Nokea
A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to:
- A. Treat thyroid storm.
- B. Prevent cardiac irritability.
- C. Treat hypocalcemic tetany.
- D. Stimulate the release of parathyroid hormone.
Correct Answer: C
Rationale: Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally removed or injured during surgery. Manifestations develop 1 to 7 days after surgery. If the client develops numbness and tingling around the mouth, fingertips, or toes or muscle spasms or twitching, the health care provider is notified immediately. Calcium gluconate should be kept at the bedside.
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When patients are started on darbepoetin alfa (Aranesp) they need monitoring of their blood counts to determine a dosage adjustment in:
- A. 6 weeks if they are a cancer patient
- B. 1 week if they have chronic renal failure
- C. 2 weeks if they are taking it for allogenic transfusion
- D. Each week throughout therapy
Correct Answer: A
Rationale: Cancer patients need blood count checks at 6 weeks for darbepoetin adjustment; renal patients adjust sooner, typically 2-4 weeks.
You are doing an admission assessment on a patient. During the medication history portion of the assessment what would be important to assess with herbal supplements?
- A. Research them for interactions with other medications
- B. Discontinue them if taking prescription medications
- C. Take them one hour before prescription medications
- D. Take them three hours after prescription medications
Correct Answer: A
Rationale: Researching herbal interactions ensures safe integration with prescribed drugs, preventing adverse effects.
A nurse is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.)
- A. 200
- B. 180
- C. 250
- D. 500
Correct Answer: A
Rationale: Calculation: (100 mL / 30 min) 60 min/hr = 200 mL/hr, matching the provided answer.
A 52-year-old overweight woman presents to the clinic for a diabetes management. She had not been doing well controlling her blood sugars with metformin. Her last hemoglobin A1c was 13.4%, despite her taking her medication every day. The physician decides to start her on a long-acting insulin that is injected only once a day for better glucose control. Also, he wants the insulin to have a minimal risk of hypoglycemia. What is the most likely medication given to this patient?
- A. Insulin aspart
- B. Insulin glargine
- C. Insulin lispro
- D. NPH insulin
Correct Answer: B
Rationale: Insulin glargine is a long-acting, peakless insulin administered once daily, with a lower risk of hypoglycemia compared to other insulins.
Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for the diarrhea. Loperamide:
- A. Can be given to patients of all ages, including infants and children, for viral gastroenteritis
- B. Slows gastric motility and reduces fluid and electrolyte loss from diarrhea
- C. Is the treatment of choice for the diarrhea associated with E. coli 0157
- D. May be used in pregnancy and by lactating women
Correct Answer: B
Rationale: Loperamide slows motility to reduce diarrhea; it's not for infants , E. coli 0157 (C, risks toxicity), or universally safe in pregnancy .