Between her admission at 1500 and the next day, she receives four doses of Lortab and one
dose of acetaminophen (Tylenol).
At 1300, she develops a fever of 101° F (38.3° C), and the
physician writes an order to give acetaminophen (Tylenol), 650 mg PO every 4 hours for
temperature over 100.5 ° F (38.1 ° C). Is there a concern with this order?
What will be an ideal response?
Keep in mind that the maximum recommended dose of acetaminophen in a 24-hour period is
3000 mg. If M.C. has received four doses of Lortab and one dose of acetaminophen, she has already
had 2650 mg (2000 plus 650) of acetaminophen. Care needs to be taken to avoid giving too much
acetaminophen, and an evaluation of M.C.'s liver status might need to be made.
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When assessing newborns in the newborn nursery, the nurse may suspect neurological impairment in newborns who:
A) sleep 18 hours a day C) exhibit a weak sucking reflex B) blink when the lights are turned on D) cry at a loud sound
Because the water in the infant's residential area is not fluoridated, when should the nurse suggest that the infant receive supplemental fluoride?
a. 2 months old b. 4 months old c. 5 months old d. 6 months old
The certified nursing assistant (CNA) tells the nurse: "I can help you with your assessment." What is the most appropriate response by the nurse?
a. "Thank you. I am having a busy day and I can use your help." b. "I'm sorry, but nurses are responsible for all patient assessment." c. "How long have you been a CNA?" d. "If you will obtain the vital signs and place them in the chart then that would be a big help."
A nurse demonstrates nonassertive behavior by doing which of the following?
a. When a patient asks about the nurse's personal life, the nurse responds to the patient's questions out of fear of not being liked by the patient. b. When a patient asks about the nurse's personal life, the nurse says that the information is personal and chooses not to discuss it. c. When a nurse feels the team leader has been unfair, the nurse approaches the team leader and asks to speak privately at a time that is convenient for the person. d. When pressured by staff members to help with their assignments, the nurse, who is too busy to help, refuses without feeling guilty but leaves the door open to help at a future date.