Nokea
A nurse cares for a client with acute pancreatitis who is prescribed gentamicin (Garamycin) 3 mg/kg/day in 3 divided doses. The client's weight is 264 lb. How many milligrams should the nurse administer for each dose? (Record your answer using a whole number.)
Correct Answer: 120 mg/dose
Rationale: 264 lb (120 kg) ? 3 mg/kg/day = 360 mg/day. 360 mg/day ÷ 3 divided doses = 120 mg/dose.
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After teaching a client who is recovering from laparoscopic cholecystectomy surgery, the nurse assesses the client's understanding. Which statement by the client indicates a correct understanding of the teaching?
- A. I should avoid fatty foods for a few weeks.
- B. Drinking at least 2 liters of water each day is suggested.
- C. I can resume normal activities immediately.
- D. I should expect severe pain for a few days.
Correct Answer: B
Rationale: Clients recovering from laparoscopic cholecystectomy should maintain adequate hydration to support recovery and prevent complications. Drinking at least 2 liters of water daily is a standard recommendation. Avoiding fatty foods is important but typically advised for longer than a few weeks. Immediate resumption of normal activities is not recommended, and severe pain is not expected.
A nurse assesses a client who is recovering from a Whipple procedure. Which assessment finding alerts the nurse to urgently contact the health care provider?
- A. Drainage from a fistula
- B. Pain in the incision site
- C. Nasogastric (NG) tube drainage
- D. Fever of 100.5°F (38.1°C)
Correct Answer: A
Rationale: Drainage from a fistula is a serious complication following a Whipple procedure, indicating potential leakage from surgical anastomoses, which requires urgent medical attention. Pain in the incision site and NG tube drainage are expected postoperative findings, and a mild fever may not be immediately concerning unless accompanied by other symptoms.
A nurse assesses a client who has cholecystitis. Which clinical manifestation indicates that the condition is chronic rather than acute?
- A. Temperature of 100°F (37.8°C)
- B. Positive Murphy's sign
- C. Light-colored stools
- D. Upper abdominal pain after eating
Correct Answer: C
Rationale: Hematuria, clay-colored stools, and dark urine are more commonly seen with chronic cholecystitis. The other symptoms are seen equally with both chronic and acute cholecystitis.
A nurse cares for a client who has obstructive jaundice. The client asks, 'Why is my skin so itchy?' How should the nurse respond?
- A. Bile salts accumulate in the skin and cause the itching.
- B. Toxes released from an inflamed gallbladder lead to itching.
- C. The nurse assesses the client who is itching.
- D. Itching is caused by a hypersensitivity reaction.
Correct Answer: A
Rationale: In obstructive jaundice, the normal flow of bile into the duodenum is blocked, allowing excess bile salts to accumulate on the skin. This leads to itching, or pruritus. The other statements are not accurate.
A nurse cares for a client with pancreatic cancer who is prescribed implanted radioactive iodine seeds. Which actions should the nurse take when caring for this client? (Select all that apply.)
- A. Dispose of linens in a biohazard bag.
- B. Place the client in a private room.
- C. Wear a lead apron when providing client care.
- D. Bundle client care to minimize exposure.
- E. Initiate Transmission-Based Precautions.
Correct Answer: B,C,D
Rationale: The client should be placed in a private room, and dirty linens kept in the client's room until the radiation source is removed. The nurse should wear a lead apron while providing care, ensuring the apron always faces the client. Bundling care minimizes exposure to radiation. Transmission-Based Precautions are not necessary for implanted radioactive iodine seeds.