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A nurse is caring for a client who has a new prescription for metformin. Which of the following laboratory results should the nurse evaluate prior to administering the first dose?
- A. Potassium level
- B. Creatinine level
- C. Platelet count
- D. Liver enzymes
Correct Answer: B
Rationale: The correct answer is B: Creatinine level. Metformin is excreted by the kidneys, so assessing the client's creatinine level is crucial to determine kidney function. Elevated creatinine levels may indicate impaired renal function and increase the risk of metformin accumulation, leading to potential toxicity. Evaluating potassium levels (choice A) is important for other medications but not specifically for metformin. Platelet count (choice C) and liver enzymes (choice D) are not directly related to metformin administration.
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A nurse in the PACU is caring for a client who received isoflurane. Which of the following assessments is the nurse's priority?
- A. Intake and output
- B. Non verbal pain cues
- C. Bowel sounds
- D. Blood pressure
Correct Answer: D
Rationale: The correct answer is D: Blood pressure. Monitoring blood pressure is crucial after administering isoflurane due to its potential side effects of hypotension. Decreased blood pressure can indicate a serious adverse reaction and prompt intervention is necessary to maintain perfusion. Assessing intake and output, nonverbal pain cues, and bowel sounds are important, but they are not the priority when managing a potential life-threatening complication like hypotension post-isoflurane administration.
A nurse is planning care for a client who has a new prescription to receive a continuous infusion of total parenteral nutrition (TPN) Which of the following interventions should the nurse implement?
- A. Change the TPN infusion tubing once every 3 days
- B. Check the client's blood glucose level regularly
- C. Insert the peripheral IV catheter for administration
- D. Monitor the client's weight every 3 days
Correct Answer: B
Rationale: The correct answer is B: Check the client's blood glucose level regularly. This is essential as TPN is a high-calorie, nutrient-dense solution that can increase the risk of hyperglycemia. Monitoring blood glucose levels helps the nurse assess the client's response to TPN and adjust the infusion rate accordingly to prevent complications.
Option A is incorrect because changing the TPN infusion tubing once every 3 days is not a priority in this situation. Option C is incorrect as TPN should be administered through a central venous catheter, not a peripheral IV catheter. Option D is incorrect as monitoring the client's weight every 3 days is not as crucial as monitoring blood glucose levels when on TPN.
A nurse is assessing a client who reports feeling dizzy while getting out of bed. The nurse suspects orthostatic hypotension related to a medication the client is taking Which of the following medications should the nurse identify as likely causing this adverse effect?
- A. Dabigatran
- B. Levothyroxine
- C. Isoproterenol
- D. Furosemide
Correct Answer: D
Rationale: The correct answer is D: Furosemide. Furosemide is a loop diuretic that works by causing increased urine production, leading to fluid loss and potential dehydration, which can result in orthostatic hypotension. This effect is more pronounced when the client changes positions quickly, such as getting out of bed.
A: Dabigatran is an anticoagulant and does not typically cause orthostatic hypotension.
B: Levothyroxine is a thyroid hormone replacement and does not usually cause orthostatic hypotension.
C: Isoproterenol is a beta-adrenergic agonist that can actually increase blood pressure, not cause orthostatic hypotension.
In summary, Furosemide is the correct answer because it is a diuretic that can lead to dehydration and orthostatic hypotension, while the other options do not typically cause this adverse effect.
A nurse is preparing to administer morphine 8 mg IV intermittent bolus to a client. The amount available is morphine 10 mg/mL. How many mL should the nurse administer?
- A. 0.8 mL
Correct Answer: A
Rationale: The correct answer is A: 0.8 mL. To calculate the amount of morphine to administer, divide the desired dose (8 mg) by the concentration (10 mg/mL). 8 mg / 10 mg/mL = 0.8 mL. The other choices are incorrect because they do not reflect the correct calculation based on the given information. A nurse must accurately calculate medication dosages to ensure patient safety.
A nurse is providing teaching to a client who has a new prescription for atenolol. Which of the following adverse effects should the nurse include in the teaching?
- A. Lightheadedness
- B. Tachycardia
- C. Dry mouth
- D. Bronchodilation
Correct Answer: A
Rationale: The correct answer is A: Lightheadedness. Atenolol is a beta-blocker that can cause a decrease in blood pressure, leading to lightheadedness due to reduced blood flow to the brain. Tachycardia (choice B) is not an adverse effect as atenolol actually slows down the heart rate. Dry mouth (choice C) is not a common adverse effect of atenolol. Bronchodilation (choice D) is not expected with atenolol as it can actually cause bronchoconstriction in some individuals.