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A nurse is preparing to administer 0800 medications to a client. The medication administration record (MAR) states 'phenobarbital' and the medication the pharmacy supplied is pentobarbital. Which of the following actions should the nurse take?
- A. Check the client's MAR to see what the client received the day before
- B. Ask the client what medication she took yesterday.
- C. Ask the client if she has any allergies.
- D. Check the prescription in the client's medical record.
Correct Answer: D
Rationale: The correct answer is D: Check the prescription in the client's medical record. This is the appropriate action for the nurse to take because it ensures that the medication being administered matches the prescription ordered by the healthcare provider. By verifying the prescription in the client's medical record, the nurse can confirm if pentobarbital is indeed the correct medication prescribed for the client. Checking the MAR alone may not provide the necessary information about the prescribed medication. Asking the client about previous medications or allergies (choices A, B, C) may not be reliable sources of information regarding the specific prescription. Therefore, option D is the most appropriate and logical course of action in this situation.
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A nurse is evaluating the laboratory results of four clients. The nurse should report which of the following laboratory results 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 warfarin and an INR of 2.0 (0.8 to 1.1).
- C. A client who has a prescription for heparin and an aPTT of 65 seconds (30-40 seconds).
- D. A client who has a prescription for warfarin and an INR of 3.0 (0.8 to 1.1).
Correct Answer: A
Rationale: The correct answer is A. A client who has a prescription for heparin and an aPTT of 90 seconds (30-40 seconds) should be reported to the provider because the aPTT result is significantly above the therapeutic range, indicating a potential risk of bleeding due to excessive anticoagulation. Heparin therapy requires close monitoring of aPTT levels to ensure the medication's efficacy and safety. Reporting this result promptly to the provider allows for timely adjustment of the heparin dosage to prevent complications.
Choices B, C, and D are incorrect because they fall within or close to the desired therapeutic ranges for the respective medications. Therefore, they do not require immediate reporting to the provider as they suggest appropriate anticoagulation levels.
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.
A nurse is caring for a client who has a new prescription for lorazepam. For which of the following adverse effects should the nurse monitor?
- A. Urinary retention
- B. Dizziness
- C. Decreased appetite
- D. Hypertension
Correct Answer: B
Rationale: Rationale: The correct answer is B, dizziness, because lorazepam is a benzodiazepine that can cause central nervous system depression, leading to dizziness as a common adverse effect. Urinary retention (A) is not a common side effect of lorazepam. Decreased appetite (C) is not typically associated with lorazepam use. Hypertension (D) is not a common adverse effect of lorazepam. It is important to monitor for dizziness as it can affect the client's safety and mobility.
A nurse is caring for a client receiving gentamicin. For which of the following should the nurse monitor the client?
- A. Tinnitus
- B. Tachycardia
- C. Polyuria
- D. Photophobia
Correct Answer: A
Rationale: The correct answer is A: Tinnitus. The nurse should monitor the client for tinnitus because gentamicin can cause ototoxicity, leading to hearing loss and tinnitus. Tachycardia (B), polyuria (C), and photophobia (D) are not commonly associated with gentamicin use. Tachycardia may be a sign of other issues, polyuria could indicate kidney problems, and photophobia is sensitivity to light, which is not a typical side effect of gentamicin. Therefore, the nurse should focus on monitoring for tinnitus as a potential adverse effect of gentamicin therapy.
A nurse is collecting data from a client who is experiencing oxycodone toxicity. Which of the following findings should the nurse expect?
- A. Tachycardia
- B. Sedation
- C. Dilated pupils
- D. Tachypnea
Correct Answer: B
Rationale: The correct answer is B: Sedation. Oxycodone is an opioid that depresses the central nervous system, leading to symptoms such as sedation or drowsiness. This is because opioids like oxycodone bind to opioid receptors in the brain, causing a calming effect. Tachycardia (A) and dilated pupils (C) are more commonly associated with stimulant toxicity rather than opioid toxicity. Tachypnea (D) is not a typical finding in opioid toxicity as opioids tend to depress the respiratory system, causing respiratory depression instead.