Nokea
An adult is receiving gentamicin IV q8h. Which laboratory tests does the nurse expect that the client will have done regularly?
- A. CBC and hemoglobin
- B. BUN and serum creatinine
- C. SGOT and SGPT
- D. Urine and blood cultures
Correct Answer: B
Rationale: BUN and serum creatinine are tests of renal function. Gentamicin is nephrotoxic. All persons receiving gentamicin should have these tests done regularly to assess for toxicity.
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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.
The health care provider has written 'Morphine sulfate 2 mgs IV every 3-4 hours prn for pain' on the chart of a child weighing 22 lb. (10 kg). What is the nurse's initial action?
- A. Check with the pharmacist
- B. Hold the medication and contact the provider
- C. Administer the prescribed dose as ordered
- D. Give the dose every 6-8 hours
Correct Answer: B
Rationale: Hold the medication and contact the provider. The usual pediatric dose of morphine is 0.1 mg/kg every 3 to 4 hours. At 10 kg, this child typically should receive 1.0 mg every 3 to 4 hours.
The client with type 2 diabetes is diagnosed with gout and prescribed allopurinol (Zyloprim). Which instruction should the nurse discuss when teaching about this medication?
- A. The client will probably develop a red rash on the body.
- B. The client should drink two (2) to three (3) liters of water a day.
- C. The client should take this medication on an empty stomach.
- D. The client will need to increase oral diabetic medications.
Correct Answer: B
Rationale: Allopurinol increases uric acid excretion, risking kidney stones; 2–3 L water daily prevents this. Rash is possible but not probable, stomach timing is flexible, and diabetes meds are unaffected.
The nurse is administering an otic drop to the 45-year-old client. Which procedure should the nurse implement when administering the drops?
- A. Place the drops when pulling the ear down and back.
- B. Place the drops when pulling the ear up and back.
- C. Place the drops in the lower conjunctival sac.
- D. Place the drops in the inner canthus and apply pressure.
Correct Answer: B
Rationale: For adults, pulling the ear up and back straightens the ear canal for otic drops. Down/back is for children, others are for ophthalmic drops.
A post-operative client has a prescription for acetaminophen with codeine. What should the nurse recognize as a primary effect of this combination?
- A. Enhanced pain relief
- B. Minimized side effects
- C. Prevention of drug tolerance
- D. Increased onset of action
Correct Answer: A
Rationale: Enhanced pain relief. Combination of analgesics with different mechanisms of action can afford greater pain relief.