Nokea
A nurse is assessing a client after administering phenytoin IV bolus for a seizure. Which of the following should the nurse identify as an adverse effect of this medication?
- A. Hypoglycemia
- B. Bradycardia
- C. Red man syndrome
- D. Hypotension
Correct Answer: D
Rationale: The correct answer is D: Hypotension. Phenytoin can cause hypotension as an adverse effect due to its vasodilatory properties. The drug can cause a decrease in blood pressure, leading to symptoms such as dizziness and lightheadedness. This adverse effect is important for the nurse to recognize as it can potentially lead to complications such as falls in the client.
A: Hypoglycemia is not a common adverse effect of phenytoin.
B: Bradycardia is not a typical adverse effect of phenytoin.
C: Red man syndrome is associated with vancomycin, not phenytoin.
Summary: Phenytoin is more likely to cause hypotension as an adverse effect, rather than hypoglycemia, bradycardia, or red man syndrome.
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A home health nurse is visiting a client who has heart failure and a prescription for furosemide. The nurse identifies that the client has gained 2.5 kg (5 lb.) since the last visit 2 days ago. Which of the following actions should the nurse take first?
- A. Encourage the client to dangle the legs while sitting in a chair
- B. Teach the client about foods low in sodium
- C. Determine medication adherence by the client
- D. Notify the provider of the client's weight gain
Correct Answer: D
Rationale: The correct answer is D: Notify the provider of the client's weight gain. This is the first action the nurse should take because sudden weight gain in a client with heart failure could indicate fluid retention, which may worsen the client's condition. By notifying the provider, the nurse can ensure timely intervention to adjust the medication or treatment plan. Encouraging leg dangling (A) may help with circulation but does not address the immediate concern of weight gain. Teaching about low-sodium foods (B) is important for long-term management but not the priority at this moment. Determining medication adherence (C) is important but should come after addressing the immediate weight gain issue.
A nurse is planning care for a client who requires treatment for high cholesterol. Which of the following prescriptions should the nurse expect to administer?
- A. Colchicine
- B. Cimetidine
- C. Colesevelam (Welchol)
- D. Chlorpromazine
Correct Answer: C
Rationale: The correct answer is C: Colesevelam (Welchol). This medication is a bile acid sequestrant commonly used to treat high cholesterol by binding to bile acids in the intestine, preventing their reabsorption, thus lowering LDL cholesterol levels. Colchicine (A) is used to treat gout, Cimetidine (B) for ulcers, and Chlorpromazine (D) for psychotic disorders. These medications are not indicated for high cholesterol.
A nurse is preparing to administer Igrasm 5mcg/kg/day subcutaneous to a client who weighs 143 lb. How many mcg should the nurse administer per day?
Correct Answer: 325 mcg
Rationale: The correct answer is 325 mcg. First, convert the client's weight from lb to kg: 143 lb ÷ 2.2 = 65 kg. Next, calculate the daily dose: 5 mcg/kg/day x 65 kg = 325 mcg/day. Therefore, the nurse should administer 325 mcg per day.
Other choices are incorrect because they do not follow the correct conversion of weight to kg and do not calculate the dose accurately based on the weight and prescribed dosage.
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.