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The client taking carbamazepine XR for seizure control reports that pieces of the medication are being passed into the stool. Which action by the nurse is most important?
- A. Report this to the health care provider.
- B. Reassure the client that this is normal.
- C. Collect the stool for laboratory analysis.
- D. Document the findings in the medical record.
Correct Answer: B
Rationale: A: It is inappropriate to report an expected finding to the HCP. B: Carbamazepine XR (Tegretol XR) is a sustained-release medication with a coating that is not absorbed but is excreted in feces and may be visible in stool. The nurse should reassure the client that this is normal. C: Collecting the stool for laboratory analysis is not necessary because the coating is not absorbed but excreted in the stool. D: The nurse should document the client teaching but usually would not document the presence of the coating in the client's stool.
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The nurse evaluates that pancrelipase is having the optimal intended benefit for the client with CF. Which assessment finding prompted the nurse's conclusion?
- A. The client lost 4 pounds in 1 month.
- B. The client no longer has heartburn.
- C. The client has increased steatorrhea.
- D. The client has improved nutritional status.
Correct Answer: D
Rationale: A: Weight gain, not weight loss, is an intended effect. B: Pancrelipase is not used to treat abdominal heartburn. C: Pancrelipase reduces the amount of fatty stools (steatorrhea). D: Pancrelipase (Pancreaze) is a pancreatic enzyme used in clients with deficient exocrine pancreatic secretions, CF, chronic pancreatitis, or steatorrhea from malabsorption syndrome. Because it aids digestion, the nutritional status should be improved.
What is the therapeutic range for carbamazepine (Tegretol)?
- A. 7-12 mcg/mL
- B. 4-10 mcg/mL
- C. 10-14 mcg/mL
- D. 1-5 mcg/mL
Correct Answer: B
Rationale: The therapeutic range for carbamazepine (Tegretol) is 4-10 mcg/mL.
The Native American client is being assessed for emotional distress following a family crisis. In anticipating pharmacological treatment, the nurse understands that the Native American client would most likely do what?
- A. Use herbal remedies and other plant therapies with healing properties
- B. Attempt to manage emotional problems on his or her own to avoid shame
- C. Rely heavily on family for support during treatment for emotional distress
- D. Want a well-established relationship with an HCP before accepting treatment
Correct Answer: A
Rationale: Native American cultures often use herbal or plant remedies with healing properties.
The nurse administered phenylephrine eye drops to the client before performing an ophthalmoscopic eye examination. Which assessment finding should the nurse expect?
- A. Tremor
- B. Hypotension
- C. Pupil miosis
- D. Pupil mydriasis
Correct Answer: D
Rationale: A: Tremors are a side effect if phenylephrine is absorbed systemically. B: Because phenylephrine absorbed systemically is a vasoconstrictor, hypertension (not hypotension) can occur as a side effect. C: Miosis is pupil constriction, not an effect of phenylephrine. D: Phenylephrine (NeoSynephrine), an adrenergic agonist, produces pupil dilation (mydriasis) by activating alpha1-adrenergic receptors on the dilator muscles of the iris.
Which statement best describes electrolytes in intracellular and extracellular fluid?
- A. There is a greater concentration of sodium in extracellular fluid and potassium in intracellular fluid
- B. There is an equal concentration of sodium and potassium in extracellular fluid
- C. There is a greater concentration of potassium in extracellular fluid and sodium in intracellular fluid
- D. There is an equal concentration of sodium and potassium between intracellular and extracellular fluid
Correct Answer: A
Rationale: There is a greater concentration of sodium in extracellular fluid and potassium in intracellular fluid, maintaining cellular function and fluid balance.