Nokea
The health care provider (HCP) places an order to administer gentamicin intravenously to a client with acute diverticulitis. It is important the nurse knows that intravenous gentamicin is administered:
- A. Over one minute via IV push
- B. Over two minutes via IV push
- C. As an IV infusion over 15-20 minutes
- D. As an IV infusion over 30 minutes to two hours
Correct Answer: D
Rationale: Gentamicin (D) is administered as an IV infusion over 30 minutes to two hours to ensure safe delivery and minimize toxicity risks like nephrotoxicity.
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The nurse is reviewing a client's medical record, and it is noted that they have a positive Murphy sign. The nurse recognizes that this sign is elicited in which abdominal quadrant?
- A. Area A
- B. Area B
- C. Area C
- D. Area D
Correct Answer: C
Rationale: Murphy's sign, elicited by pain on palpation of the right upper quadrant (Area C) during inspiration, is associated with cholecystitis.
The nurse observes a newly hired nurse care for a client with a colostomy. Which action by the newly hired nurse requires follow-up? Select all that apply.
- A. Empties the pouch when it is one-third to one-half full.
- B. Washes the surrounding skin with moisturizing soap.
- C. Indicates that the reddish appearance of the stoma as normal.
- D. Applies sterile gloves prior to changing the device.
- E. Applies isopropyl alcohol to the surrounding skin to promote adherence with the wafer.
Correct Answer: B,D,E
Rationale: Using moisturizing soap (B) can interfere with appliance adhesion, sterile gloves (D) are unnecessary as clean gloves suffice, and isopropyl alcohol (E) can irritate the skin. Emptying the pouch appropriately (A) and recognizing a normal stoma (C) are correct.
The nurse has instructed self-management strategies for a client diagnosed with gastroesophageal reflux disease (GERD). Which statement by the client would indicate a correct understanding of the teaching?
- A. It's much better for me to wear loose-fitting clothes right now.
- B. I stopped eating grilled chicken and now eat more ground hamburger.
- C. If I wake up with GERD symptoms, I should lower the head of my bed while sleeping.
- D. I should take my prescribed omeprazole after meals.
Correct Answer: A
Rationale: Loose-fitting clothes (A) reduce abdominal pressure, helping manage GERD. Hamburger (B) is high-fat and worsens reflux, lowering the bed (C) increases symptoms, and omeprazole (D) is taken before meals.
The nurse is caring for a client who has ascites and hepatic encephalopathy. Which of the following prescriptions should the nurse clarify with the primary healthcare provider (PHCP)?
- A. Alprazolam
- B. Rifaximin
- C. Lactulose
- D. Spironolactone
Correct Answer: A
Rationale: Alprazolam (A), a benzodiazepine, can worsen hepatic encephalopathy by increasing sedation and ammonia levels. Rifaximin (B), lactulose (C), and spironolactone (D) are appropriate for managing hepatic encephalopathy and ascites.
The nurse is caring for a client who recently had a partial gastrectomy. Which of the following medications should the nurse anticipate that the primary health care provider (PHCP) will order?
- A. Cyanocobalamin
- B. Metoclopramide
- C. Sucralfate
- D. Hydroxyzine
Correct Answer: A
Rationale: Cyanocobalamin (A) is anticipated post-gastrectomy to prevent vitamin B12 deficiency due to reduced intrinsic factor production.