Nokea
In teaching bleeding precautions to a client with leukemia, the PN should include which of the following instructions?
- A. Use a soft toothbrush
- B. Use dental floss daily
- C. Hold pressure on any scrapes for 1-2 minutes
- D. Use a triple-edged razor
Correct Answer: A
Rationale: A soft toothbrush minimizes gum bleeding in leukemia clients with low platelets. Dental floss and razors increase bleeding risk, and pressure should be held for 5-10 minutes.
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The nurse is preparing to administer Azithromycin, and the pharmacy has provided the drug in a powder form that requires reconstitution connected to a saline piggyback. Which of the following is least concerning when preparing the medication?
- A. The expiration date on the powder vial is the same as the current date.
- B. The brand/trade name is not listed on the vial.
- C. The storage instructions on the vial says 'store at room temperature', and the vial is very cold to the touch indicating it has been taken out of a freezer.
- D. The bag of saline is leaking.
Correct Answer: B
Rationale: The brand or trade name is not required to be on the medication label if the generic name is present. The nurse should check that the medication is not expired and that it has been stored according to the storage instructions. If the saline bag is leaking, it may indicate that the container is damaged and the fluid may not be sterile.
The HCP prescribes risperidone to manage the hallucinations of the client diagnosed with paranoid schizophrenia. Which client statements reflect a need for further education regarding the medication's side effects? Select all that apply.
- A. Diarrhea may be a problem for me.
- B. I'll most likely develop high blood pressure.
- C. Being too nervous is a side effect of my medicine.
- D. I will need to watch what I eat so I won't gain weight.
- E. Getting up too quickly when I'm sitting can make me dizzy.
- F. I will need to be careful driving because this can make me drowsy.
Correct Answer: A,B
Rationale: Constipation, not diarrhea, and hypotension, not hypertension, are side effects of risperidone, indicating a need for further education.
The 8-year-old child with gastroenteritis is prescribed to receive 500 mL of lactated Ringer's (LR) solution over the next 10 hours. How many milliliters per hour should the nurse administer?
Correct Answer: 50
Rationale: 500 mL / 10 hr = 50 mL/hr
Which of the following is not considered one of the main mechanisms of Type II Diabetes treatment?
- A. Medications
- B. Nutrition
- C. Increased activity
- D. Continuous Insulin
Correct Answer: D
Rationale: Insulin is not required in continuous treatment for every Type II diabetic, as many can manage with lifestyle changes and oral medications.
The 12-year-old weighing 50 kg is hospitalized with bacterial pneumonia and an upper respiratory tract infection. The nurse is reviewing the child's serum laboratory report illustrated. Based on the findings, which HCP order is most important for the nurse to question?
- A. Amikacin sulfate 375 mg IVPB q12h
- B. Guaifenesin 50-100 mg q4h prn for cough
- C. Dextrose 5% in 0.25 NaCl with 20 mEq/L KCl at 90 mL/hr
- D. Acetaminophen 325-650 mg q4-6h prn, not to exceed 3000 mg/24 hr
Correct Answer: A
Rationale: A: Amikacin (Amikin) is an aminoglycoside, which is nephrotoxic and should be questioned. The serum creatinine and BUN levels are elevated, suggesting decreased renal function. B: Guaifenesin (Robitussin) is used for cough. The dose is within the range for a child of 12 years. C: The serum osmolality is high, suggesting dehydration, and the potassium is low. D5 in 0.25 NaCl with 20 mEq/L at 90 mL/hr will treat the dehydration and hypokalemia. D: The acetaminophen (Tylenol) dose is within parameters, but it is concerning with the decreased renal function. Because acetaminophen is prn and amikacin is timed, the amikacin is more important to question.