DOSAGE CALCULATION RN ADULT MEDICAL
SURGICAL PROCTORED EXAM
1. A nurse is planning to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of enoxaparin
40 mg/0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the nurse plan
to take?
A. Expel the air bubble from the prefilled syringe before injecting.
B. Insert the needle completely into the client's tissue.
C. Administer the injection in the client's thigh.
D. Aspirate carefully after inserting the needle into the client's skin.: B.
The nurse should inject the needle on the prefilled syringe completely when admin- istering enoxaparin in order to
administer the medication by deep subcutaneous injection.
2. A nurse is caring for a hospitalized client who is receiving IV heparin for a deep-vein thrombosis. The client
begins vomiting blood. After the heparin has been stopped, which
of the following medications should the nurse prepare to administer?
A. Vitamin K1
B. Atropine
C. Protamine
D. Calcium gluconate: C.
,Protamine reverses the anticoagulant effect of heparin.
3. 3. A nurse is planning to administer
IV alteplase to a client who is demonstrating manifestations of a massive pulmonary embolism. Which of the
following interventions should the nurse plan to take?
A. Administer IM enoxaparin along with the alteplase dose.
B. Hold direct pressure on puncture sites for up to 30 min.
C. Administer aminocaproic acid IV prior to alteplase infusion.
D. Prepare to administer alteplase within 8 hr of manifestation onset.: B.
The nurse should plan to hold direct pressure on puncture sites for 10 to 30 min or until oozing of blood stops.
4. A nurse is monitoring a client who takes aspirin 81 mg PO daily. The nurse should identify which of
the following manifestations as adverse effects of daily aspirin therapy? (Se- lect all that apply.)
A. Hypertension
B. Coffee-ground emesis
, C. Tinnitus
D. Paresthesias of the extremities E. Nausea: B. CORRECT: GI bleeding with dark stools or coffee-ground
emesis can be an adverse effect of aspirin therapy.
C. CORRECT: Tinnitus and hearing loss can occur as an adverse effect of aspirin therapy
D. Paresthesias of the extremities are not adverse effects of aspirin therapy.
E. CORRECT: Nausea, vomiting, and abdominal pain can occur as a result of aspirin therapy.
5. 5. A nurse is caring for a client who
has atrial fibrillation and a new prescription for dabigatran to prevent de- velopment of thrombosis. Which of
the following medications is prescribed concurrently to treat an adverse effect of dabigatran?
A. Vitamin K1
B. Protamine
C. Omeprazole
D. Probenecid: C.
Omeprazole or another proton pump inhibitor is prescribed for a client who is taking dabigatran and has abdominal pain
and other GI findings that can occur as adverse effects of dabigatran. The nurse should advise the client who has GI
effects to take dabigatran with food.
SURGICAL PROCTORED EXAM
1. A nurse is planning to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of enoxaparin
40 mg/0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the nurse plan
to take?
A. Expel the air bubble from the prefilled syringe before injecting.
B. Insert the needle completely into the client's tissue.
C. Administer the injection in the client's thigh.
D. Aspirate carefully after inserting the needle into the client's skin.: B.
The nurse should inject the needle on the prefilled syringe completely when admin- istering enoxaparin in order to
administer the medication by deep subcutaneous injection.
2. A nurse is caring for a hospitalized client who is receiving IV heparin for a deep-vein thrombosis. The client
begins vomiting blood. After the heparin has been stopped, which
of the following medications should the nurse prepare to administer?
A. Vitamin K1
B. Atropine
C. Protamine
D. Calcium gluconate: C.
,Protamine reverses the anticoagulant effect of heparin.
3. 3. A nurse is planning to administer
IV alteplase to a client who is demonstrating manifestations of a massive pulmonary embolism. Which of the
following interventions should the nurse plan to take?
A. Administer IM enoxaparin along with the alteplase dose.
B. Hold direct pressure on puncture sites for up to 30 min.
C. Administer aminocaproic acid IV prior to alteplase infusion.
D. Prepare to administer alteplase within 8 hr of manifestation onset.: B.
The nurse should plan to hold direct pressure on puncture sites for 10 to 30 min or until oozing of blood stops.
4. A nurse is monitoring a client who takes aspirin 81 mg PO daily. The nurse should identify which of
the following manifestations as adverse effects of daily aspirin therapy? (Se- lect all that apply.)
A. Hypertension
B. Coffee-ground emesis
, C. Tinnitus
D. Paresthesias of the extremities E. Nausea: B. CORRECT: GI bleeding with dark stools or coffee-ground
emesis can be an adverse effect of aspirin therapy.
C. CORRECT: Tinnitus and hearing loss can occur as an adverse effect of aspirin therapy
D. Paresthesias of the extremities are not adverse effects of aspirin therapy.
E. CORRECT: Nausea, vomiting, and abdominal pain can occur as a result of aspirin therapy.
5. 5. A nurse is caring for a client who
has atrial fibrillation and a new prescription for dabigatran to prevent de- velopment of thrombosis. Which of
the following medications is prescribed concurrently to treat an adverse effect of dabigatran?
A. Vitamin K1
B. Protamine
C. Omeprazole
D. Probenecid: C.
Omeprazole or another proton pump inhibitor is prescribed for a client who is taking dabigatran and has abdominal pain
and other GI findings that can occur as adverse effects of dabigatran. The nurse should advise the client who has GI
effects to take dabigatran with food.
