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A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?
- A. One
- B. Two
- C. Three
- D. Four
Correct Answer: A
Rationale: Phenobarbital, with a long half-life of 4 days, remains at therapeutic levels in the body for an extended period. Due to this prolonged duration of action, the nurse should administer phenobarbital once a day to maintain a consistent therapeutic effect without the need for multiple daily doses. Administering the medication more than once a day would not be necessary and could increase the risk of side effects or toxicity. Therefore, the correct answer is to administer phenobarbital once a day.
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A healthcare provider is preparing to administer an IV bolus of Morphine to a client for pain management. Which of the following assessments is the healthcare provider's priority?
- A. Respiratory rate
- B. Pain level
- C. Blood pressure
- D. Level of consciousness
Correct Answer: A
Rationale: The priority assessment for a healthcare provider preparing to administer an IV bolus of Morphine is the client's respiratory rate. Morphine can cause respiratory depression as a significant adverse effect, so monitoring the respiratory rate is crucial to detect any signs of respiratory compromise and intervene promptly. Assessing the respiratory rate takes precedence over other assessments because respiratory depression can lead to serious complications. While pain level, blood pressure, and level of consciousness are important assessments, they are not the priority when administering Morphine, as the risk of respiratory depression is a more immediate concern.
A child is prescribed Amoxicillin 20 mg/kg/day PO to be administered every 12 hr. The child weighs 44 lb. The available medication is amoxicillin suspension 250 mg/5 mL. How many mL should be given per dose?
- A. 4 mL
- B. 5 mL
- C. 6 mL
- D. 3 mL
Correct Answer: A
Rationale: To calculate the dosage per administration: Convert the weight to kg (44 lb / 2.2 lb/kg = 20 kg). Then, (20 mg/kg/day x 20 kg) / 2 (for every 12 hr dosing) = 200 mg per dose. (200 mg / 250 mg) x 5 mL = 4 mL per dose. Therefore, the nurse should administer 4 mL of amoxicillin suspension per dose. Choice B, 5 mL, is incorrect because the calculation shows that 4 mL is the correct dose. Choices C and D are also incorrect as they are not in line with the calculated dosage based on the weight of the child and the concentration of the medication.
A client has a prescription for Phenytoin. Which of the following instructions should the nurse include?
- A. Take this medication at bedtime.
- B. Increase your intake of calcium-rich foods.
- C. Brush and floss your teeth regularly.
- D. Avoid eating foods high in potassium.
Correct Answer: C
Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a condition that leads to overgrowth of gum tissue. Good oral hygiene practices such as regular brushing and flossing can help prevent or minimize this side effect. In contrast, choices A, B, and D are not directly related to managing the side effects of Phenytoin. Taking the medication at bedtime (choice A) is not a specific instruction related to oral hygiene. Increasing calcium-rich foods intake (choice B) may be beneficial for bone health but is not directly related to preventing gingival hyperplasia. Avoiding foods high in potassium (choice D) is not a necessary instruction for a client taking Phenytoin.
A client has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?
- A. Hypokalemia
- B. Hypernatremia
- C. Neutropenia
- D. Bradycardia
Correct Answer: C
Rationale: Neutropenia is a serious adverse effect associated with ACE inhibitors like Captopril. Neutropenia refers to a decreased level of neutrophils, which are important white blood cells in fighting infection. Monitoring the client's complete blood count (CBC) is essential to detect neutropenia early. Hypokalemia (Choice A) is more commonly associated with diuretics, not ACE inhibitors. Hypernatremia (Choice B) is an increase in sodium levels, not typically caused by Captopril. Bradycardia (Choice D) is not a common adverse effect of ACE inhibitors like Captopril.
A client has been prescribed Valsartan. Which of the following adverse effects should the nurse monitor?
- A. Hyperkalemia
- B. Hypoglycemia
- C. Bradycardia
- D. Hypercalcemia
Correct Answer: A
Rationale: Corrected Rationale: Valsartan is an angiotensin II receptor blocker (ARB) that can lead to hyperkalemia by inhibiting the action of aldosterone. Hyperkalemia is a potential adverse effect, making it essential for the nurse to closely monitor the client's potassium levels to prevent complications such as cardiac arrhythmias.
Incorrect Options Rationale:
- Option B, Hypoglycemia, is not a common adverse effect of Valsartan.
- Option C, Bradycardia, is not typically associated with Valsartan use.
- Option D, Hypercalcemia, is not a known adverse effect of Valsartan; instead, Valsartan can lead to hyperkalemia.