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 effective treatment of infections while minimizing toxicity risks.
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The nurse is evaluating the evidence-based practice used for the units' client care standards. Which of the following provides the most support for evidence-based practice?
- A. Client preference
- B. Practice guidelines
- C. Care plans
- D. Research journal articles
- E. Systematic literature reviews
Correct Answer: B, D, E
Rationale: Evidence-based practice relies on practice guidelines (B), research articles (D), and systematic reviews (E) for high-quality evidence. Client preference (A) and care plans (C) are individualized but less rigorous.
The nurse is teaching a client with a history of atrial fibrillation about medication adherence. The nurse should tell the client to:
- A. Take anticoagulants as prescribed
- B. Skip doses if feeling better
- C. Increase caffeine intake
- D. Avoid hydration
Correct Answer: A
Rationale: Anticoagulants reduce stroke risk in atrial fibrillation, so adherence is critical.
Priapism may be a sign of:
- A. Altered neurological function
- B. Imminent death
- C. Urinary incontinence
- D. Reproductive dysfunction
Correct Answer: A
Rationale: Priapism in the trauma client is due to the neurological dysfunction seen in spinal cord injury. Priapism is an abnormal erection of the penis; it may be accompanied by pain and tenderness. This may disappear as spinal cord edema is relieved. It is not associated with death, urinary incontinence, or reproductive dysfunction as a primary issue.
The client is prescribed digoxin (Lanoxin) for heart failure. Which instruction should the nurse include in the teaching plan?
- A. Take the medication with meals to prevent nausea.'
- B. Report a pulse below 60 beats per minute.'
- C. Increase potassium-rich foods in your diet.'
- D. Take an extra dose if you miss one.'
Correct Answer: B
Rationale: Digoxin toxicity is increased with bradycardia, so a pulse below 60 beats per minute should be reported. It can be taken with or without food, potassium monitoring is important but not increasing, and extra doses are dangerous.
A client requires log rolling after back surgery. Correctly provide the sequence of steps the nurse should follow when performing the procedure.
- A. Obtain assistance; three nurses are preferable.
- B. Maintain client's position in alignment with pillows.
- C. Position two nurses on the side the client will be turned to and the third nurse on the opposite side of the bed.
- D. Designate the person at the head of the bed to be in charge of coordinating the move.
- E. Place a pillow between the client's knees.
- F. Move the client in one coordinated movement when the nurse at the head of the bed signals to move the client.
- G. Instruct the client to place the arms across the chest.
Correct Answer: A, C, D, G, E, B, F
Rationale: Log rolling sequence: Obtain assistance (A), position nurses (C), designate leader (D), instruct arm placement (G), place pillow (E), align with pillows (B), move coordinately (F).