Nokea
A nurse is preparing to administer a new prescription for ampicillin 1.5g IV every 6 hr to a client who has an upper respiratory infection. The client also has a prescription for a sputum specimen for culture and sensitivity. Which of the following actions should the nurse plan to take?
- A. Verify the prescription.
- B. Administer the medication at 1000, 1400, 1800, and 2200.
- C. Assess the client for an allergy to penicillin
- D. Document giving the medications
- E. Obtain a sputum for culture and sensitivity
Correct Answer: A,C,D,E
Rationale: Correct Answer: A, C, D, E
Rationale:
A: Verify the prescription - It is essential for the nurse to confirm the accuracy and appropriateness of the new medication order before administration.
C: Assess the client for an allergy to penicillin - Since ampicillin is a penicillin antibiotic, it is crucial to evaluate the client for any potential allergic reactions.
D: Document giving the medications - Documentation is a critical aspect of nursing practice to ensure accurate recording of the medication administration.
E: Obtain a sputum for culture and sensitivity - This action is necessary to identify the causative organism and determine the most effective antibiotic therapy for the client's infection.
Summary:
B: Administering the medication at specific times is not relevant to the question.
F, G: No additional options provided.
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A nurse is caring for a client who is receiving neostigmine. Which of the following manifestations should the nurse identify as an adverse reaction to the medication?
- A. Hypoactive bowel sounds
- B. Sweating
- C. Respiratory distress
- D. Urinary retention
- E. Bradycardia
Correct Answer: B,C,E
Rationale: The correct manifestations for an adverse reaction to neostigmine are sweating, respiratory distress, and bradycardia. Neostigmine is a cholinesterase inhibitor, which can lead to overstimulation of the parasympathetic nervous system. Sweating is a common side effect due to increased cholinergic activity. Respiratory distress can occur due to bronchoconstriction from excessive cholinergic stimulation. Bradycardia can result from increased vagal tone. Hypoactive bowel sounds and urinary retention are not typically associated with neostigmine.
A nurse is preparing to administer dopamine 5 mcg/kg/min by continuous IV infusion to a client who weighs 220 lb. Available is 400 mg of dopamine in 250 mL of 0.9% sodium chloride. The nurse should set the IV pump to deliver how many mL/hr?
- A. 18.8 mL/hr
Correct Answer: A
Rationale: The correct answer is A: 18.8 mL/hr. To calculate the rate of dopamine infusion, we first need to convert the client's weight from pounds to kilograms by dividing it by 2.2 (220 lb / 2.2 = 100 kg). Next, we calculate the total daily dose of dopamine by multiplying the weight in kg by the ordered dose (100 kg x 5 mcg/kg/min x 60 min/hr x 24 hr/day = 720,000 mcg/day). Then, we convert the total daily dose to mL/hr by dividing it by the concentration of dopamine in the IV solution (720,000 mcg/day / 400 mg/250 mL x 1000 mcg/mg = 18.8 mL/hr). This calculation ensures the correct dosage is administered to the client. Other choices are incorrect as they do not follow the necessary conversion steps or include miscalculations in the dosage determination.
A nurse is reviewing the medical record of a client who is taking epoetin alfa. Which of the following laboratory tests should the nurse monitor to determine the effectiveness of the medication?
- A. Thyroid-stimulating hormone
- B. Hemoglobin
- C. Blood glucose
- D. Alanine aminotransferase
- E. Iron
Correct Answer: B,E
Rationale: The correct answers are B: Hemoglobin and E: Iron. Hemoglobin levels indicate the oxygen-carrying capacity of the blood, which is crucial for evaluating the effectiveness of epoetin alfa in treating anemia. Epoetin alfa stimulates red blood cell production, leading to an increase in hemoglobin levels. Monitoring iron levels is also important because iron is essential for red blood cell production. Thyroid-stimulating hormone, blood glucose, and alanine aminotransferase are not directly related to the effectiveness of epoetin alfa in treating anemia.
A nurse is providing teaching to a client who has a new prescription for atenolol. Which of the following adverse effects should the nurse include in the teaching?
- A. Lightheadedness
- B. Tachycardia
- C. Dry mouth
- D. Bronchodilation
Correct Answer: A
Rationale: The correct answer is A: Lightheadedness. Atenolol is a beta-blocker that can cause a decrease in blood pressure, leading to lightheadedness due to reduced blood flow to the brain. Tachycardia (choice B) is not an adverse effect as atenolol actually slows down the heart rate. Dry mouth (choice C) is not a common adverse effect of atenolol. Bronchodilation (choice D) is not expected with atenolol as it can actually cause bronchoconstriction in some individuals.
A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which of the following findings should the nurse identify as an adverse effect of TPN
- A. 2+ deep tendons reflexes
- B. Casual blood glucose 100 mg/dl
- C. Potassium 4.8 mEq/L
- D. 2+ peripheral pitting Edema
Correct Answer: D
Rationale: The correct answer is D: 2+ peripheral pitting Edema. This is due to fluid overload from TPN, leading to excessive fluid accumulation in peripheral tissues. Deep tendon reflexes (A) and normal blood glucose levels (B) are not typically adverse effects of TPN. Potassium within normal range (C) is a positive finding. Peripheral pitting edema (D) indicates fluid imbalance.