Nokea
A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances?
- A. Hypocalcemia
- B. Hypokalemia
- C. Hyponatremia
- D. Hypomagnesemia
Correct Answer: C
Rationale: The correct answer is C: Hyponatremia. When a client taking lithium starts a new exercise program, they may sweat more, leading to sodium loss. Hyponatremia is characterized by low sodium levels in the blood, which can be exacerbated by the diuretic effect of lithium. This can result in symptoms such as confusion, muscle cramps, weakness, and seizures. Assessing for hyponatremia is crucial to prevent complications.
Incorrect choices:
A: Hypocalcemia - Not directly related to lithium or exercise.
B: Hypokalemia - More commonly associated with diuretic use or excessive potassium loss.
D: Hypomagnesemia - More commonly seen in alcoholism or malnutrition.
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A nurse Is evaluating the laboratory results of four clents. The nurse should report which of the following laboratory results should the nurse report to the provider?
- A. A client who has a prescription for heparin and an aPTT of 90 seconds (30-40 seconds).
- B. A client who has a prescription for heparin and an aPTT of 65 seconds (30-40 seconds).
- C. A client who has a prescription for warfarin and an INR of 3.0 (0.8 to 1.1).
- D. A client who has a prescription for warfarin and an INR of 2.0 (0.8 to 1.1).
Correct Answer: A
Rationale: Correct Answer: A
Rationale: A client with a prescription for heparin and an aPTT of 90 seconds indicates that the client's blood is taking too long to clot, which puts the client at risk for bleeding. The aPTT range for a client on heparin therapy is 30-40 seconds, so a result of 90 seconds is significantly elevated and requires immediate attention to prevent bleeding complications.
Summary of other choices:
B: A client with a prescription for heparin and an aPTT of 65 seconds falls within the normal range of 30-40 seconds, so this result does not require immediate reporting.
C: A client with a prescription for warfarin and an INR of 3.0 is within the therapeutic range (2-3) for warfarin therapy, so this result does not require immediate reporting.
D: A client with a prescription for warfarin and an INR of 2.0 is also
A nurse is administering 4 mg of hydromorphone to a client by mouth every 4 hr. The medication is provided as hydromorphone 8 mg per tablet. Which of the following actions is appropriate for the nurse to take?
- A. Return the remaining medication to the facility's pharmacy.
- B. Store the remaining half of the pill in the automated medication dispensing system.
- C. Place the remaining half of the pill in the unit dose package.
- D. Dispose of the remaining medication while another nurse observes.
Correct Answer: D
Rationale: The correct answer is D: Dispose of the remaining medication while another nurse observes. This is the appropriate action because hydromorphone is a controlled substance with high abuse potential. The nurse should follow proper medication disposal protocols to prevent diversion or misuse. Returning the medication to the pharmacy (choice A) may not ensure proper disposal. Storing the remaining half of the pill in the automated medication dispensing system (choice B) or placing it in the unit dose package (choice C) could lead to unauthorized access. Disposing of the medication while another nurse observes (choice D) ensures accountability and adherence to safety measures.
Which of the following statements should the nurse include when teaching the client about the prescribed medication?
- A. The medication can cause nausea, so take with a meal.
- B. You can experience vivid nightmares.
- C. You may notice your urine becomes lighter in color.
- D. Consumption of a high protein meal can reduce the effectiveness of the medication.
- E. You may initially notice an increase in involuntary movements.
Correct Answer: A
Rationale: The correct answer is A because taking the medication with a meal can help reduce nausea. This statement is important to ensure client compliance and improve medication tolerance. Choice B is incorrect as vivid nightmares are not a common side effect of the medication. Choice C is incorrect as urine color change is not relevant to this medication. Choice D is incorrect as high protein meals do not affect medication effectiveness. Choice E is incorrect as an increase in involuntary movements is not expected with this medication.
A nurse is assessing a client who reports taking over-the-counter antacids. Which of the following findings should the nurse identify as a manifestation of hypercalcemia?
- A. Constipation
- B. Decreased urine output
- C. Positive Trousseau's sign
- D. Headache
Correct Answer: A
Rationale: The correct answer is A: Constipation. Hypercalcemia can result from excessive intake of antacids containing calcium carbonate. High levels of calcium in the blood can lead to constipation due to its inhibitory effect on smooth muscle contraction in the intestinal tract. Decreased urine output (choice B) is more indicative of dehydration or renal issues. Positive Trousseau's sign (choice C) is associated with hypocalcemia, not hypercalcemia. Headache (choice D) is a nonspecific symptom and not a typical manifestation of hypercalcemia.
A nurse is preparing to administer 4,000 units of heparin subcutaneously to a client who has deep-vein thrombosis. Available is heparin 10,000 units/mL. How many mL of heparin should the nurse administer? (Round to the nearest tenth.)
Correct Answer: 0.4
Rationale: To calculate the mL of heparin to administer, use the formula: desired dose (4,000 units) ÷ concentration (10,000 units/mL) = X mL. 4,000 ÷ 10,000 = 0.4 mL. The correct answer is 0.4 mL because it accurately represents the calculated dose needed for the client. Other choices are incorrect as they do not align with the correct calculation.