Nokea
A preterm infant with sepsis is receiving Gentamycin (garamycin). Which physiological alteration places the preterm infant at increased risk for toxicity related to aminoglycoside therapy?
- A. Lack of subcutaneous fat deposits
- B. Immature central nervous system
- C. Presence of fetal hemoglobin
- D. Immaturity of the renal system
Correct Answer: D
Rationale: The immature renal system in preterm infants reduces the ability to excrete aminoglycosides like Gentamycin, increasing the risk of toxicity.
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When assessing a laboring client, the nurse finds a prolapsed cord. The nurse should:
- A. Attempt to replace the cord
- B. Place the client on her left side
- C. Elevate the client's hips
- D. Cover the cord with a dry, sterile gauze
Correct Answer: C
Rationale: Elevating the hips relieves pressure on the prolapsed cord, maintaining fetal oxygenation.
A client who experienced a cardiac arrest and resuscitation is exhibiting characteristics of mild anoxic brain injury. Which of the following characteristics does the nurse expect her to exhibit? Select all that apply.
- A. Decreased ability to concentrate.
- B. Seizures.
- C. Memory impairment.
- D. Semicomatose state.
- E. Decreased balance.
- F. Restlessness.
Correct Answer: A,C,E,F
Rationale: Mild anoxic brain injury may cause decreased concentration (A), memory impairment (C), decreased balance (E), and restlessness (F). Seizures (B) and semicomatose state (D) are more typical of severe injury.
A newborn weighed 7 pounds at birth. At 6 months of age, the infant could be expected to weigh:
- A. 14 pounds
- B. 18 pounds
- C. 25 pounds
- D. 30 pounds
Correct Answer: A
Rationale: Infants typically double their birth weight by 6 months, so a 7-pound newborn would weigh approximately 14 pounds.
The nurse should explain to a client that tolbutamide (Orinase) is effective for diabetics who
- A. can no longer produce any insulin.
- B. produce minimal amounts of insulin.
- C. are unable to administer their injections.
- D. have a sustained decreased blood glucose.
Correct Answer: B
Rationale: oral hypoglycemic agents are administered to type II (non-insulindependent) clients who are able to produce minimal amounts of insulin
The nurse is caring for a client with a head injury who has an intracranial pressure monitor in place. Assessment reveals an ICP reading of 66. What is the nurse's best action?
- A. Notify the physician
- B. Record the reading as the only action
- C. Turn the client and recheck the reading
- D. Place the client supine
Correct Answer: A
Rationale: An ICP of 66 mmHg is critically high (normal <20 mmHg), indicating severe brain swelling. Notifying the physician is urgent for immediate intervention.