Nokea
A client receiving Gentamycin (garamycin) IVPB has a morning peak level of 12 μg/mL. The nurse should:
- A. Notify the physician because the level is too high.
- B. Administer the medication at the scheduled time.
- C. Request an order to administer the medication IM.
- D. Repeat the level 30 minutes before the next dose.
Correct Answer: A
Rationale: The nurse should notify the physician because the level is too high (therapeutic range for Garamycin is 4-10 μg/mL). Answers B and C are incorrect because they would increase the peak level. Answer D refers to the time for drawing a trough level, making it incorrect.
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The nurse is monitoring a client’s EKG strip and notes coupled premature ventricular contractions greater than 10 per minute.
- A. Which medication should the nurse expect to administer for a client with coupled PVCs greater than 10 per minute?
- B. Atropine sulfate (Atropine) IV.
- C. Isoproterenol (Isuprel) IV.
- D. Verapamil (Calan) IV.
- E. Lidocaine hydrochloride (Xylocaine) IV.
Correct Answer: D
Rationale: Lidocaine is the drug of choice for frequent or coupled PVCs, as it suppresses ventricular arrhythmias that could lead to ventricular tachycardia. Atropine treats bradycardia, isoproterenol is used for heart block, and verapamil is a calcium-channel blocker for supraventricular arrhythmias.
During the first 72 hours post CVA, the nurse should position the client:
- A. Supine
- B. Semi-Fowler
- C. Left Sim's
- D. Prone
Correct Answer: B
Rationale: Semi-Fowler's position (30-45 degrees) reduces intracranial pressure and promotes venous drainage in the acute phase post-stroke.
The nurse is caring for clients in the student health center.
- A. What is the best response by the nurse to a client whose boyfriend Test ed positive for hepatitis B?
- B. That must have been a real shock to you.'
- C. You should be Test ed for hepatitis B.'
- D. You’ll receive the hepatitis B immune globulin (HBIG).'
- E. Have you had unprotected sex with your boyfriend?'
Correct Answer: D
Rationale: The nurse should first assess the client’s exposure risk, as hepatitis B is transmitted through sexual contact or parenteral routes. Asking about unprotected sex determines the need for Test ing or prophylaxis. Empathizing, recommending Test ing, or discussing HBIG are secondary to assessing exposure.
An adult who has chronic obstructive pulmonary disease (COPD) is receiving oxygen at home via nasal cannula. In addition to instructing the client and his family about not smoking when oxygen is in use, what should the nurse plan to include in the teaching?
- A. If the prescribed liter flow does not relieve his difficulty breathing, increase the liter flow by up to 2 L/min every four hours.
- B. Try not to shuffle across the carpeted floor.
- C. Clean the nasal cannula with alcohol several times a day.
- D. Increase the oxygen flow rate if you develop shortness of breath.
Correct Answer: B
Rationale: Shuffling across carpet generates static electricity, risking sparks near oxygen, which is a fire hazard. Adjusting oxygen flow without medical orders or cleaning with alcohol (instead of soap and water) is unsafe.
A nurse is doing preconception counseling with a woman who is planning a pregnancy. Which of the following statements suggests that the client understands the connection between alcohol consumption and fetal alcohol syndrome?
- A. I understand that a glass of wine with dinner is healthy.
- B. Beer is not really hard alcohol, so I guess I can drink some.
- C. If I drink, my baby may be harmed before I know I am pregnant.
- D. Drinking with meals reduces the effects of alcohol.
Correct Answer: C
Rationale: If I drink, my baby may be harmed before I know I am pregnant. This reflects awareness of alcohol's early fetal risks.