Nokea
A nurse is reviewing a list of current medications for a client who is starting therapy with furosemide. Which of the following medications should the nurse identify as being contraindicated?
- A. Levothyroxine
- B. Lithium carbonate
- C. Albuterol
- D. Cetirizine
Correct Answer: B
Rationale: The correct answer is B: Lithium carbonate. Furosemide can cause sodium depletion, leading to increased lithium levels and potential lithium toxicity. Levothyroxine (A) is not contraindicated with furosemide. Albuterol (C) may increase the risk of hypokalemia when used with furosemide but is not a contraindication. Cetirizine (D) does not have significant interactions with furosemide.
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A nurse is preparing to administer enoxaparin 5 mg/kg subcutaneous daily to a client who has deep-vein thrombosis. The client weighs 152 lb. Available is 120 mg/0.8 mL prefilled syringe. Calculate the dosage in mL that the nurse should administer. (Round the answer to the nearest tenth. Use a leading zero if applicable. Do not use a trailing zero.)
- A. 0.7
Correct Answer: A
Rationale: To calculate the dosage in mL, first convert the client's weight from pounds to kilograms: 152 lb ÷ 2.2 = 69.1 kg. Then, multiply the weight by the dose (5 mg/kg): 69.1 kg x 5 mg/kg = 345.5 mg. Next, determine the volume needed by dividing the dose by the concentration (120 mg/0.8 mL): 345.5 mg ÷ 120 mg/0.8 mL = 2.3 mL. Round to the nearest tenth, giving 2.3 mL. The correct answer is A (0.7 mL) because 2.3 mL is incorrectly rounded. Other choices are incorrect due to incorrect calculations or rounding.
A nurse is preparing to administer a daily dose of warfarin to a client. Which of the following laboratory values should the nurse check prior to administration?
- A. WBC
- B. INR
- C. Platelets
- D. APTT
Correct Answer: B
Rationale: The correct answer is B: INR. The International Normalized Ratio (INR) is a crucial laboratory value to monitor before administering warfarin, an anticoagulant. INR helps assess the effectiveness and safety of warfarin therapy by measuring the clotting time of blood. This ensures that the dose is within the therapeutic range to prevent clotting or bleeding complications. Checking white blood cells (WBC), platelets, or activated partial thromboplastin time (APTT) is not directly related to warfarin administration. WBC count indicates infection or inflammation, platelets assess clotting ability, and APTT evaluates the intrinsic pathway of coagulation. However, these values do not specifically guide warfarin dosing like the INR does.
Nurses’ notes
Vital Signs
Medication Administration Record
Client reports tightness in the chest that radiates to the left arm. States pain as 7 on a scale of 0 to 10. Client is diaphoretic and short of breath.
Which of the following instructions should the nurse include when reinforcing teaching to the client about their medication? Select all that apply.
- A. Lie down with feet elevated if dizziness occurs while taking this medication.
- B. Apply the patch daily to a hairless area of the skin.
- C. The medication will be effective 30 to 45 min following application.
- D. Remove the patch 12 to 14 hr following application.
- E. Remove the patch if you experience a headache.
- F. Place the patch on the same area every day.
Correct Answer: A,B,D
Rationale: Correct answer: A, B, D
Rationale:
A: Instructing the client to lie down with feet elevated if dizziness occurs is important as it can prevent falls and injury.
B: Applying the patch to a hairless area of the skin ensures proper drug absorption and effectiveness.
D: Removing the patch after 12 to 14 hours prevents skin irritation and ensures the medication is not being overexposed.
Incorrect answer explanations:
C: The time frame given for medication effectiveness is inaccurate and may lead to confusion.
E: Removing the patch if experiencing a headache is not a standard instruction and may interfere with the medication's intended purpose.
F: Placing the patch on the same area daily can lead to skin irritation or decreased drug absorption due to buildup.
A nurse is caring for a client who has hypertension and has been taking hydrochlorothiazide. Which of the following laboratory values should the nurse evaluate?
- A. Coagulation studies
- B. Thyroid levels
- C. Complete blood count
- D. Serum electrolyte levels
Correct Answer: D
Rationale: The correct answer is D: Serum electrolyte levels. Hydrochlorothiazide is a diuretic that can lead to electrolyte imbalances, such as hypokalemia and hyponatremia. Monitoring serum electrolyte levels is crucial to prevent complications like arrhythmias. Coagulation studies (A) are not typically affected by hydrochlorothiazide. Thyroid levels (B) are unrelated to this medication. Complete blood count (C) is not directly impacted by hydrochlorothiazide. Thus, evaluating serum electrolyte levels is the most relevant and essential assessment in this scenario.
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.