Nokea
A client with a history of chronic kidney disease is prescribed sodium polystyrene sulfonate (Kayexalate). The nurse should explain that this medication works by:
- A. Reducing blood pressure.
- B. Binding potassium in the gut.
- C. Increasing urine output.
- D. Decreasing blood glucose.
Correct Answer: B
Rationale: Sodium polystyrene sulfonate binds potassium in the gut, reducing serum potassium levels in chronic kidney disease.
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Ergonovine maleate (Ergotrate) 200 mcg I.M. has been ordered. The ampule label reads 0.2 mg/mL. The nurse should administer how many milliliters?
- A. 1 mL
- B. 2 mL
- C. 0.5 mL
- D. 1.5 mL
Correct Answer: C
Rationale: First, convert micrograms to milligrams: 200 mcg = 0.2 mg. Then: 0.2 mg / X mL = 0.2 mg / 1 mL, so X = 1 mL.
A client with a history of seizures is prescribed phenytoin (Dilantin). Which laboratory value should the nurse monitor?
- A. Liver function tests
- B. Renal function tests
- C. Complete blood count
- D. Electrolytes
Correct Answer: A
Rationale: Phenytoin can cause hepatotoxicity, so liver function tests should be monitored regularly to detect potential liver damage early.
The nurse is caring for a client with a chest tube in place for a pneumothorax. Which of the following findings indicates that the chest tube is functioning properly?
- A. Continuous bubbling in the water seal chamber.
- B. Absence of tidaling in the water seal chamber.
- C. Fluctuation of fluid in the drainage tube with respiration.
- D. No drainage in the collection chamber.
Correct Answer: C
Rationale: Fluctuation (tidaling) in the drainage tube with respiration indicates the chest tube is patent and functioning to remove air or fluid.
A client with a diagnosis of myasthenia gravis is prescribed pyridostigmine (Mestinon). The nurse should teach the client to take the medication:
- A. On an empty stomach.
- B. With meals to reduce side effects.
- C. At bedtime to promote sleep.
- D. As needed for muscle weakness.
Correct Answer: B
Rationale: Pyridostigmine should be taken with food to reduce gastrointestinal side effects like nausea.
Before the nurse administers I.V. replacement of 5% dextrose in water with potassium chloride, what nursing intervention must be completed first?
- A. Adding potassium chloride to the bag at the bedside
- B. Evaluating laboratory results for electrolytes
- C. Priming tubing using sterile technique
- D. Checking the rate for I.V. push administration
Correct Answer: B
Rationale: Evaluating electrolyte levels, especially potassium, is critical before administering potassium chloride to prevent hyperkalemia. Adding potassium at the bedside is unsafe, and priming or checking rates follows.