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A nurse on a medical unit is preparing to administer alendronate 40 mg PO for an older adult client who has Paget's disease of the bone. Which of the following actions should be the nurse's priority?
- A. Administer the medication to the client before breakfast in the morning.
- B. Assist the client to a chair before administering the medication.
- C. Give the medication to the client with water rather than milk.
- D. Educate the client on how to take the medication at home.
Correct Answer: A
Rationale: The correct answer is to administer the medication to the client before breakfast in the morning. Alendronate should be taken on an empty stomach before breakfast to ensure optimal absorption. Choice B is incorrect because assisting the client to a chair is not directly related to the administration of alendronate. Choice C is incorrect as there is no specific requirement to avoid taking alendronate with milk. Choice D is also incorrect as the priority at this moment is the correct administration of the medication in the hospital setting.
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A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40mg daily, but the client reports she has been taking extra doses to promote weight loss. Which of the following indicates she is dehydrated?
- A. Urine specific gravity of 1.035
- B. Urine specific gravity of 444
- C. Urine specific gravity of 2000
- D. Urine specific gravity of 1111.1
Correct Answer: A
Rationale: A urine specific gravity greater than 1.030 indicates dehydration. In this case, a urine specific gravity of 1.035 suggests concentrated urine, indicating dehydration. Choices B, C, and D have values that are not within the normal range for urine specific gravity and do not indicate dehydration. A urine specific gravity of 444, 2000, or 1111.1 are not physiologically possible values and are therefore incorrect.
A nurse is preparing to administer prochlorperazine 2.5 mg IV. Available is prochlorperazine injection 5 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth)
- A. 0.5 mL
- B. 0.005 mL
- C. 0.05 mL
- D. 5 mL
Correct Answer: A
Rationale: To calculate the mL needed, set up a proportion: 5 mg / 1 mL = 2.5 mg / X mL. Cross multiply to find X: 5 * X = 2.5 * 1, X = 2.5 / 5 = 0.5 mL. Therefore, the nurse should administer 0.5 mL. Choice B, 0.005 mL, is incorrect as it doesn't match the calculated result. Choice C, 0.05 mL, is incorrect as it is ten times the correct value. Choice D, 5 mL, is incorrect as it represents the total volume of the entire vial, not the amount needed for the specific dose.
A nurse is preparing to administer ampicillin 500 mg in 50 ml of dextrose 5% in water (D5W) to infuse over 15 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the nurse set the manual IV infusion to deliver? (Round to the nearest whole number)
- A. 33 gtt/min
- B. 66 gtt/min
- C. 10 gtt/min
- D. 14 gtt/min
Correct Answer: A
Rationale: To calculate the IV flow rate, you multiply the drop factor (10 gtt/mL) by the volume to be infused per minute (50 mL / 15 min). This gives you 10 gtt/mL 50 mL / 15 min = 33.33. Rounding to the nearest whole number, the nurse should set the manual IV infusion to deliver 33 gtt/min. Choice B (66 gtt/min) is incorrect as it is the result of doubling the correct answer. Choice C (10 gtt/min) is incorrect as it only considers the drop factor without accounting for the volume to be infused. Choice D (14 gtt/min) is incorrect as it miscalculates the infusion rate based on the given information.
A client with gout is prescribed allopurinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects?
- A. Nausea
- B. Metallic taste
- C. Fever
- D. Drowsiness
Correct Answer: C
Rationale: The correct answer is C: Fever. Fever can indicate a serious hypersensitivity reaction to allopurinol, known as allopurinol hypersensitivity syndrome, which can be severe and even life-threatening. Nausea and drowsiness are common side effects of allopurinol but not necessarily indications to discontinue the medication. Metallic taste is not typically associated with allopurinol use. Therefore, the nurse should emphasize to the client the importance of reporting any signs of fever promptly for further evaluation and management.
A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects?
- A. Increases blood pressure
- B. Prevents esophageal bleeding
- C. Decreases heart rate
- D. Reduces ammonia levels
Correct Answer: D
Rationale: The correct answer is D: Reduces ammonia levels. Lactulose is used to reduce blood ammonia levels in clients with hepatic encephalopathy. Options A, B, and C are incorrect because lactulose does not have the therapeutic effect of increasing blood pressure, preventing esophageal bleeding, or decreasing heart rate.