Nokea
A nurse is consulting a formulary about a client's new prescription for raloxifene. The nurse should identify that this medication is used to treat which of the following conditions?
- A. Osteoporosis
- B. Hypothyroidism
- C. Urinary tract infection
Correct Answer: A
Rationale: The correct answer is A: Osteoporosis. Raloxifene is a medication used to prevent and treat osteoporosis by increasing bone density. It is a selective estrogen receptor modulator that mimics estrogen's effects on bone without affecting other tissues like the uterus. This helps to reduce the risk of fractures in postmenopausal women. Choices B, C, D, E, F, and G are incorrect because raloxifene is not indicated for hypothyroidism, urinary tract infections, or any other conditions besides osteoporosis.
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A nurse is assessing a client who has hypermagnesemia. Which of the following medications should the nurse prepare to administer?
- A. Protamine sulfate
- B. Acetylcysteine
- C. Calcium gluconate
- D. Flumazenil
Correct Answer: C
Rationale: The correct answer is C: Calcium gluconate. In hypermagnesemia, there is an excess of magnesium in the blood, leading to muscle weakness, cardiac arrhythmias, and respiratory depression. Calcium gluconate is the antidote for hypermagnesemia as it works by antagonizing the effects of magnesium. By administering calcium gluconate, the nurse can help reverse the symptoms associated with hypermagnesemia and restore normal calcium levels in the body. Protamine sulfate (Choice A) is used to reverse the effects of heparin, acetylcysteine (Choice B) is used as an antidote for acetaminophen overdose, and flumazenil (Choice D) is used to reverse the effects of benzodiazepines. These medications are not indicated for hypermagnesemia.
A nurse is teaching a client about oral contraceptive. Which of the following information should the nurse include in the teaching?
- A. Abdominal pain is an expected adverse effect of oral contraceptives
- B. It can take up to 1 year to become pregnant after stopping an oral contraceptive
- C. Some herbal supplements can decrease the effectiveness of an oral contraceptive
- D. A pelvic examination is needed prior to starting an oral contraceptive
Correct Answer: C
Rationale: The correct answer is C: Some herbal supplements can decrease the effectiveness of an oral contraceptive. The nurse should include this information in the teaching to ensure the client understands potential interactions. Herbal supplements like St. John's Wort can reduce the effectiveness of oral contraceptives by increasing their metabolism. This can lead to contraceptive failure and unintended pregnancy. Option A is incorrect because abdominal pain is not an expected adverse effect of oral contraceptives. Option B is incorrect as fertility typically returns quickly after stopping oral contraceptives, not taking up to a year. Option D is incorrect as a pelvic examination is not always necessary before starting oral contraceptives.
A nurse is reviewing the laboratory data of a client prior to administering IV tobramycin. Which of the following laboratory values should the nurse report to the provider?
- A. Sodium 137 mEq/L
- B. Hct 4.3%
- C. Hgb 15 g/dL
- D. Creatinine 2.5 mg/dL
Correct Answer: D
Rationale: The correct answer is D: Creatinine 2.5 mg/dL. Elevated creatinine levels indicate potential kidney dysfunction, which is crucial when administering nephrotoxic medications like tobramycin to prevent further kidney damage. Elevated creatinine levels can lead to drug accumulation, increasing the risk of toxicity.
Choice A (Sodium 137 mEq/L) is within normal range and not directly related to tobramycin administration. Choices B (Hct 4.3%) and C (Hgb 15 g/dL) are related to red blood cell levels and not specifically relevant to tobramycin administration. Therefore, they do not need immediate reporting.
A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect?
- A. Oxygen saturation 96%
- B. PaCO2 30 mm Hg
- C. Increase in BP
- D. Decrease in protein
Correct Answer: C
Rationale: The correct answer is C: Increase in BP. Albumin is a colloid solution that helps increase blood volume and subsequently improves blood pressure in shock patients. Increasing blood volume leads to an increase in blood pressure. Option A is incorrect because oxygen saturation is not directly affected by albumin infusion. Option B is incorrect because a low PaCO2 level is not a direct effect of albumin infusion. Option D is incorrect because albumin is a protein and its infusion would not lead to a decrease in protein levels.
A nurse is caring for a client who is to receive potassium replacement. The provider's prescription reads, 'Potassium chloride 30 mEq in 0.9% sodium chloride 100 mL IV over 30 min.' Which of the following reasons should the nurse clarify this prescription with the provider?
- A. Potassium chloride should be diluted in dextrose 5% in water.
- B. The potassium infusion rate is too rapid.
- C. Another formulation of potassium should be given IV.
- D. The client should be treated by giving potassium by IV bolus.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Potassium chloride infusion rate should not exceed 10 mEq/hr to prevent hyperkalemia and cardiac arrhythmias.
2. In this case, 30 mEq in 100 mL over 30 min exceeds the safe rate.
3. Clarification is needed to adjust the infusion rate to avoid potential harm.
4. Other choices are incorrect as dextrose dilution, different formulations, and IV bolus are not the primary concerns.