Nokea
The client with type 2 diabetes is diagnosed with gout and prescribed allopurinol (Zyloprim). Which instruction should the nurse discuss when teaching about this medication?
- A. The client will probably develop a red rash on the body.
- B. The client should drink two (2) to three (3) liters of water a day.
- C. The client should take this medication on an empty stomach.
- D. The client will need to increase oral diabetic medications.
Correct Answer: B
Rationale: Allopurinol increases uric acid excretion, risking kidney stones; 2–3 L water daily prevents this. Rash is possible but not probable, stomach timing is flexible, and diabetes meds are unaffected.
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The nurse is hanging 1,000 mL of IV fluids to run for eight (8) hours. The intravenous tubing is a microdrip. How many gtt/min should the IV rate be set?
Correct Answer: 15
Rationale: Microdrip is 60 gtt/mL. Rate: (1,000 mL / 8 hr) x (60 gtt/mL / 60 min) = 125 mL/hr x 1 gtt/min = 15.625 gtt/min, rounded to 15 gtt/min.
A client is receiving dexamethasone (Decadron) therapy. What should the nurse plan to monitor in this client?
- A. Urine output every 4 hours
- B. Blood glucose levels every 12 hours
- C. Neurological signs every 2 hours
- D. Oxygen saturation every 8 hours
Correct Answer: B
Rationale: The drug Decadron increases gluconeogenesis. This may lead to hyperglycemia. Therefore the blood sugar level and acetone production must be monitored.
A nurse who has been named in a lawsuit can use which of these factors for the best protection in a court of law?
- A. Clinical specialty certification in the associated area of practice
- B. Documentation on the specific client record with a focus on the nursing process
- C. Yearly evaluations and proficiency reports prepared by nurse's manager
- D. Verification of provider's orders for the plan of care with identification of outcomes
Correct Answer: B
Rationale: Documentation is the key to protect nurses when a lawsuit is filed. The thorough documentation should include all steps of the nursing process - assessment, analysis, plan, intervention, evaluation.
A client confides in the RN that a friend has told her the medication she takes for depression, Wellbutrin, was taken off the market because it caused seizures. What is an appropriate response by the nurse?
- A. Ask your friend about the source of this information.'
- B. Omit the next doses until you talk with the doctor.'
- C. There were problems, but the recommended dose is changed.'
- D. Your health care provider knows the best drug for your condition.'
Correct Answer: C
Rationale: Wellbutrin was introduced in the U.S. in 1985 and then withdrawn because of the occurrence of seizures in some patients taking the drug. The drug was reintroduced in 1989 with specific recommendations regarding dose ranges to limit the occurrence of seizures. The risk of seizure appears to be strongly associated with dose.
The nurse is preparing to administer 37.5 mg of meperidine (Demerol) IM to a client who is having pain. The medication comes in a 50-mg/mL vial. Which action should the nurse implement?
- A. Notify the pharmacist to bring the correct vial.
- B. Have another nurse verify wastage of medication.
- C. Administer one (1) mL of medication to the client.
- D. Request the HCP to increase the client's dose.
Correct Answer: B
Rationale: Dose: 37.5 mg / 50 mg/mL = 0.75 mL. Wasting 0.25 mL requires verification by another nurse, per narcotic protocols.