NCLEX FUNDAMENTALS II EXAM WITH
RATIONAL
A health care provider's prescription reads potassium chloride 20 mEq in 1000 mL normal
saline and infuse at 100 mL/hr. The nurse assisting in caring for the client determines that
the client will receive how many milliequivalents (mEq) of potassium every hour? Fill in the
blank.
Rationale:
Use the ratio and proportion formula to solve this problem, and then solve for x.
20 mEq: 1000 mL :: x mg: 100 mL
Multiply means and extremes then divide to solve for x.
1000x = 2000x = 2 mEq
Penicillin V 250 mg orally every 8 hours, is prescribed for a child with a respiratory infection.
The child's weight is 45 pounds. The safe pediatric dosage is 25 to 50 mg/kg/day. Which
statement accurately describes the prescribed dosage for this child?
Rationale:
Convert pounds to kilograms by dividing by 2.2 and then determine the dosage
frequency.Pounds to kilograms:45 lb ÷ 2.2 lb/kg = 20.45 kgDosage parameters:25
mg/kg/day × 20.45 kg = 511.25 mg/day50 mg/kg/day × 20.45 kg = 1022.5 mg/dayDosage
frequency:250 mg × 3 doses (every 8 hours) = 750 mg/dayThe dosage is within the safe
dosage range.
The nurse is assigned to care for an Asian-American client. The nurse develops a plan of care
based on which belief?
Rationale:
Asian Americans believe that illness is caused by an imbalance between yin and yang, by
prolonged sitting or lying, or by overexertion. In the African-American culture, illness is
viewed as a disharmonious state that may be caused by demons and spirits. Native
Americans believe that illness is caused by supernatural forces.
An anxious client is experiencing respiratory alkalosis from hyperventilation as a result of
anxiety. The nurse should do which action to help the client experiencing this acid-base
disorder?
Rationale:
An anxious client benefits from emotional support and reassurance, which in turn reduces
anxiety and may lower the respiratory rate. The client may benefit from the administration
of a sedative or antianxiety medication, if it is prescribed. The client should try to breathe
more slowly and shallowly. Lying supine provides no benefit to the client.
The nurse is assisting in the care of a client receiving codeine sulfate for pain. The nurse
should make note of which finding to detect an adverse effect of this medication?
Rationale:
The client taking codeine sulfate is at risk for constipation. Thus, the nurse monitors the
frequency of bowel movements. The nurse also would monitor the client for hypotension,
decreased respirations, and urinary retention. The nurse would plan measures to counteract
these expected effects such as encouraging fluids, coughing and deep breathing, and
increasing mobility to the extent tolerated by the client.
A client who takes theophylline (Theo-24) for chronic obstructive pulmonary disease (COPD)
is seen in the health care clinic. A theophylline level is drawn, and the nurse determines that
,the client is compliant with the medication regimen if which laboratory result is reported?
, Test-Taking Strategy:
Focus on the subject, administration of theophylline, and note the word compliant.
Familiarity with the therapeutic level of theophylline is needed to select the correct option.
Remember that the therapeutic range for the serum theophylline level is 10 to 20 mcg/mL.
Review:
Therapeutic range of theophylline.
The health care provider prescribes ibuprofen (children's Motrin) 5 mg per kg for a child who
weighs 13 pounds. How many milligrams (mg) should the nurse administer to the child?
Fill in the blank. Record your answer using one decimal place.
Rationale:
A child who weighs 13 pounds weighs 5.9 kg. This is determined by dividing 13 by 2.2 to
obtain the weight in kilograms (1 kg = 2.2 lb). Once that is determined, 5.9 is multiplied by 5
mg to yield 29.5 mg.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Fundamental Skills: Medication/IV Calculations
Strategy(ies): Subject
Priority Concepts: Clinical Judgment, Safety
Diphenhydramine hydrochloride (Benadryl) 25 mg orally every 6 hours is prescribed for a
child with an allergic reaction. The child weighs 25 kg. The safe pediatric dosage is 5
mg/kg/day. What should the nurse determine about the medication dosage?
Rationale:
Calculate the dosage parameters using the safe dosage range identified in the question
and the child's weight in kilograms. Next, determine the total daily dosage.Dosage
parameters: 5 mg/kg × 25 kg = 125 mg/dayDosage frequency: 25 mg × 4 doses = 100
mg/dayThe dosage is safe.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Data Collection
Content Area: Fundamental Skills: Medication/IV Calculations
Strategy(ies): Subject
Priority Concepts: Clinical Judgment, Safety
A health care provider's prescription reads triazolam (Halcion), 125 mcg orally at bedtime
daily. The medication bottle is labeled triazolam, 0.125-mg tablets. The nurse prepares how
many tablet(s) to administer 1 dose? Fill in the blank.
Rationale:
Convert 125 mcg to mg. In the metric system, to convert smaller to larger, divide by 1000 or
move the decimal three places to the left. Therefore, 125 mcg = 0.125 mg. One tablet is
administered.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Planning
Content Area: Fundamental Skills: Medication/IV Calculations
RATIONAL
A health care provider's prescription reads potassium chloride 20 mEq in 1000 mL normal
saline and infuse at 100 mL/hr. The nurse assisting in caring for the client determines that
the client will receive how many milliequivalents (mEq) of potassium every hour? Fill in the
blank.
Rationale:
Use the ratio and proportion formula to solve this problem, and then solve for x.
20 mEq: 1000 mL :: x mg: 100 mL
Multiply means and extremes then divide to solve for x.
1000x = 2000x = 2 mEq
Penicillin V 250 mg orally every 8 hours, is prescribed for a child with a respiratory infection.
The child's weight is 45 pounds. The safe pediatric dosage is 25 to 50 mg/kg/day. Which
statement accurately describes the prescribed dosage for this child?
Rationale:
Convert pounds to kilograms by dividing by 2.2 and then determine the dosage
frequency.Pounds to kilograms:45 lb ÷ 2.2 lb/kg = 20.45 kgDosage parameters:25
mg/kg/day × 20.45 kg = 511.25 mg/day50 mg/kg/day × 20.45 kg = 1022.5 mg/dayDosage
frequency:250 mg × 3 doses (every 8 hours) = 750 mg/dayThe dosage is within the safe
dosage range.
The nurse is assigned to care for an Asian-American client. The nurse develops a plan of care
based on which belief?
Rationale:
Asian Americans believe that illness is caused by an imbalance between yin and yang, by
prolonged sitting or lying, or by overexertion. In the African-American culture, illness is
viewed as a disharmonious state that may be caused by demons and spirits. Native
Americans believe that illness is caused by supernatural forces.
An anxious client is experiencing respiratory alkalosis from hyperventilation as a result of
anxiety. The nurse should do which action to help the client experiencing this acid-base
disorder?
Rationale:
An anxious client benefits from emotional support and reassurance, which in turn reduces
anxiety and may lower the respiratory rate. The client may benefit from the administration
of a sedative or antianxiety medication, if it is prescribed. The client should try to breathe
more slowly and shallowly. Lying supine provides no benefit to the client.
The nurse is assisting in the care of a client receiving codeine sulfate for pain. The nurse
should make note of which finding to detect an adverse effect of this medication?
Rationale:
The client taking codeine sulfate is at risk for constipation. Thus, the nurse monitors the
frequency of bowel movements. The nurse also would monitor the client for hypotension,
decreased respirations, and urinary retention. The nurse would plan measures to counteract
these expected effects such as encouraging fluids, coughing and deep breathing, and
increasing mobility to the extent tolerated by the client.
A client who takes theophylline (Theo-24) for chronic obstructive pulmonary disease (COPD)
is seen in the health care clinic. A theophylline level is drawn, and the nurse determines that
,the client is compliant with the medication regimen if which laboratory result is reported?
, Test-Taking Strategy:
Focus on the subject, administration of theophylline, and note the word compliant.
Familiarity with the therapeutic level of theophylline is needed to select the correct option.
Remember that the therapeutic range for the serum theophylline level is 10 to 20 mcg/mL.
Review:
Therapeutic range of theophylline.
The health care provider prescribes ibuprofen (children's Motrin) 5 mg per kg for a child who
weighs 13 pounds. How many milligrams (mg) should the nurse administer to the child?
Fill in the blank. Record your answer using one decimal place.
Rationale:
A child who weighs 13 pounds weighs 5.9 kg. This is determined by dividing 13 by 2.2 to
obtain the weight in kilograms (1 kg = 2.2 lb). Once that is determined, 5.9 is multiplied by 5
mg to yield 29.5 mg.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Fundamental Skills: Medication/IV Calculations
Strategy(ies): Subject
Priority Concepts: Clinical Judgment, Safety
Diphenhydramine hydrochloride (Benadryl) 25 mg orally every 6 hours is prescribed for a
child with an allergic reaction. The child weighs 25 kg. The safe pediatric dosage is 5
mg/kg/day. What should the nurse determine about the medication dosage?
Rationale:
Calculate the dosage parameters using the safe dosage range identified in the question
and the child's weight in kilograms. Next, determine the total daily dosage.Dosage
parameters: 5 mg/kg × 25 kg = 125 mg/dayDosage frequency: 25 mg × 4 doses = 100
mg/dayThe dosage is safe.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Data Collection
Content Area: Fundamental Skills: Medication/IV Calculations
Strategy(ies): Subject
Priority Concepts: Clinical Judgment, Safety
A health care provider's prescription reads triazolam (Halcion), 125 mcg orally at bedtime
daily. The medication bottle is labeled triazolam, 0.125-mg tablets. The nurse prepares how
many tablet(s) to administer 1 dose? Fill in the blank.
Rationale:
Convert 125 mcg to mg. In the metric system, to convert smaller to larger, divide by 1000 or
move the decimal three places to the left. Therefore, 125 mcg = 0.125 mg. One tablet is
administered.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Planning
Content Area: Fundamental Skills: Medication/IV Calculations
