Nokea
A nurse is preparing to administer ampicillin and gentamicin sulfate via IV infusion. Which of the following resources should the nurse consult first regarding medication compatibility?
- A. Health care provider
- B. Hospital pharmacist
- C. Nurse manager
- D. Medication sales representative
Correct Answer: B
Rationale: The correct answer is B: Hospital pharmacist. The nurse should consult the pharmacist first for medication compatibility as they are experts in drug interactions and compatibility. Pharmacists can provide specific guidance on whether ampicillin and gentamicin sulfate can be safely administered together via IV infusion. Consulting the health care provider (choice A) may also be necessary for prescribing information, but pharmacists have specialized knowledge on drug interactions. The nurse manager (choice C) may not have the expertise in medication compatibility. Consulting a medication sales representative (choice D) is not appropriate as their role is to promote and sell medications rather than provide clinical guidance on compatibility.
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A nurse working on a medical unit is completing the admission of a client who reports a severe allergy to penicillin. Which of the following actions should the nurse take?
- A. Remove all objects that contain latex from the client’s room.
- B. Verify the client’s medication prescriptions do not include cephalosporin.
- C. Notify dietary services to adjust the client’s diet.
- D. Have the client purchase a medication alert bracelet to wear in the hospital.
Correct Answer: B
Rationale: The correct answer is B: Verify the client’s medication prescriptions do not include cephalosporin. This is essential because cephalosporins are antibiotics that share a similar structure to penicillin and can potentially cause an allergic reaction in individuals with a penicillin allergy. By ensuring that the client's medication prescriptions do not include cephalosporin, the nurse is taking a proactive step to prevent any adverse reactions.
Removing objects containing latex (choice A) is not directly related to the client’s penicillin allergy. Notifying dietary services to adjust the client’s diet (choice C) is unnecessary as the allergy is to penicillin, not food. Having the client purchase a medication alert bracelet (choice D) is not as immediate or essential as verifying medication prescriptions.
A nurse is caring for a client who has named a person to serve as his health care proxy. The client states he needs clarification about this type of advance directive. Which of the following statements by the client indicates a need for clarification?
- A. The health care proxy does not go into effect until I am incapable of making decisions.
- B. I have to choose a family member as my health proxy.
- C. I can change who I designate as my health care proxy at any time.
- D. If I become incapacitated, end-of-life choices will be made by my proxy.
Correct Answer: B
Rationale: The correct answer is B: "I have to choose a family member as my health proxy." This statement indicates a need for clarification because it is incorrect. The client can choose any competent adult to be their health care proxy, not just a family member. This misconception may limit the client's options and understanding of their rights.
Incorrect choices:
A: This statement is correct as the health care proxy only goes into effect when the client is incapable of making decisions.
C: This statement is correct as the client can change their designated health care proxy at any time.
D: This statement is correct as the health care proxy will make end-of-life choices if the client becomes incapacitated.
A nurse is preparing to administer dextrose 5% in 0.45% sodium chloride IV to infuse at 100 mL/hr. The nurse is using microtubing. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round to the nearest whole number)
Correct Answer: 100
Rationale: The correct answer is 100 gtt/min. To calculate the IV flow rate in gtt/min for microtubing, you can use the formula: gtt/min = (mL/hr x tubing factor) / 60. In this case, the mL/hr is 100, and for microtubing, the tubing factor is usually 60. So, (100 x 60) / 60 = 100 gtt/min. This ensures the dextrose 5% in 0.45% sodium chloride solution is infused at the correct rate. Other choices would be incorrect because they do not follow the correct calculation for microtubing flow rates.
A nurse is assessing a client who has hypothyroidism. Which of the following findings should the nurse expect?
- A. Exophthalmos
- B. Photophobia
- C. Lethargy
- D. Weight loss
Correct Answer: C
Rationale: Rationale: Hypothyroidism is characterized by decreased thyroid hormone levels, leading to symptoms such as lethargy due to slowed metabolism. Exophthalmos (bulging eyes) is associated with hyperthyroidism. Photophobia (sensitivity to light) is not a common symptom of hypothyroidism. Weight loss is more indicative of hyperthyroidism due to increased metabolism. Therefore, the correct answer is C: Lethargy, as it aligns with the expected findings in hypothyroidism.
A nurse is caring for a client who has an endotracheal tube and is receiving mechanical ventilation. Which of the following actions should the nurse take to reduce the risk of ventilator-associated pneumonia?
- A. Turn the client every 4 hours.
- B. Brush the client’s teeth with a suction toothbrush every 12 hours.
- C. Provide humidity by maintaining moisture within the ventilator tubing.
- D. Position the head of the client’s bed in the flat position.
Correct Answer: B
Rationale: The correct answer is B: Brush the client's teeth with a suction toothbrush every 12 hours. This action helps reduce the risk of ventilator-associated pneumonia by preventing the buildup of bacteria in the oral cavity that could be aspirated into the lungs. Ventilator-associated pneumonia is often caused by bacteria from the oral cavity entering the respiratory system. Regular oral care, including brushing the teeth, helps to reduce the bacterial load in the mouth. Turning the client every 4 hours (choice A) helps prevent pressure ulcers but does not directly reduce the risk of ventilator-associated pneumonia. Providing humidity in the ventilator tubing (choice C) is important for maintaining airway moisture but does not specifically target pneumonia prevention. Positioning the head of the client's bed flat (choice D) is important for proper ventilation but does not address oral care and bacterial buildup.