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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An adult is receiving gentamicin IV q8h. Which laboratory tests does the nurse expect that the client will have done regularly?
- A. CBC and hemoglobin
- B. BUN and serum creatinine
- C. SGOT and SGPT
- D. Urine and blood cultures
Correct Answer: B
Rationale: BUN and serum creatinine are tests of renal function. Gentamicin is nephrotoxic. All persons receiving gentamicin should have these tests done regularly to assess for toxicity.
The male client is self-medicating with the H-2 antagonist cimetidine (Tagamet). Which complication can occur while taking this medication?
- A. Melena.
- B. Gynecomastia.
- C. Pyrosis.
- D. Eructation.
Correct Answer: B
Rationale: Cimetidine can cause gynecomastia due to antiandrogen effects, especially in males. Melena, pyrosis, or eructation are unrelated.
The health care provider has written 'Morphine sulfate 2 mgs IV every 3-4 hours prn for pain' on the chart of a child weighing 22 lb. (10 kg). What is the nurse's initial action?
- A. Check with the pharmacist
- B. Hold the medication and contact the provider
- C. Administer the prescribed dose as ordered
- D. Give the dose every 6-8 hours
Correct Answer: B
Rationale: Hold the medication and contact the provider. The usual pediatric dose of morphine is 0.1 mg/kg every 3 to 4 hours. At 10 kg, this child typically should receive 1.0 mg every 3 to 4 hours.
The nurse is caring for a client who is receiving procainamide (Pronestyl) intravenously. It is important for the nurse to monitor which of the following parameters?
- A. Hourly urinary output
- B. Serum potassium levels
- C. Continuous EKG readings
- D. Neurological signs
Correct Answer: C
Rationale: Continuous EKG readings. Procainamide (Pronestyl) is used to suppress cardiac arrhythmias. When administered intravenously, it must be accompanied by continuous cardiac monitoring by ECG.
A nurse is to collect a sputum specimen for acid-fast bacillus (AFB) from a client. Which action should the nurse take first?
- A. Ask client to cough sputum into container
- B. Have the client take several deep breaths
- C. Provide an appropriate specimen container
- D. Assist with oral hygiene
Correct Answer: D
Rationale: Assist with oral hygiene. Obtain a specimen early in the morning after mouth care. The other responses follow this first action: the client should take several deep breaths then cough into the appropriate sterile container to obtain the AFB specimen of the sputum.