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A nurse in a provider's office is reviewing the laboratory findings of client who has been taking gemfibrozil for 3 months. Which of the following findings should the nurse expect?
- A. Increased serum creatinine
- B. Reduced serum calcium
- C. Increased Hgb
- D. Reduced triglycerides
Correct Answer: D
Rationale: The correct answer is D: Reduced triglycerides. Gemfibrozil is a lipid-lowering medication that works by decreasing triglyceride levels. The nurse should expect a reduction in triglycerides as a therapeutic effect of the medication. Option A (Increased serum creatinine) is incorrect as gemfibrozil typically does not affect creatinine levels. Option B (Reduced serum calcium) is incorrect as gemfibrozil does not impact calcium levels. Option C (Increased Hgb) is incorrect as gemfibrozil does not directly affect hemoglobin levels. Therefore, the nurse should anticipate a decrease in triglyceride levels as the expected finding in a client taking gemfibrozil.
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Vital Signs Day 1: Temperature 37.5° C (99.5° F), Heart rate 98/min, Respiratory rate 20/min, Blood pressure 180/86 mm Hg, Oxygen saturation 95% on room air, Weight 90 kg (198 lb); 2 months later: Temperature 37.5° C (99.5° F), Heart rate 48/min, Respiratory rate 20/min, Blood pressure 140/76 mm Hg, Oxygen saturation 97% on room air, Weight 91 kg (200 lb)
The nurse is evaluating the client's response to the medication. The client's ___________ and ____________ indicate the client's condition is improving.
- A. HDL Level
- B. Heart rate
- C. Potassium level
- D. Weight
- E. blood Pressure
Correct Answer: B, E
Rationale: The correct answer is B, Heart rate and E, Blood Pressure. Monitoring heart rate and blood pressure are vital signs that reflect the overall cardiovascular function and response to medication. An improvement in heart rate and blood pressure indicates better circulation and cardiac output, suggesting the client's condition is improving. The other choices (A, C, D) do not directly reflect the client's cardiovascular status and are not appropriate indicators of medication response. Weight (D) can fluctuate for various reasons, and HDL level (A) and Potassium level (C) are important but specific to different aspects of health. Thus, heart rate and blood pressure are the most relevant indicators in this context.
A nurse is preparing to administer medication to a client who has a new prescription. Which of the following actions should the nurse take first?
- A. Identify the client using two means of identification.
- B. Document the time of the medication administration.
- C. Validate the prescription with the available medication.
- D. Calculate the correct amount of the medication.
Correct Answer: A
Rationale: The correct answer is A. Identifying the client using two means of identification is the first step to ensure the right patient receives the right medication. This process involves checking the client's name, date of birth, and/or unique identifier against the prescription and their identification band. Documenting the time of administration (B) is important but should come after verifying the patient's identity. Validating the prescription (C) and calculating the correct amount (D) are essential steps but should follow patient identification to prevent errors.
A nurse is reviewing the allergies of a client who has rheumatoid arthritis prior to administering celecoxib to the client. The nurse should identify that which of the following allergies is a contraindication for receiving this medication?
- A. Sulfonamides
- B. Shellfish
- C. Fluoroquinolones
- D. Peanuts
Correct Answer: A
Rationale: The correct answer is A: Sulfonamides. Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) and belongs to the class of sulfonamides. Patients allergic to sulfonamides are at risk of cross-reactivity with celecoxib, leading to severe allergic reactions. Shellfish (B), fluoroquinolones (C), and peanuts (D) are not related to the mechanism of action or composition of celecoxib, so they are not contraindications. It is important for the nurse to identify sulfonamide allergies to prevent adverse reactions in patients receiving celecoxib.
A nurse is preparing to administer regular insulin 4 units and NPH insulin 10 units subcutaneously to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse take first?
- A. Inject 10 units of air into the NPH insulin vial.
- B. Draw up 10 units from the NPH insulin vial.
- C. Inject 4 units of air into the regular insulin vial.
- D. Draw up 4 units from the regular insulin vial.
Correct Answer: C
Rationale: The correct answer is C: Inject 4 units of air into the regular insulin vial. This action is done to prevent negative pressure in the vial, making it easier to withdraw the correct dose of insulin. By injecting air first, the nurse ensures that the exact amount of insulin can be withdrawn accurately without causing any damage to the vial or affecting the dose.
Choice A is incorrect as injecting air into the NPH insulin vial is not necessary before drawing up the insulin. Choice B is incorrect as drawing up the NPH insulin before preparing the regular insulin would be out of sequence. Choice D is incorrect as drawing up the regular insulin before injecting air into the vial could lead to difficulty in withdrawing the correct dose.
A nurse is reinforcing teaching with a client who will be self-administering enoxaparin subcutaneously using prefilled syringes. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will use my upper arms for injections.
- B. I will massage the site after injecting the medication.
- C. I will expel the air bubble from the syringe before injecting the medication.
- D. I will pinch up the skin before injecting the medication.
Correct Answer: D
Rationale: Correct Answer: D. "I will pinch up the skin before injecting the medication."
Rationale: Pinching up the skin before injecting enoxaparin helps ensure proper subcutaneous injection technique, reducing the risk of injecting into muscle or causing discomfort. Pinching up the skin creates a subcutaneous tissue fold, providing a proper injection site and allowing for the medication to be delivered effectively. This step also minimizes the risk of bruising and ensures the medication is absorbed appropriately.
Summary of other choices:
A: Incorrect - Using upper arms for injections is not recommended for subcutaneous injections like enoxaparin.
B: Incorrect - Massaging the site after injecting can disrupt the medication's absorption and is not recommended.
C: Incorrect - Expelling air bubbles is important for intramuscular injections but not necessary for subcutaneous injections like enoxaparin.