A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the client reports she has been taking extra doses to promote weight loss. Which of the following findings indicates she is dehydrated?
- A. Urine specific gravity of 1.020
- B. Urine specific gravity of 1.035
- C. Decreased skin turgor
- D. Decreased heart rate
Correct Answer: B
Rationale: The correct answer is B. A urine specific gravity greater than 1.030 is indicative of dehydration as it reflects concentrated urine. Choice A is incorrect as a specific gravity of 1.020 is within the normal range. Choice C, decreased skin turgor, can be a sign of dehydration but is not as specific as urine specific gravity. Choice D, decreased heart rate, is not typically a direct indicator of dehydration.
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A nurse is caring for a client who has congestive heart failure and is taking digoxin. The client reports nausea and refuses to eat breakfast. Which of the following actions should the nurse take first?
- A. Encourage the client to eat the toast on the breakfast tray
- B. Administer an antiemetic
- C. Inform the client's provider
- D. Check the client's apical pulse
Correct Answer: D
Rationale: The correct answer is to check the client's apical pulse first. Nausea can be a sign of digoxin toxicity, and assessing the client's heart rate is crucial in this situation. Administering an antiemetic or encouraging the client to eat should come after ensuring the client's safety. While informing the provider is important, the immediate concern is to assess for potential digoxin toxicity by checking the client's apical pulse.
A nurse is preparing to administer furosemide 4 mg/kg/day PO divided into 2 equal doses daily to a toddler who weighs 22 lb. How many mg should the nurse administer per dose?
- A. 10 mg
- B. 20 mg
- C. 30 mg
- D. 40 mg
Correct Answer: B
Rationale: To calculate the correct dose, first, convert the toddler's weight from pounds to kilograms: 22 lb / 2.2 lb/kg = 10 kg. Next, multiply the weight in kilograms by the dosage: 4 mg/kg x 10 kg = 40 mg/day. Since the total daily dose is divided into 2 equal doses, each dose would be 20 mg. Therefore, the correct answer is 20 mg. Choice A (10 mg) is incorrect because it does not account for the correct weight-based dosage. Choice C (30 mg) and Choice D (40 mg) are incorrect as they do not correctly calculate the dose based on the weight of the toddler and the prescribed dosage per kg.
A nurse is preparing to administer an enteral tube feeding through an NG tube at 250 mL over 4 hr. The nurse should set the pump to deliver how many mL/hr?
- A. 60 mL/hr
- B. 62 mL/hr
- C. 63 mL/hr
- D. 65 mL/hr
Correct Answer: C
Rationale: Calculation: 250 mL / 4 hours = 62.5 mL/hr, which should be rounded up to 63 mL/hr. This ensures the correct rate is set for continuous feeding. Choice A (60 mL/hr) is incorrect as it does not reflect the accurate calculation. Choice B (62 mL/hr) is close but does not round up to the nearest whole number as required. Choice D (65 mL/hr) is higher than the correct calculation and would deliver the feeding solution at a faster rate than prescribed.
A healthcare provider is assessing a client who is receiving IV gentamicin three times daily. Which of the following findings indicates that the client is experiencing an adverse effect of this medication?
- A. Hypoglycemia
- B. Proteinuria
- C. Nasal congestion
- D. Visual disturbances
Correct Answer: B
Rationale: Corrected Rationale: Gentamicin is known to cause nephrotoxicity as an adverse effect. Proteinuria, which is the presence of excess proteins in the urine, may indicate kidney damage from the medication. Monitoring renal function is crucial in clients receiving gentamicin. Choice A, hypoglycemia, is not a typical adverse effect of gentamicin. Choices C and D, nasal congestion and visual disturbances, are not commonly associated with gentamicin use or its adverse effects.
A healthcare provider is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid-stimulating hormone (TSH) level and a decreased total T3 and T4 level. The healthcare provider should anticipate a prescription for which of the following medications?
- A. Methimazole
- B. Somatropin
- C. Levothyroxine
- D. Propylthiouracil
Correct Answer: C
Rationale: The client's symptoms and lab results indicate hypothyroidism, and levothyroxine is the standard treatment to replace the deficient thyroid hormones. Methimazole and propylthiouracil are used to treat hyperthyroidism by decreasing the production of thyroid hormones. Somatropin is a growth hormone used in conditions of growth hormone deficiency, not for hypothyroidism.