Nokea
The child is to start on medication therapy for enuresis that has not resolved with behavioral interventions. Which medication should the nurse anticipate being prescribed for the child?
- A. Lorazepam
- B. Desmopressin
- C. Nitrofurantoin
- D. Spironolactone
Correct Answer: B
Rationale: A: Lorazepam (Ativan) is a benzodiazepine used to treat anxiety. A side effect is drowsiness, which could impair a child's ability to waken for voiding. B: Desmopressin (DDAVP) is an analog of arginine vasopressin, which acts as an antidiuretic. It promotes resorption of water in the renal tubule or decreases bladder filling. C: Nitrofurantoin (Macrobid) is a urinary tract antiseptic used to treat UTIs and would not be used with enuresis. D: Spironolactone (Aldactone) is a potassium-sparing diuretic that would promote, not inhibit, diuresis.
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The 4-year-old with meningitis is to receive ceftriaxone 750 mg IVPB over 30 minutes. The pharmacy provided 750 mg in 50 mL D5W to be infused IVPB through a microdrip infusion system (tubing drop factor 60 gtt/min). At what rate, in gtt per min, should the nurse program the IVPB pump?
Correct Answer: 100
Rationale: Volume to be infused is 50 mL over 30 minutes. Calculate mL/min: 50 mL/ 30 min = 1.6667 mL/min. Convert to gtt/min using the drop factor: 1.6667 mL/min x 60 gtt/mL = 100 gtt/min.
The nurse telephones the HCP to request a pm anxiolytic medication order for a hospitalized client having occasional anxiety. Which medication, if prescribed, should the nurse question regarding its effectiveness for prn use?
- A. Buspirone
- B. Lorazepam
- C. Clorazepate
- D. Clonazepam
Correct Answer: A
Rationale: Buspirone (BuSpar) has a 10- to 14-day delay in therapeutic onset, making it unsuitable for prn use.
An infection in a central venous access device is not eliminated by giving antibiotics through the catheter. How might bacterial glycocalyx contribute to this?
- A. It protects the bacteria from antibiotic and immunologic destruction.
- B. Glycocalyx neutralizes the antibiotic, rendering it ineffective.
- C. It competes with the antibiotic for binding sites on the microbe.
- D. Glycocalyx provides nutrients for microbial growth.
Correct Answer: A
Rationale: Glycocalyx is a viscous polysaccharide or polypeptide slime that covers microbes, enhancing adherence to surfaces, resisting phagocytic engulfment, and preventing antibiotics from contacting the microbe.
The client has been receiving clonidine 0.1 mg via transdermal patch once every 7 days. The NA removes the patch with morning cares. Eight hours later, the nurse discovers that the clonidine patch is no longer present. Which assessment finding should be most concerning to the nurse?
- A. Skin tear is noted on the client's upper chest.
- B. Client reports having an excruciating headache.
- C. Blood pressure is noted to be 182/100 mm Hg.
- D. The ECG monitor shows a heart rate of 120 bpm.
Correct Answer: C
Rationale: A: Although a skin tear is concerning and may have occurred during removal, it is not the most concerning. B: Headache can occur from the abrupt removal of clonidine but is not the most concerning. C: Clonidine (Catapres) is an antihypertensive medication. Rebound hypertension occurs from abrupt withdrawal. Immediate intervention is required to lower the BP. D: Tachycardia is an adverse effect of clonidine.
Which of the following injuries, if demonstrated by a client entering the Emergency Department, is the highest priority?
- A. open leg fracture
- B. open head injury
- C. stab wound to the chest
- D. traumatic amputation of a thumb
Correct Answer: C
Rationale: A stab wound to the chest might result in lung collapse and mediastinal shift that, if untreated, could lead to death. Treatment of an obstructed airway or a chest wound is a higher priority than hemorrhage. The principle of ABC (airway, breathing, and circulation) prioritizes care decisions.