Nokea
An older adult client is to receive an antibiotic, gentamicin. What diagnostic finding indicates the client may have difficulty excreting the medication?
- A. High gastric pH
- B. High serum creatinine
- C. Low serum albumin
- D. Low serum blood urea nitrogen
Correct Answer: B
Rationale: An elevated serum creatinine indicates reduced renal function. Reduced renal function will delay the excretion of many medications.
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A nurse from the float pool is giving medications on a pediatric unit and is to give medications to a 2-year-old child in room 534, bed B. The child in that room does not have an identification band. What is the best action for the nurse to take?
- A. Ask the child what his name is
- B. Give the medication to the child in room 534, bed B
- C. Refuse to give the medication
- D. Ask the adults beside the bed the name of the child in that bed
Correct Answer: C
Rationale: Refusing to give medication without proper identification ensures safety, as a 2-year-old cannot reliably confirm identity.
The nurse caring for a client with myasthenia gravis is reviewing the nursing care plan. Which is recognized as the priority nursing diagnosis?
- A. Risk for injury
- B. Acute pain
- C. Ineffective airway clearance
- D. Impaired mobility
Correct Answer: C
Rationale: Clients with myasthenia gravis have problems with the muscular activity of breathing. Answers A, B, and D are not the priority, so they are wrong.
The nurse is caring for 2 children who have had surgical repair of congenital heart defects. For which defect is it a priority to assess for findings of heart conduction disturbance?
- A. Arterial septal defect
- B. Patent ductus arteriosus
- C. Aortic stenosis
- D. Ventricular septal defect
Correct Answer: D
Rationale: Ventricular septal defect. Surgical repair involves manipulation of the ventricular septum, increasing the risk of conduction disturbances.
The nurse is caring for an infant with suspected meningitis and preparing to assist with a lumbar puncture. What is the appropriate nursing intervention?
- A. Administer oxygen via nasal cannula for client comfort and safety
- B. Clean area with povidone iodine in a circular motion moving outward
- C. Hold the child with the head and knees tucked in and the back rounded out
- D. Monitor and record vital signs every 15 minutes throughout the procedure
Correct Answer: C
Rationale: During a lumbar puncture for an infant, holding the child in a flexed position with head and knees tucked and back rounded ensures proper spinal alignment for safe needle insertion. Oxygen is not routinely needed, cleaning is typically done by the provider, and vital sign monitoring is important but not the primary intervention.
Which client condition is concerning and requires further nursing observation and intervention? Select all that apply.
- A. Client with asthma exacerbation and blood pressure is 150/90 mm Hg
- B. Client with spinal cord injury and blood pressure is 50/60 mm Hg
- C. Client with coronary artery disease on metoprolol, pulse is 62/min
- D. Elderly client with black stool; pulse is 112/min
- E. Neonate crying inconsolably at feeding time; pulse is 160/min
Correct Answer: B,D,E
Rationale: Concerning conditions include: spinal cord injury with hypotension suggesting neurogenic shock; black stool and tachycardia indicating possible GI bleeding; and inconsolable neonate with tachycardia suggesting distress. Asthma with hypertension and stable pulse on metoprolol are less urgent.