Nokea
The client has been receiving garamycin 65 mg IVPB every 8 hours for the past 6 days. Which lab result indicates an adverse reaction to the medication?
- A. WBC 7500
- B. Serum glucose 92
- C. Protein 3.5
- D. Serum Creatinine 2.0
Correct Answer: D
Rationale: Garamycin (gentamicin) is an aminoglycoside antibiotic that can cause nephrotoxicity. A serum creatinine level of 2.0 mg/dL is elevated (normal range is approximately 0.6-1.2 mg/dL), indicating potential kidney damage, an adverse reaction. Answers A, B, and C represent normal or unrelated lab values.
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The nurse is caring for a client with oral candidiasis who has a new prescription for nystatin oral suspension. Which of the following actions should the nurse take? Select all that apply.
- A. Tell the client to avoid eating or drinking for at least 30 minutes after taking nystatin.
- B. Monitor the client's oral mucous membranes for redness, swelling, and irritation.
- C. Remind the client to discontinue the nystatin once the symptoms subside.
- D. Shake the bottle of nystatin thoroughly before measuring the dose.
- E. Instruct the client to swish the nystatin around the mouth.
Correct Answer: A,B,D,E
Rationale: For nystatin oral suspension: avoid eating/drinking for 30 minutes to ensure contact time; monitor oral membranes for treatment response; shake the bottle for proper dosing; and swish in the mouth for efficacy. Discontinuing early risks recurrence.
Which statement, if made by the client, indicates a possible problem?
- A. I have a bowel movement every other day.'
- B. My stools recently are black.'
- C. Sometimes I have to strain when I go to the bathroom.'
- D. I usually have three stools a day.'
Correct Answer: B
Rationale: Black stools may indicate gastrointestinal bleeding, a serious concern requiring evaluation. Other statements reflect normal variations or minor issues.
A 36 year-old female client has a hemoglobin level of 14 g/dl and a hematocrit of 42% following a D&C. Which of the following would the nurse expect to find when assessing this client?
- A. Capillary refill less than 3 seconds
- B. Pale mucous membranes
- C. Respirations 20 breaths per minute
- D. Complaints of fatigue when ambulating
Correct Answer: A
Rationale: Capillary refill less than 3 seconds. Since the hemoglobin and hematocrit are normal for an adult female, additional assessments should be normal. This capillary refill time is normal.
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.
A client who has a known history of cardiac problems and is still smoking enters the clinic complaining of sudden onset of sharp, stabbing pain that intensifies with a deep breath. The pain is occurring on only one side and can be isolated upon general assessment. The nurse concludes that this description is most likely caused by:
- A. pleurisy.
- B. pleural effusion.
- C. atelectasis.
- D. tuberculosis.
Correct Answer: A
Rationale: Pleurisy is an inflammation of the pleura and is often accompanied by abrupt onset of pain. Symptoms of pleurisy are abrupt pain that is usually unilateral and localized to a specific portion of the chest.