Nokea
A client with osteomylitis has an order for a trough level to be done because he is taking Gentamycin. When should the nurse call the lab to obtain the trough level?
- A. Before the first dose
- B. 30 minutes before the fourth dose
- C. 30 minutes after the first dose
- D. 30 minutes before the first dose
Correct Answer: B
Rationale: Trough levels measure the lowest drug concentration and are drawn just before a dose after steady-state, typically around the fourth dose for Gentamicin.
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Diphenoxylate hydrochloride and atropine sulfate (Lomotil) is prescribed for the client with ulcerative colitis. The nurse realizes that the medication is having a therapeutic effect when the following is noted:
- A. There is an absence of peristalsis.
- B. The number of diarrhea stools decreases.
- C. Cramping in the abdomen has increased.
- D. Abdominal girth size increases.
Correct Answer: B
Rationale: Lomotil is an antidiarrheal that slows intestinal motility, reducing the frequency of diarrhea stools, indicating its therapeutic effect.
Physician's orders for a client with acute pancreatitis include the following: strict NPO and nasogastric tube to low intermittent suction. The nurse recognizes that witholding oral intake will:
- A. Reduce the secretion of pancreatic enzymes
- B. Decrease the client's need for insulin
- C. Prevent the secretion of gastric acid
- D. Eliminate the need for pain medication
Correct Answer: A
Rationale: Withholding oral intake (NPO) reduces stimulation of the pancreas, thereby decreasing the secretion of pancreatic enzymes that can exacerbate pancreatitis.
A client must take oral potassium supplements every day. The nurse explains to the client that the potassium supplements
- A. need to be stored in the refrigerator.
- B. should only be taken in the evening before bed.
- C. should be diluted in a glass of cold water or juice.
- D. need to be taken on an empty stomach.
Correct Answer: C
Rationale: Oral potassium supplements should be diluted in water or juice to reduce gastric irritation and improve absorption.
Which play activity is best suited to the gross motor skills of the toddler?
- A. Coloring book and crayons
- B. Ball
- C. Building cubes
- D. Swing set
Correct Answer: B
Rationale: Playing with a ball encourages gross motor skills like kicking and throwing, suitable for a toddler's developmental stage.
Which type of leukemia is more common in older adults?
- A. Acute myelocytic leukemia
- B. Acute lymphocytic leukemia
- C. Chronic lymphocytic leukemia
- D. Chronic granulocytic leukemia
Correct Answer: C
Rationale: Chronic lymphocytic leukemia (CLL) is most common in older adults, typically diagnosed in those over 60, due to its indolent nature and prevalence in this age group.