Nokea
Aluminum hydroxide gel (Amphojel) is ordered for an adult who has acute renal failure. What is the primary reason for administering this drug to this client?
- A. To prevent the development of Curling's ulcers
- B. To bind phosphates
- C. To maintain normal pH
- D. To prevent diarrhea
Correct Answer: B
Rationale: In renal failure, aluminum hydroxide binds phosphates in the gut, reducing hyperphosphatemia, a common complication.
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The client is complaining of nausea, and the nurse administers the antiemetic promethazine (Phenergan), IVP. Which intervention has priority for this client after administering this medication?
- A. Instruct the client to call the nurse before getting out of bed.
- B. Evaluate the effectiveness of the medication.
- C. Assess the client's abdomen and bowel sounds.
- D. Tell the client not to eat or drink for at least one (1) hour.
Correct Answer: A
Rationale: Promethazine causes sedation and orthostatic hypotension; instructing to call before ambulating prevents falls, the priority post-IVP.
The client with postmenopausal osteoporosis is prescribed the bisphosphonate alendronate (Fosamax). Which discharge instruction should the nurse discuss with the client?
- A. The medication must be taken with the breakfast meal only.
- B. Remain upright for at least 30 minutes after taking medication.
- C. The tablet should be chewed thoroughly before swallowing.
- D. Stress the importance of having monthly hormone levels.
Correct Answer: B
Rationale: Alendronate requires upright posture for 30 minutes post-dose to prevent esophageal irritation, per FDA guidelines. Meal timing, chewing, or hormone levels are incorrect.
An adult client has rheumatoid arthritis. Aspirin 975 mg q4h PRN is ordered for pain. At 2:00 P.M., the client requests pain medication. Aspirin was last given at 9:30 A.M. What is the most appropriate initial action for the nurse to take?
- A. Give the aspirin as ordered
- B. Question the order because it is a higher than normal dosage
- C. Attempt to divert the client's attention from the pain
- D. Assess the nature of the pain
Correct Answer: A
Rationale: The time since the last dose (4.5 hours) is within the q4h PRN order, and 975 mg is a standard high dose for rheumatoid arthritis.
You are caring for a client with deep vein thrombosis who is on Heparin IV. The latest APTT is 50 seconds. If the laboratory normal range is 16-24 seconds, you would anticipate
- A. maintaining the current heparin dose
- B. increasing the heparin as it does not appear therapeutic
- C. giving protamine sulfate as an antidote
- D. repeating the blood test 1 hour after giving heparin
Correct Answer: A
Rationale: maintaining the current heparin dose. The range for a therapeutic APTT is 1.5-2 times the control. Therefore the client is receiving a therapeutic dose of Heparin.
A woman who is receiving cancer chemotherapy exhibits all of the following. Which is most indicative of bone marrow depression?
- A. Alopecia
- B. Petechiae
- C. Stomatitis
- D. Constipation
Correct Answer: B
Rationale: Petechiae indicate low platelets, a sign of bone marrow depression, a common chemotherapy side effect.