Nokea
A client with hyperparathyroidism has a serum calcium level of 13 mg/dL. Which medication should be prepared to administer as prescribed to the client?
- A. Calcium chloride
- B. Calcium gluconate
- C. Calcitonin (Miacalcin)
- D. Large doses of vitamin D
Correct Answer: C
Rationale: The normal serum calcium level ranges from 8.6 to 10.0 mg/dL. In hypercalcemia, as seen in this client, Calcitonin (Miacalcin) is used to decrease plasma calcium levels by inhibiting bone resorption. Calcium gluconate and calcium chloride are typically used for hypocalcemia, not hypercalcemia. Large doses of vitamin D should be avoided in hypercalcemia as they can exacerbate hypercalcemia by increasing calcium absorption from the intestines.
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A client is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol?
- A. The development of complaints of insomnia
- B. The development of audible expiratory wheezes
- C. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication
- D. A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min after two doses of the medication
Correct Answer: B
Rationale: The development of audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm, associated with propranolol. Beta-blockers can trigger bronchospasm, especially in clients with chronic obstructive pulmonary disease or asthma. This complication can lead to significant respiratory distress and should be addressed promptly to prevent further complications.
Mafenide acetate (Sulfamylon) is prescribed for a client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action?
- A. Notifying the registered nurse
- B. Discontinuing the medication
- C. Informing the client that this is normal
- D. Applying a thinner film than prescribed to the burn site
Correct Answer: C
Rationale: The correct action is to inform the client that local discomfort and burning are normal reactions to Mafenide acetate. This medication is used to treat burns by reducing bacteria in avascular tissues. Discontinuing the medication or applying a thinner film than prescribed is not necessary or recommended in this situation.
A client has a prescription for albuterol (Proventil HFA) (two puffs) and beclomethasone dipropionate (Qvar) (nasal inhalation, two puffs) by metered-dose inhaler. The medications are to be administered by the nurse by giving the:
- A. Albuterol first and then the beclomethasone dipropionate
- B. Beclomethasone dipropionate first and then the albuterol
- C. Alternating a single puff of each, beginning with the albuterol
- D. Alternating a single puff of each, beginning with the beclomethasone dipropionate
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with diabetes mellitus is prescribed Humulin NPH insulin. The client asks the nurse how to store unopened vials of insulin. The nurse instructs the client to:
- A. Freeze the insulin.
- B. Refrigerate the insulin.
- C. Store the insulin in a dark, dry place.
- D. Keep the insulin at room temperature.
Correct Answer: B
Rationale: Unopened vials of insulin should be stored in the refrigerator until needed. Freezing insulin can damage it, affecting its efficacy. Storing insulin in a dark, dry place or at room temperature is not recommended as it can lead to degradation of the insulin. Refrigeration helps maintain the stability and effectiveness of insulin.
A client taking fexofenadine (Allegra) is scheduled for allergy skin testing and tells the nurse in the healthcare provider's office that a dose was taken this morning. The nurse determines that:
- A. The client should reschedule the appointment.
- B. A lower dose of allergen will need to be injected.
- C. A higher dose of allergen will need to be injected.
- D. The client should have the skin test read a day later than usual.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.