Nokea
A client receiving Vancocin (vancomycin) has a serum level of 20 mcg/mL. The nurse knows that the therapeutic range for vancomycin is:
- A. 5-10 mcg/mL
- B. 10-25 mcg/mL
- C. 25-40 mcg/mL
- D. 40-60 mcg/mL
Correct Answer: B
Rationale: The therapeutic range for vancomycin is 10-25 mcg/mL, ensuring efficacy while minimizing toxicity; a level of 20 mcg/mL is within this range.
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The nurse is assisting a client who has experienced a left-sided cerebral vascular accident. The client requires assistance with personal hygiene. Which intervention should the nurse do initially?
- A. provide positive feedback
- B. place hygiene items on the client's left side
- C. provide assistive devices
- D. assess abilities and level of deficit
Correct Answer: D
Rationale: Assessing the client’s abilities and deficits first guides appropriate hygiene assistance, considering left-sided neglect or weakness.
The nurse is auscultating the apical pulse over the PMI (point of maximum impact). Which heart sounds would be audible?
- A. S2 and S3
- B. S3 and S4
- C. S4 and S1
- D. S1 and S2
Correct Answer: D
Rationale: S1 (mitral/tricuspid closure) and S2 (aortic/pulmonic closure) are normally audible at the PMI. S3 and S4 are less common and indicate pathology.
A 2-year-old is hospitalized with suspected intussusception. Which finding is associated with intussusception?
- A. Currant jelly stools
- B. Projectile vomiting
- C. Ribbonlike stools
- D. Palpable mass over the flank
Correct Answer: A
Rationale: Currant jelly stools, caused by blood and mucus, are a hallmark of intussusception due to intestinal obstruction.
A 17-year-old adolescent, diagnosed with schizophrenia, is admitted by the nurse to a psychiatric facility. Which behaviors would characterize this diagnosis? Select all that apply.
- A. flat affect
- B. fast speech pattern
- C. hallucinations
- D. feeling energized
Correct Answer: A,C
Rationale: Flat affect and hallucinations are hallmark symptoms of schizophrenia. Fast speech or feeling energized may occur but are not specific to this diagnosis.
The RN is planning client assignments. Which is the least appropriate task for the nursing assistant?
- A. Assisting a COPD client admitted 2 days ago to get up in the chair
- B. Feeding a client with bronchitis who is paralyzed on the right side
- C. Accompanying a discharged emphysema client to the transportation area
- D. Assessing an emphysema client complaining of difficulty breathing
Correct Answer: D
Rationale: Assessment of breathing difficulty requires RN expertise to evaluate and intervene, making it inappropriate for a nursing assistant.