A nurse is caring for a client who has hypertension and has been taking hydrochlorothiazide. Which of the following laboratory values should the nurse evaluate?
- A. Coagulation studies
- B. Thyroid levels
- C. Complete blood count
- D. Serum electrolyte levels
Correct Answer: D
Rationale: The correct answer is D: Serum electrolyte levels. Hydrochlorothiazide is a diuretic that can lead to electrolyte imbalances, such as hypokalemia and hyponatremia. Monitoring serum electrolyte levels is crucial to prevent complications like arrhythmias. Coagulation studies (A) are not typically affected by hydrochlorothiazide. Thyroid levels (B) are unrelated to this medication. Complete blood count (C) is not directly impacted by hydrochlorothiazide. Thus, evaluating serum electrolyte levels is the most relevant and essential assessment in this scenario.
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A nurse is reinforcing discharge teaching with a client who has a new diagnosis of type 2 diabetes mellitus and a prescription for exenatide. Which of the following instructions should the nurse include in the teaching?
- A. Contact the provider if you experience unexplained muscle pain.
- B. Take the medication at bedtime.
- C. Discard excess medication after 60 days.
- D. Inject the medication into the subcutaneous tissue of your abdomen.
Correct Answer: D
Rationale: The correct answer is D: Inject the medication into the subcutaneous tissue of your abdomen. Exenatide is a medication that is administered through subcutaneous injection, typically into the abdomen. This is the correct route of administration to ensure proper absorption and effectiveness of the medication. Option A is incorrect as it is not directly related to the administration of exenatide. Option B is incorrect because exenatide is usually taken before meals, not at bedtime. Option C is incorrect as the disposal timeline for exenatide is typically shorter than 60 days.
A nurse is preparing to administer acetaminophen 10 mg/kg PO every 6 hr to a toddler who weighs 26.4 lb. Available is acetaminophen 80 mg/0.8 mL liquid. How many mL should the nurse administer with each dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
- A. 1.2
Correct Answer: A
Rationale: To calculate the correct dose, first convert the toddler's weight from pounds to kilograms: 26.4 lb / 2.2 = 12 kg. Then calculate the dose: 10 mg/kg * 12 kg = 120 mg per dose. Next, determine how many mL of the liquid acetaminophen contain 120 mg: 80 mg/0.8 mL = 120 mg/X mL. Cross multiply to find X = 1.2 mL. Therefore, the correct answer is A: 1.2 mL. Other choices are incorrect as they do not align with the calculated dose based on the toddler's weight and the concentration of the liquid form of acetaminophen available.
A nurse is caring for a client who has a prescription for morphine 4 mg IM stat. The medication is dispensed in a 5 mg/mL prefilled syringe. Which of the following actions should the nurse take?
- A. Dispose of the excess medication in the sharps container.
- B. Give the full contents of the prefilled syringe.
- C. Discard the excess medication with a second nurse as a witness.
- D. Inject the prescribed dose and save the rest for a later use.
Correct Answer: C
Rationale: The correct answer is C: Discard the excess medication with a second nurse as a witness. The nurse should discard the excess medication in the presence of another nurse to ensure proper disposal and avoid any medication errors or potential harm to the patient. This action aligns with medication safety practices and helps prevent medication errors.
Choice A: Disposing of the excess medication in the sharps container is incorrect because it does not involve a witness for proper disposal and may not follow facility protocols.
Choice B: Giving the full contents of the prefilled syringe would result in administering more medication than prescribed, risking harm to the patient.
Choice D: Injecting the prescribed dose and saving the rest for later use is incorrect as it goes against safe medication practices and may lead to errors in dosing.
In summary, choice C is the correct action to ensure safe and appropriate disposal of excess medication, while the other choices may lead to potential errors and harm to the patient.
A nurse is reinforcing teaching with a client who has a new prescription for sustained-release verapamil. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will crush the tablet to make it easier to swallow.
- B. I will increase my daily intake of fiber and fluid.
- C. I will follow up with monthly laboratory tests to check for anemia.
- D. I will sit upright for 30 minutes after taking the medication.
Correct Answer: B
Rationale: The correct answer is B: I will increase my daily intake of fiber and fluid. This response indicates understanding because sustained-release verapamil can cause constipation as a side effect. Increasing fiber and fluid intake can help prevent constipation and promote proper bowel function. Crushing sustained-release tablets can alter the drug's intended release mechanism, leading to potential overdose or underdose. Following up with monthly laboratory tests for anemia is not directly related to verapamil therapy. Sitting upright after taking the medication is more relevant for bisphosphonates to prevent esophageal irritation.
A nurse is caring for a client who is taking allopurinol. Which of the following laboratory findings indicates the medication has been effective?
- A. Decreased triglycerides
- B. Decreased uric acid
- C. Increased albumin
- D. Increased potassium
Correct Answer: B
Rationale: The correct answer is B: Decreased uric acid. Allopurinol is used to treat high levels of uric acid in the blood, which can lead to conditions like gout. A decrease in uric acid levels indicates that the medication is effectively lowering the client's uric acid levels. Triglycerides (choice A) are not directly affected by allopurinol. Albumin (choice C) and potassium (choice D) levels are not typically influenced by allopurinol therapy.
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