Nokea
A nurse is preparing to administer gentamicin to a child who weighs 44 lb. The provider prescribes 6 mg/kg/day IV to be administered in three equal doses. Available is gentamicin 40 mg/mL. How many mL should the nurse administer with each dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 1 mL
Rationale: The correct answer is 1 mL. To calculate the dose for each administration, first convert the child's weight from pounds to kilograms (44 lb = 20 kg). The total daily dose is 6 mg/kg/day, so for a 20 kg child, the total daily dose is 120 mg (6 mg/kg/day x 20 kg). Since it is to be given in three equal doses, each dose would be 40 mg (120 mg total dose ÷ 3 doses). Since the available concentration is 40 mg/mL, the nurse would administer 1 mL for each dose (40 mg ÷ 40 mg/mL = 1 mL). Therefore, the correct answer is 1 mL.
Incorrect answers:
- Choice B: This is incorrect as it does not follow the correct calculation method.
- Choice C: This is incorrect as it does not consider the weight of the child and the total daily dose required.
- Choice D: This is incorrect as it does not
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A nurse in a provider's office is reviewing the laboratory findings of client who has been taking gemfibrozil for 3 months. Which of the following findings should the nurse expect?
- A. Increased serum creatinine
- B. Reduced serum calcium
- C. Increased Hgb
- D. Reduced triglycerides
Correct Answer: D
Rationale: The correct answer is D: Reduced triglycerides. Gemfibrozil is a lipid-lowering medication that works by decreasing triglyceride levels. The nurse should expect a reduction in triglycerides as a therapeutic effect of the medication. Option A (Increased serum creatinine) is incorrect as gemfibrozil typically does not affect creatinine levels. Option B (Reduced serum calcium) is incorrect as gemfibrozil does not impact calcium levels. Option C (Increased Hgb) is incorrect as gemfibrozil does not directly affect hemoglobin levels. Therefore, the nurse should anticipate a decrease in triglyceride levels as the expected finding in a client taking gemfibrozil.
A nurse is collecting data from a client who is experiencing oxycodone toxicity. Which of the following findings should the nurse expect?
- A. Tachypnea
- B. Sedation
- C. Dilated pupils
- D. Tachycardia
Correct Answer: B
Rationale: The correct answer is B: Sedation. Oxycodone is an opioid that depresses the central nervous system, leading to sedation as a common manifestation of toxicity. Tachypnea (A) is more commonly associated with opioid withdrawal rather than toxicity. Dilated pupils (C) are more indicative of stimulant toxicity, not opioids. Tachycardia (D) is unlikely with oxycodone toxicity due to its depressant effects on the cardiovascular system. Other choices are not relevant to oxycodone toxicity.
A nurse is caring for a client who started taking amitriptyline 6 days ago. The client reports that the medication is not helping. Which of the following responses should the nurse make?
- A. I will inform your provider so they can prescribe a different medication.
- B. You will need to take this medication on an empty stomach for it to be more effective.
- C. You will need to wait a couple of weeks to feel the therapeutic effect of the medication.
- D. I will ask your provider to increase the dose of the medication.
Correct Answer: C
Rationale: The correct response is C: "You will need to wait a couple of weeks to feel the therapeutic effect of the medication." Amitriptyline, a tricyclic antidepressant, often takes 2-4 weeks to reach its full therapeutic effect. This is due to the time required for the medication to build up in the body and for the brain chemistry to adjust. It is crucial for the nurse to educate the client about this delayed onset of action to manage their expectations and prevent premature discontinuation.
Choices A, B, and D are incorrect because they do not address the pharmacokinetics or expected timeline for amitriptyline to take effect. Informing the provider for a different medication, taking on an empty stomach, or increasing the dose may not be necessary or safe without giving the current medication adequate time to work. The nurse should prioritize patient education on the medication's expected timeline rather than making immediate changes.
A nurse is collecting data from a client who is taking high doses of aspirin to treat rheumatoid arthritis. Which of the following findings indicates that the client has salicylism?
- A. Tinnitus
- B. Nuchal rigidity
- C. Pharyngitis
- D. Pruritus
Correct Answer: A
Rationale: The correct answer is A: Tinnitus. Salicylism is a toxic condition caused by high levels of salicylates, such as aspirin, in the body. Tinnitus is a common early sign of salicylism due to its ototoxic effects on the auditory nerve. Nuchal rigidity, pharyngitis, and pruritus are not typically associated with salicylism. Nuchal rigidity is more indicative of meningitis, pharyngitis suggests a throat infection, and pruritus is itching which is not specific to salicylism. Therefore, tinnitus is the most relevant finding in this context.
A nurse is collecting data from a client who is taking sumatriptan. Which of the following reports indicates a therapeutic response to the medication?
- A. Increased bone mass
- B. Relief of chest pain
- C. Improved mood
- D. Absence of headache
Correct Answer: D
Rationale: The correct answer is D: Absence of headache. Sumatriptan is a medication used to treat migraines by constricting blood vessels in the brain. A therapeutic response to sumatriptan would be the absence of a headache, as the medication is intended to relieve migraine symptoms. Increased bone mass (A), relief of chest pain (B), and improved mood (C) are not expected therapeutic responses to sumatriptan. These symptoms are not typically associated with the mechanism of action or indications for sumatriptan use. Therefore, the absence of a headache is the most appropriate indicator of a therapeutic response to sumatriptan in this scenario.