Nokea
A nurse is preparing to administer phenobarbital 3 mg/kg/day PO in two divided doses to a client who weighs 145 lb. The amount available is phenobarbital 100 mg/tablet. How many tablets should the nurse administer per 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
Rationale: To determine the total daily dose, convert the client's weight from lb to kg (145 lb / 2.2 = 65.91 kg). Then calculate the total daily dose in mg (3 mg/kg/day * 65.91 kg = 197.73 mg/day). Since it is divided into two doses, the nurse should administer approximately 99 mg per dose. Since each tablet is 100 mg, the nurse should administer 1 tablet per dose. This is the correct answer, as it ensures the client receives the prescribed dose. Other choices are incorrect as they do not align with the calculated dose needed, leading to potential under or overdosing.
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A nurse is reviewing the medication administration record of a client who has a wound infection. The client has prescriptions for cefotetan and an NSAID. The nurse should monitor for which of the following medication interactions?
- A. Bleeding
- B. Dysrhythmias
- C. Dizziness
- D. Jaundice
Correct Answer: A
Rationale: The correct answer is A: Bleeding. Cefotetan is a cephalosporin antibiotic that can increase the risk of bleeding when taken with NSAIDs due to their additive effects on platelet function. The combination can lead to gastrointestinal bleeding or bruising. Dysrhythmias (choice B) are not typically associated with this drug combination. Dizziness (choice C) and jaundice (choice D) are not common interactions with cefotetan and NSAIDs.
A nurse in a clinic is preparing to administer the measles, mumps, rubella (MMR) vaccine to a client. Which of the following findings should indicate to the nurse that the client has a contraindication for the MMR vaccine?
- A. The client had a local reaction from a previous immunization
- B. The client reports having diarrhea this morning
- C. The client is at 9 weeks of gestation
- D. The client reports an allergy to penicillin.
Correct Answer: C
Rationale: The correct answer is C: The client is at 9 weeks of gestation. Administering the MMR vaccine during pregnancy is contraindicated due to the theoretical risk of causing harm to the fetus. The live attenuated MMR vaccine should not be given to pregnant women as it may potentially harm the developing fetus. It is crucial to avoid administration during pregnancy to prevent any adverse effects on the unborn child.
Other options are incorrect because:
A: The client had a local reaction from a previous immunization - Local reactions to previous vaccines are not contraindications to receiving the MMR vaccine.
B: The client reports having diarrhea this morning - Diarrhea is not a contraindication for the MMR vaccine.
D: The client reports an allergy to penicillin - Allergy to penicillin is not a contraindication for the MMR vaccine.
A nurse is monitoring a client's response to receiving glipizide instead of guaifenesin. Which of the following actions should the nurse take?
- A. Lower the head of the client's bed.
- B. Check the client for urinary retention
- C. Offer the client a carbohydrate snack.
- D. Test the client's deep-tendon reflexes.
Correct Answer: C
Rationale: The correct answer is C: Offer the client a carbohydrate snack. Glipizide is an oral antidiabetic medication that can lower blood sugar levels by stimulating the release of insulin from the pancreas. If the client receives glipizide instead of guaifenesin (an expectorant), there is a risk of hypoglycemia due to the medication's blood sugar-lowering effects. Offering a carbohydrate snack can help prevent or treat hypoglycemia by quickly raising blood sugar levels. Lowering the head of the bed (A), checking for urinary retention (B), and testing deep-tendon reflexes (D) are not directly related to the client's response to glipizide.
A nurse is administering phenytoin to a client. The nurse should monitor for which of the following adverse effects?
- A. Tinnitus
- B. Bleeding gums
- C. Jaundice
- D. Deep vein thrombosis
Correct Answer: B
Rationale: The correct answer is B: Bleeding gums. Phenytoin is an antiepileptic medication known to cause gingival hyperplasia, leading to bleeding gums. Monitoring for this adverse effect is crucial to prevent further complications. Tinnitus (A) is associated with aspirin overdose. Jaundice (C) is a potential adverse effect of liver-damaging medications. Deep vein thrombosis (D) is not directly related to phenytoin administration.
A nurse is caring for a client who is receiving filgrastim. The nurse should monitor the client for which of the following adverse effects?
- A. Hypertension
- B. Fluid retention
- C. Bone pain
- D. Hypokalemia
Correct Answer: C
Rationale: The correct answer is C: Bone pain. Filgrastim is a medication that stimulates the production of white blood cells. Bone pain is a common adverse effect because it indicates the bone marrow is producing more cells. Monitoring for bone pain is crucial to assess the effectiveness of the medication. Hypertension (A) and fluid retention (B) are not typically associated with filgrastim. Hypokalemia (D) is not a common adverse effect of filgrastim.