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A nurse is caring for a patient who has a new prescription for metformin. Which of the following laboratory tests should the nurse monitor? Which lab test should the nurse monitor for metformin?
- A. Liver function tests
- B. Thyroid function tests
- C. Complete blood count
- D. Renal function tests
Correct Answer: D
Rationale: The correct answer is D: Renal function tests. Metformin is primarily excreted by the kidneys, so monitoring renal function tests like serum creatinine and estimated glomerular filtration rate (eGFR) is crucial to assess kidney function and prevent potential metformin-induced lactic acidosis. Monitoring liver function tests (A) is not essential for metformin therapy, as metformin is not metabolized by the liver. Thyroid function tests (B) are not directly affected by metformin. Complete blood count (C) is not typically monitored specifically for metformin therapy. Therefore, the most appropriate choice is D as it directly reflects metformin's clearance and potential for toxicity.
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A nurse is caring for a patient who is postoperative following a cesarean section. Which of the following findings should the nurse report to the provider? Which finding post-cesarean should the nurse report?
- A. Lochia serosa
- B. Fundus firm at the umbilicus
- C. Mild cramping
- D. Foul-smelling vaginal discharge
Correct Answer: D
Rationale: The correct answer is D: Foul-smelling vaginal discharge. This finding indicates a possible infection, which is crucial to report to the provider for prompt intervention. Foul odor may indicate endometritis or other postoperative complications.
A: Lochia serosa is a normal finding post-cesarean.
B: Fundus firm at the umbilicus is a normal finding post-cesarean, indicating proper involution.
C: Mild cramping is common post-cesarean due to uterine contractions as it returns to its pre-pregnancy size.
A nurse is caring for a patient who is receiving total parenteral nutrition (TPN). Which of the following laboratory values should the nurse monitor? Which lab value should the nurse monitor for TPN?
- A. Serum glucose
- B. Serum calcium
- C. Serum magnesium
- D. Serum sodium
Correct Answer: A
Rationale: The correct answer is A: Serum glucose. When a patient is receiving TPN, monitoring serum glucose levels is crucial as TPN solutions contain high concentrations of glucose. Elevated glucose levels can lead to hyperglycemia, which can result in complications such as osmotic diuresis and hyperosmolar hyperglycemic state. Monitoring glucose levels helps in adjusting TPN infusion rates to maintain a stable blood glucose level.
Incorrect answers:
B: Serum calcium - Calcium levels are not directly affected by TPN and are not typically monitored specifically for patients receiving TPN.
C: Serum magnesium - While magnesium levels may be affected by TPN, glucose monitoring is more critical due to the high glucose content in TPN.
D: Serum sodium - Sodium levels are not directly influenced by TPN and are not typically monitored specifically for patients receiving TPN.
Nurses’ Notes at 0700hrs
The client appears fatigued and reports a persistent headache. He has been experiencing muscle aches throughout his body. He also complains of a sore throat and has had a fever for the past two days. The client’s skin is warm to the touch and he appears slightly dehydrated.
Vital Signs at 0700hrs
• Temperature: 39.5°C (103.1°F)
• Blood pressure: 128/56 mm Hg
• Heart rate: 112/min
• Respiratory rate: 22/min
• SaO2: 96% on room air
Diagnostic Results at 0700hrs
• Complete blood count shows elevated white blood cells
• Throat culture has been sent to the lab for analysis
• Chest X-ray pending
A nurse is caring for a 45-year-old male client in the emergency department. The client was admitted at 0700hrs with a 2-day history of headache, muscle aches, fever, sore throat, and fatigue.The nurse is preparing to administer an antibiotic to the client. Which of the following actions should the nurse take? (Select all that apply)
- A. Wear a mask when caring for the client.
- B. Encourage the client to increase fluid intake.
- C. Place the client in a private room.
- D. Place the client on contact precautions.
- E. Monitor the client's temperature every 4 hours.
- F. Check the client's allergy history before administering the antibiotic.
- G. Educate the client about the importance of completing the full course of antibiotics.
Correct Answer: B,E,F,G
Rationale: The correct actions the nurse should take are to encourage the client to increase fluid intake, monitor the client's temperature every 4 hours, check the client's allergy history before administering the antibiotic, and educate the client about the importance of completing the full course of antibiotics.
Encouraging fluid intake helps maintain hydration and aids in the body's recovery. Monitoring temperature helps assess the client's response to treatment. Checking allergy history is crucial to prevent adverse reactions. Educating the client about completing the full course of antibiotics ensures effective treatment and prevents antibiotic resistance.
Wearing a mask (choice A) is not necessary for this situation unless the client is suspected of having a contagious respiratory illness. Placing the client in a private room (choice C) and placing the client on contact precautions (choice D) are not indicated unless the client is diagnosed with a specific contagious infection, which is not mentioned in the scenario.
A nurse is admitting a patient exhibiting manic behavior. The patient reports recent personal stressors, including the loss of her mother and a divorce. What should be the nurse's priority action? What is the priority action for a manic patient?
- A. Encourage self-care.
- B. Assist the patient in identifying coping behaviors.
- C. Prevent self-directed violence.
- D. Identify support systems.
Correct Answer: C
Rationale: The correct answer is C: Prevent self-directed violence. When dealing with a manic patient, the priority action should always be to ensure the safety of the patient and others. Manic episodes can lead to impulsive and risky behaviors, including self-harm or suicide attempts. By prioritizing the prevention of self-directed violence, the nurse can address the immediate threat to the patient's well-being. Encouraging self-care (choice A) and identifying coping behaviors (choice B) are important aspects of care but may not be the most urgent in this situation. Identifying support systems (choice D) is also valuable but does not address the immediate safety concerns presented by the manic behavior.
A nurse is educating a patient with benign prostatic hypertrophy who has been newly prescribed finasteride. What should the nurse include in the teaching? What should the nurse include in finasteride teaching?
- A. Decreased libido is an adverse effect of the medication.
- B. Avoid drinking grapefruit juice when taking this medication.
- C. PSA levels will increase while taking this medication.
- D. Expect to see a response from the medication within one week.
Correct Answer: A
Rationale: The correct answer is A: Decreased libido is an adverse effect of the medication. Finasteride is a 5-alpha reductase inhibitor commonly used to treat benign prostatic hypertrophy. One of the common side effects of finasteride is a decrease in libido due to its mechanism of action on hormone levels. This information is crucial for the patient to be aware of to monitor and report any changes in sexual function. Choice B is incorrect because grapefruit juice does not interact with finasteride. Choice C is incorrect as PSA levels typically decrease with finasteride treatment. Choice D is incorrect as it may take several months to see a response from the medication due to its mechanism of action on prostate size.