m}^2$.'

The latest hemodynamic assessment reveals a cardiac index of $1.8\text{ L/min/m}^2$. The nurse prepares to perform the next titration step according to the protocol.

At what value in $\text{mL/hr}$ will the nurse program the infusion pump for the new dose? (Round the final answer to the nearest tenth.)

An emergency department nurse is managing a client in a hypertensive crisis. The client weighs $85\text{ kg}$ and is currently receiving a continuous intravenous (IV) infusion of sodium nitroprusside at $25\text{ mL/hr}$. The IV bag contains $50\text{ mg}$ of sodium nitroprusside mixed in $250\text{ mL}$ of $5\%$ Dextrose in Water ($D_5W$). According to the facility protocol, the nurse must titrate the infusion upward by $0.5\text{ mcg/kg/min}$ if the mean arterial pressure (MAP) remains above $80\text{ mm Hg}$. The client's current MAP is $94\text{ mm Hg}$. After increasing the dosage by one increment, what will be the new infusion pump rate in $\text{mL/hr}$? Record your answer to the nearest tenth.

A nurse is collecting an obstetrical history from a client admitted to the labor and birth unit. The client reports the following history:

- Currently pregnant with twins.
- Delivered a viable male infant at $39$ weeks of gestation, who is now $5$ years old and healthy.
- Delivered viable female twins at $34$ weeks of gestation, both of whom are now $3$ years old and healthy.
- Experienced a spontaneous abortion at $10$ weeks of gestation.
- Delivered a stillborn fetus at $22$ weeks of gestation.

Using the GTPAL system, calculate the number that represents the client's "Preterm" (P) deliveries. Record your answer as a whole number.

A nurse is performing an assessment on a newborn $1$ minute after birth. The nurse notes the following findings:
- Heart rate: $114$ beats/min
- Respiratory effort: Loud, vigorous cry
- Muscle tone: Active, spontaneous movement of all extremities
- Reflex irritability: Vigorous cry and pulls away during bulb syringe suctioning
- Color: Pink trunk with bluish hands and feet

Calculate the newborn's $1$-minute APGAR score. (Enter only the final numeric value)

A critical care nurse is preparing to initiate a continuous IV infusion of dobutamine for a client with severe heart failure. The healthcare provider has prescribed dobutamine at $5 \text{ mcg/kg/min}$. The client weighs $198 \text{ lb}$. The medication is supplied as dobutamine $500 \text{ mg}$ in $250 \text{ mL}$ of 5% dextrose in water (D5W). At what rate, in $\text{mL/hr}$, should the nurse set the IV infusion pump? (Record your answer using one decimal place.)

A nurse is performing an initial assessment on a neonate exactly 1 minute after birth. The neonate presents with a heart rate of 142 beats per minute, a vigorous cry, active spontaneous movement of all extremities, a strong cough and sneeze during nasal suctioning, and a completely pink trunk with blue hands and feet. Calculate the neonate's 1-minute Apgar score.

At exactly 5 minutes of life, a newborn is assessed by the delivery room team. The documented findings include: an apical pulse of 94 beats per minute, weak and irregular respirations, slight flexion of the arms and legs, a strong sneeze in response to bulb suctioning of the nares, and completely pink skin over the entire body.

Based on these findings, what is the infant's total Apgar score?

A patient with septic shock, weighing $165\text{ lbs}$, is receiving a continuous intravenous infusion of norepinephrine via a dedicated central venous catheter to minimize the risk of extravasation. The current infusion rate delivers $0.05\text{ mcg/kg/min}$. The patient's mean arterial pressure (MAP) is currently $58\text{ mmHg}$. The hemodynamic titration protocol prescribes increasing the dose by $0.02\text{ mcg/kg/min}$ every $5\text{ minutes}$ until the MAP is $\ge 65\text{ mmHg}$. The medication is supplied as $4\text{ mg}$ of norepinephrine in $250\text{ mL}$ of 5% dextrose in water (D5W). The nurse prepares to initiate the first titration increment. What should the new infusion pump rate be set at in $\text{mL/hr}$? (Round to the nearest tenth)

A nurse is caring for a client with decompensated heart failure who weighs $187\text{ lb}$. The healthcare provider prescribes a continuous IV infusion of dobutamine at $7.5\text{ mcg/kg/min}$. The pharmacy dispenses a premixed IV bag containing dobutamine $500\text{ mg}$ in $250\text{ mL}$ of $5\%\text{ dextrose in water}$. At what rate, in $\text{mL/hr}$, should the nurse set the IV infusion pump? (Record your answer to the nearest tenth.)

A nurse is evaluating a newborn to determine the 5-minute APGAR score. The newborn's assessment findings are as follows:

- Heart rate: 112 beats/min
- Respiratory effort: Slow, weak cry
- Muscle tone: Some flexion of extremities
- Reflex irritability: Grimace in response to stimulation
- Color: Body pink, hands and feet cyanotic

Calculate the newborn's APGAR score.

A nurse is caring for a client in the intensive care unit who is experiencing a hypertensive emergency. The client weighs $209\text{ lbs}$. The healthcare provider prescribes a continuous intravenous infusion of sodium nitroprusside at $3\text{ mcg/kg/min}$. The pharmacy dispenses a premixed IV bag containing $50\text{ mg}$ of sodium nitroprusside in $250\text{ mL}$ of $5\%$ dextrose in water (D5W).

At what rate, in $\text{mL/hr}$, should the nurse set the infusion pump? (Record your answer using one decimal place.)

An adult client who is $24\text{ hours}$ postoperative following a small bowel resection remains NPO (nothing by mouth). The primary healthcare provider prescribes a continuous intravenous (IV) infusion of $1000\text{ mL}$ of lactated Ringer's solution to be administered over an $8\text{-hour}$ period.

At what rate in milliliters per hour (mL/hr) should the nurse set the electronic IV infusion pump? Record your answer as a whole number.

A primary health care provider prescribes a continuous intravenous heparin infusion for a client diagnosed with a deep vein thrombosis. The client's admission weight is $198\text{ lb}$. The prescribed infusion rate is $15\text{ units/kg/hr}$, and the medication arrives from the pharmacy as a premixed $500\text{ mL}$ bag containing $25,000\text{ units}$ of heparin. At what rate should the nurse set the infusion pump in $\text{mL/hr}$? (Record the answer as a whole number)

A nurse is evaluating a 48-hour-old newborn prior to discharge. The newborn's birth weight was $3,500\text{ g}$, and the current weight is $3,255\text{ g}$. Calculate the newborn's percentage of body weight loss. Enter only the numeric value.

A rapid response nurse is managing a client who experienced a severe extravasation of a continuous norepinephrine infusion from a peripheral intravenous catheter. Following the facility's extravasation management protocol, the primary health care provider prescribes phentolamine mesylate $0.15\text{ mg/kg}$ to be infiltrated subcutaneously around the ischemic site.

The client weighs $191.4\text{ lbs}$.

The pharmacy dispenses phentolamine in lyophilized vials, which the nurse reconstitutes to yield a concentration of $5\text{ mg/mL}$.

The protocol mandates that the exact calculated phentolamine dose must be further diluted with $0.9\%$ sodium chloride to achieve a final total syringe volume of $12\text{ mL}$ prior to administration.

How many milliliters ($\text{mL}$) of $0.9\%$ sodium chloride must the nurse draw up to mix with the phentolamine? Record your answer to the nearest tenth.

A client with severe gastroenteritis requires intravenous rehydration. The treatment plan includes $1,000\text{ mL}$ of $0.9\%$ sodium chloride to run over a $4\text{-hour}$ period. At what rate in $\text{mL/hr}$ should the nurse program the infusion pump? (Record your answer using a whole number.)

A client is admitted to the cardiac intensive care unit with acute decompensated heart failure and a severely elevated blood pressure. The client is receiving a continuous intravenous (IV) infusion of nitroglycerin currently running at $15\text{ mcg/min}$. The provider's prescription states: "Titrate nitroglycerin infusion upward by $5\text{ mcg/min}$ every 5 minutes until systolic blood pressure is less than $140\text{ mm Hg}$." The pharmacy provides a premixed nitroglycerin solution of $50\text{ mg}$ in $250\text{ mL}$ of $5\%$ dextrose in water (D5W). The client's blood pressure remains elevated, requiring exactly two dosage titrations over the next 10 minutes. What will the nurse set the IV infusion pump rate to in $\text{mL/hr}$ following the second titration? Record your answer as a number with one decimal place.

An emergency department team is treating a client for a hypertensive emergency. The provider prescribes a continuous sodium nitroprusside infusion with instructions to begin at $0.3 \text{ mcg/kg/min}$ and titrate upward by $0.3 \text{ mcg/kg/min}$ every $5 \text{ minutes}$ until the mean arterial pressure (MAP) falls below $100 \text{ mm Hg}$.

The client's admission weight is $231 \text{ lbs}$.
The pharmacy supplies a premixed IV bag containing $50 \text{ mg}$ of sodium nitroprusside in $250 \text{ mL}$ of $5\%$ dextrose in water ($D_5W$).

The nurse initiates the infusion. Because the client's MAP remains consistently above $100 \text{ mm Hg}$ during the initial monitoring period, the nurse performs exactly three protocol-directed upward titrations.

Determine the new IV pump rate in $\text{mL/hr}$ immediately following the third titration. Round your final answer to the nearest whole number.

A client with severe acute respiratory distress syndrome (ARDS) is mechanically ventilated and requires continuous sedation. The healthcare provider prescribes a propofol infusion at $30 \text{ mcg/kg/min}$. The client weighs $209 \text{ lb}$. The pharmacy dispenses propofol $1,000 \text{ mg}$ in a $100 \text{ mL}$ lipid emulsion. What should the nurse set the infusion pump rate to in $\text{mL/hr}$? Record your answer to the nearest whole number.