Nokea
A client with asthma develops respiratory acidosis. Based on this diagnosis, what should the nurse expect the client's serum potassium level to be?
- A. normal
- B. elevated
- C. low
- D. unrelated to the pH
Correct Answer: B
Rationale: Hyperkalemia occurs in a state of acidosis because potassium moves from injured cells into the bloodstream.
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The nurse is leading a group session for clients with panic disorder. Which statement made by the client indicates that further teaching is needed?
- A. I need to be able to identify triggers that escalate my anxiety to the point of panic.
- B. Diazepam is the long-term medication of choice because of its nonaddicting quality.
- C. Citalopram has been found to be helpful in the long-term treatment of panic disorder.
- D. I can use guided imagery and meditation to effectively reduce my anxiety symptoms.
Correct Answer: B
Rationale: Buspirone, not diazepam (Valium), is the long-term medication of choice for panic disorder due to its nonaddicting quality.
The 17-year-old female is about to have a drug screen test for employment. The adolescent tells the nurse of a recent UTI that was treated with antibiotics. Which antibiotic, if identified by the client, could produce a false-positive urine screening test for opioids?
- A. Cephalexin
- B. Ceftazidime
- C. Amoxicillin
- D. Ciprofloxacin
Correct Answer: D
Rationale: A: Cephalexin (Keflex) does not interfere with urine testing for opioids. B: Ceftazidime (Fortaz), a cephalosporin, does not interfere with urine testing for opioids. C: Amoxicillin (Amoxil), an aminopenicillin, does not interfere with urine testing for opioids. D: Fluoroquinolones, such as ciprofloxacin (Cipro), can cause false-positive urine opiate screens.
The HCP's progress notes state a plan to initiate an oral NSAID for the child's pain. Based on this information, the nurse should consult with the HCP when noting that which medication was the only analgesic prescribed?
- A. Naproxen
- B. Tolmetin
- C. Ibuprofen
- D. Hydromorphone
Correct Answer: D
Rationale: A: Naproxen (Aleve) is an NSAID. B: Tolmetin (Tolectin) is an NSAID. C: Ibuprofen (Advil, Motrin) is an NSAID. D: Hydromorphone (Dilaudid) is an opioid analgesic, not an NSAID.
The nurse working on the pediatric unit has scheduled medications to administer at this time. Which assessments should prompt the nurse to conclude that the prescribed medication should be withheld and the HCP immediately notified?
- A. Oral hydrocodone with acetaminophen to the 10-year-old with burn injuries who is feeling dizzy and light-headed
- B. Oral acetaminophen to the 6-month-old with a fever of 102°F (38.9°C) from an infection who has developed a rash
- C. Clindamycin IV to the 16-year-old male with aspiration pneumonia from near-drowning who has a BP of 92/56 mm Hg
- D. Phenobarbital IV to the 5-year-old with intermittent seizures who states feeling tired and appears to be drowsy
Correct Answer: C
Rationale: A: Dizziness and light-headedness are side effects of hydrocodone with acetaminophen (Vicodin), and the nurse may choose to withhold a scheduled dose. These are not potentially life-threatening or warranting an immediate call to the HCP. B: A rash is a side effect of acetaminophen (Tylenol). However, the rash is not potentially life-threatening or warranting an immediate call to the HCP. C: An adverse effect of clindamycin (Cleocin) is hypotension. A BP of 92/56 mm Hg is low for a 16-year-old. Normal BP for a 16-year-old male is 111/63 mm Hg to 136/90 mm Hg, depending on height percentile. The nurse should compare the previous BP readings with the current one to determine the degree of BP variation and then immediately notify the HCP because the BP can decrease further. D: Tiredness and drowsiness are side effects of phenobarbital (Luminal). However, these are expected. The nurse would not withhold phenobarbital unless there were additional neurological alterations that would warrant contacting the HCP.
The nurse is reviewing documentation on four clients prior to administering medications. The nurse should immediately withhold the medication and notify the HCP about which client?
- A. Client 1
- B. Client 2
- C. Client 3
- D. Client 4
Correct Answer: D
Rationale: Client 4's symptoms of tardive dyskinesia (lip smacking, uncontrolled rhythmic movements) may be irreversible, requiring immediate medication withdrawal and HCP notification.