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 reviewing a client's 0800 laboratory values at 1100. The nurse notes that the client received heparin at 1000. Which of the following laboratory values warrants an incident report?
- A. ePTT 90 seconds
- B. Hgb 16 g/dL
- C. INR 1.6
- D. WBC 6,000/mm3
Correct Answer: A
Rationale: The correct answer is A: ePTT 90 seconds. This value indicates a higher than normal clotting time, which could potentially lead to bleeding complications due to excessive anticoagulation from heparin. The other values (B, C, D) are within normal ranges and do not indicate an immediate risk or adverse outcome related to heparin administration. An incident report is necessary to document and address the elevated ePTT to ensure appropriate interventions are taken to prevent harm to the patient.
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 preparing to administer potassium chloride elixir 20 mEq/day PO to divide equally every 12 hr. Available is 6.7 mEq/5 mL. How many mL should the nurse administer per dose? (Round to the nearest tenth.)
Correct Answer: 7.5
Rationale: The correct answer is 7.5 mL. To determine this, first calculate the total daily dose: 20 mEq/day ÷ 2 doses/day = 10 mEq/dose. Next, find the mL per dose using the available concentration: 10 mEq ÷ 6.7 mEq/5 mL = 7.46 mL, which rounds to 7.5 mL. This ensures the patient receives the correct dose of potassium chloride elixir. Other choices are incorrect because they do not follow the correct calculation or rounding process, leading to potential under or overdosing.
Which of the following statements should the nurse include in the teaching about the new medication?
- A. You should take this medication with dairy products.
- B. This medication may cause constipation.
- C. It is common to experience headache or blurred vision while taking this medication.
- D. You should avoid the sun while taking this medication.
- E. You should use an alternate method of birth control while taking this medication.
Correct Answer: D
Rationale: The correct answer is D: You should avoid the sun while taking this medication. This is important because some medications can increase sensitivity to sunlight, leading to sunburn or skin reactions. Avoiding the sun can prevent these adverse effects.
A: You should not take this medication with dairy products as it may interfere with the absorption of the medication.
B: Constipation is a common side effect of some medications, but it is not specific to this particular medication.
C: Headache or blurred vision may occur with some medications, but it is not specific to this particular medication.
E: Using an alternate method of birth control may be necessary if the medication interferes with hormonal contraceptives, but this information is not provided in the question stem.
A nurse is assessing a client who is taking haloperidol and is experiencing pseudoparkinsonism. Which of the following findings should the nurse document as a manifestation of pseudoparkinsonism?
- A. Serpentine limb movement
- B. Shuffling gait
- C. Nonreactive pupils
- D. Smacking lips
Correct Answer: B
Rationale: The correct answer is B: Shuffling gait. Pseudoparkinsonism is a side effect of antipsychotic medications like haloperidol, characterized by symptoms similar to Parkinson's disease. A shuffling gait, which is a slow, dragging walk with short steps and reduced arm swing, is a classic manifestation. Serpentine limb movement (A) is not associated with pseudoparkinsonism. Nonreactive pupils (C) are not a typical symptom of pseudoparkinsonism. Smacking lips (D) is a sign of tardive dyskinesia, another side effect of antipsychotic medications.