Nokea
Laboratory reference ranges
BUN
10-20 mg/dL
(3.6-7.1 mmol/L)
An 80-year-old client is receiving amikacin, an aminoglycoside antibiotic, IVPB every 12 hours. Which of the following data obtained
by the practical nurse is most important to report to the registered nurse before the client receives the next dose?
- A. client reports tinnitus
- B. Blood pressure 104/60 mm Hg
- C. urine output of 400 mL since last dose
Correct Answer: A
Rationale: Tinnitus may indicate ototoxicity, requiring immediate reporting. Low BP and urine output are less urgent without context of medication.
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The nurse is reinforcing teaching on oral care and symptom management to a client with head and neck cancer who has developed mouth sores related to external radiation therapy. Which of the following instructions should the nurse include? Select all that apply.
- A. Apply a water-soluble lubricating agent to moisturize mouth tissue
- B. Avoid hot liquids and foods that are spicy or acidic
- C. Brush your teeth with a soft-bristle toothbrush
- D. Cleanse the mouth with saline after meals and at bedtime
- E. Rinse with alcohol-based antiseptic mouthwash to decrease mouth odor
Correct Answer: A,B,C,D
Rationale: Water-soluble lubricant , avoiding irritants , soft brushing , and saline rinses promote comfort. Alcohol-based mouthwash irritates sores.
A client with chronic pancreatitis is receiving Pancreatin. Which of the following observations is most indicative that the drug treatment is having the desired effect?
- A. The client's appetite is improved.
- B. The client's weight loss is greater than 10 pounds.
- C. The client's stools contain less fat and occur with less frequency.
- D. The client's tissue bruises less easily.
Correct Answer: C
Rationale: Pancreatin replaces pancreatic enzymes, aiding fat digestion. Reduced fat in stools and less frequent bowel movements indicate effective treatment. Appetite improvement is secondary, weight loss is undesirable, and bruising is unrelated.
The nurse has taught the parents of a 6-year-old client with cystic fibrosis who has a prescription for pancreatic enzymes. Which of the following statements by a parent would require follow-up?
- A. It is acceptable for my child to chew the medication before swallowing it
- B. I should give the medication with or just before my child has a meal or snack
- C. I need to monitor the total amount of medication that I give to my child every day.
- D. It is acceptable to open the capsule and sprinkle the medication on a tablespoon of applesauce.
Correct Answer: A
Rationale: Chewing pancreatic enzymes destroys the enteric coating, reducing efficacy. Timing with meals , monitoring doses , and sprinkling on applesauce are correct practices.
The nurse is reviewing new orders for a client with chronic kidney disease. The nurse should clarify the order for
- A. dietary sodium restriction
- B. magnesium hydroxide
- C. fluid restriction
- D. furosemide
Correct Answer: B
Rationale: Magnesium hydroxide risks toxicity in CKD due to impaired excretion. Sodium restriction , fluid restriction , and furosemide are appropriate.
The nurse is discussing iron deficiency anemia with a community group. Which of the following persons are at risk for iron deficiency anemia? Select all that apply.
- A. A 15-month-old who drinks a lot of milk
- B. A 6-year-old who has sickle cell anemia
- C. An adolescent female
- D. A woman who is 8 months pregnant
- E. An African-American middle-aged man
- F. A 78-year-old on a fixed income
Correct Answer: A,C,D,F
Rationale: Toddlers drinking excessive milk, adolescent females (due to menstruation), pregnant women (increased iron demand), and elderly on fixed incomes (poor diet) are at risk. Sickle cell anemia and African-American males are not specific risk factors.