Nokea
A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances?
- A. Hypocalcemia
- B. Hypokalemia
- C. Hyponatremia
- D. Hypomagnesemia
Correct Answer: C
Rationale: The correct answer is C: Hyponatremia. When a client taking lithium starts a new exercise program, they may sweat more, leading to sodium loss. Hyponatremia is characterized by low sodium levels in the blood, which can be exacerbated by the diuretic effect of lithium. This can result in symptoms such as confusion, muscle cramps, weakness, and seizures. Assessing for hyponatremia is crucial to prevent complications.
Incorrect choices:
A: Hypocalcemia - Not directly related to lithium or exercise.
B: Hypokalemia - More commonly associated with diuretic use or excessive potassium loss.
D: Hypomagnesemia - More commonly seen in alcoholism or malnutrition.
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A nurse is providing teaching to a client who has a new prescription for theophylline, a sustained-released capsule. Which of the following statements by the client indicates an understanding of the teaching?
- A. I can take my medication in the morning with my coffee.
- B. I may sprinkle the medication in applesauce.
- C. I should limit my fluid intake while on this medication.
- D. I will need to have blood levels drawn.
Correct Answer: D
Rationale: Answer D is correct because monitoring blood levels is crucial for theophylline therapy due to its narrow therapeutic range. Regular monitoring helps ensure the drug is at a safe and effective level in the body. Taking the medication with food or fluids, as indicated in choices A and C, can affect its absorption or metabolism, leading to suboptimal effects or toxicity. Sprinkling the medication in applesauce, as in choice B, can alter the drug's sustained-release mechanism, causing rapid release and possible adverse effects. Therefore, choice D is the best option for ensuring theophylline therapy's safety and efficacy.
A nurse is instructing a client who has a new prescription for a daily dose of lovastatin extended-release. Which of the following information should the nurse include in the teaching?
- A. You will need liver function tests before beginning therapy.
- B. Avoid consuming dairy products while taking this medication.
- C. You may crush the medication and mix it with applesauce.
- D. You should take the medication in the morning.
Correct Answer: A
Rationale: The correct answer is A: You will need liver function tests before beginning therapy. This is important because lovastatin, a statin medication, can potentially cause liver damage. Liver function tests are necessary to monitor for any signs of liver toxicity. Choice B is incorrect because there is no specific interaction between lovastatin and dairy products. Choice C is incorrect as lovastatin extended-release should not be crushed as it may affect its effectiveness. Choice D is incorrect as there is no specific time of the day required to take lovastatin.
A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering it to a client who has diabetes mellitus. Which of the following actions should the nurse take first?
- A. Withdraw the regular insulin from the vial
- B. Withdraw the NPH insulin from the vial
- C. Inject air into the NPH vial
- D. Inject air into the regular insulin vial
Correct Answer: C
Rationale: The correct answer is C: Inject air into the NPH vial. This step is crucial to prevent creating a vacuum in the vial when withdrawing the NPH insulin, ensuring accurate dosage measurement. Injecting air into the NPH vial equalizes pressure, making it easier to withdraw the correct amount of insulin without causing air bubbles.
Choice A is incorrect as withdrawing regular insulin first may lead to air being drawn into the syringe when withdrawing NPH insulin. Choice B is incorrect because withdrawing NPH insulin first without equalizing pressure may cause difficulty in drawing the correct amount of insulin. Choice D is incorrect as injecting air into the regular insulin vial before withdrawing NPH insulin is unnecessary and may introduce air bubbles into the syringe.
A nurse is monitoring laboratory values for a client who has chronic heart failure and is receiving digoxin. Which of the following values should the nurse report to the provider?
- A. Sodium 1.38 mEq/dL
- B. Magnesium 1.5 mEq/L
- C. BUN level 10 mg/dL
- D. Potassium 2.9 mEq/L
Correct Answer: D
Rationale: The correct answer is D: Potassium 2.9 mEq/L. Low potassium levels can predispose the client to digoxin toxicity, leading to potentially life-threatening arrhythmias. Hypokalemia increases the risk of digoxin binding to cardiac tissue, enhancing its toxic effects. The nurse should report this value to the provider immediately for prompt intervention to prevent complications.
Incorrect Choices:
A: Sodium 1.38 mEq/dL - Low sodium levels are not directly related to digoxin toxicity.
B: Magnesium 1.5 mEq/L - While magnesium levels are important for cardiac function, they are not as directly linked to digoxin toxicity as potassium.
C: BUN level 10 mg/dL - BUN levels are not specific indicators of digoxin toxicity.
Summary: Potassium levels are crucial to monitor in clients taking digoxin due to the risk of toxicity. Sodium, magnesium, and BUN levels are important but not as
A nurse is caring for a client who has breast cancer and reports pain. 1 hr after administration of prescribed morphine 10 mg IV. Which of the following medications should the nurse expect to administer?
- A. Naloxone IV
- B. Morphine tablet
- C. Lidocaine patch
- D. Fentanyl transmucosal
Correct Answer: D
Rationale: The correct answer is D: Fentanyl transmucosal. Fentanyl is a potent opioid used for severe pain, and transmucosal administration provides rapid relief. Naloxone (A) is an opioid antagonist used to reverse opioid overdose, not for pain management. Morphine tablet (B) is not indicated for immediate relief after IV morphine. Lidocaine patch (C) is used for localized pain, not post-IV opioid pain control. Therefore, fentanyl transmucosal (D) is the most appropriate choice for rapid pain relief in this scenario.