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The healthcare provider is caring for a patient who is receiving an intravenous antibiotic. The patient has a serum drug trough of 1.5 mcg/mL. The normal trough for this drug is 1.7 mcg/mL to 2.2 mcg/mL. What will the healthcare provider expect the patient to experience?
- A. Inadequate drug effects
- B. Increased risk of superinfection
- C. Minimal adverse effects
- D. Slowed onset of action
Correct Answer: A
Rationale: A serum drug trough level below the normal range (1.7 mcg/mL to 2.2 mcg/mL) indicates that the medication concentration is insufficient to provide therapeutic effects, leading to inadequate drug effects. A low trough level does not directly correlate with an increased risk of superinfection, minimal adverse effects, or a slowed onset of action, as these are more related to the drug's concentration within the therapeutic range.
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A client in a physician's office has just made an appointment for an exercise stress test. The client should be instructed to:
- A. Wear sweatpants and a heavy sweatshirt
- B. Eat a small meal just before the procedure
- C. Wear comfortable rubber-soled shoes such as sneakers
- D. Avoid consuming caffeine for 30 minutes before the procedure
Correct Answer: C
Rationale: The client should wear comfortable rubber-soled shoes, such as sneakers, for the exercise stress test. This choice ensures safety and stability during the procedure. Wearing sweatpants and a heavy sweatshirt (Choice A) would not be appropriate as the client needs to wear light, loose, comfortable clothing. Eating a small meal just before the procedure (Choice B) could lead to discomfort during the test. Avoiding caffeine for 30 minutes before the procedure (Choice D) is not a specific instruction related to the attire or preparation for the test.
A client is unsure of the decision to undergo peritoneal dialysis (PD) and wishes to discuss the advantages of this treatment with the nurse. Which statements by the nurse are accurate regarding PD? (Select all that apply.)
- A. You will not need vascular access to perform PD.
- B. There is less restriction of protein and fluids.
- C. You have flexible scheduling for the exchanges.
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D, as all the statements are accurate advantages of peritoneal dialysis (PD). Peritoneal dialysis does not require vascular access, offers less restriction on protein and fluids, and provides flexibility in scheduling for the exchanges. Choice A is correct because one of the advantages of PD is not needing vascular access, which is required in hemodialysis. Choice B is correct because PD allows for less dietary restriction compared to hemodialysis. Choice C is correct because PD allows for flexible scheduling of exchanges, providing more independence to the individual undergoing treatment.
A client with a family history of polycystic kidney disease (PKD is being assessed by a nurse. For which clinical manifestations should the nurse assess? (Select all that apply.)
- A. Nocturia
- B. Flank pain
- C. Increased abdominal girth
- D. B & C
Correct Answer: D
Rationale: Clients with PKD commonly present with flank pain and increased abdominal girth due to abdominal distention caused by cysts. Bloody urine is also a common symptom due to tissue damage from PKD. Nocturia and dysuria are not typical manifestations of PKD. Constipation is not directly associated with PKD. Therefore, the correct choices are flank pain and increased abdominal girth, making option D the correct answer.
The nurse is preparing to administer the first dose of hydrochlorothiazide (HydroDIURIL) 50 mg to a patient who has a blood pressure of 160/95 mm Hg. The nurse notes that the patient had a urine output of 200 mL in the past 12 hours. The nurse will perform which action?
- A. Administer the medication as ordered.
- B. Encourage the patient to drink more fluids.
- C. Hold the medication and request an order for serum BUN and creatinine.
- D. Request an order for serum electrolytes and administer the medication.
Correct Answer: C
Rationale: The correct action is to hold the medication and request an order for serum BUN and creatinine. Thiazide diuretics, such as hydrochlorothiazide, are contraindicated in renal failure. In this case, the patient has oliguria, which is a reduced urine output, indicating potential renal insufficiency. Before administering the diuretic, it is crucial to evaluate the patient's renal function through serum BUN and creatinine levels. Encouraging the patient to drink more fluids (Choice B) may not address the underlying issue of renal function. Administering the medication as ordered (Choice A) without assessing renal function can be harmful. Requesting serum electrolytes and administering the medication (Choice D) overlooks the need for a specific evaluation of renal function in this scenario.
A client admitted from a nursing home after several recent falls needs a urine sample for culture and sensitivity. What should the nurse complete first?
- A. Obtain urine sample for culture and sensitivity.
- B. Administer intravenous antibiotics.
- C. Encourage protein intake and additional fluids.
- D. Consult physical therapy for gait training.
Correct Answer: A
Rationale: In this scenario, the priority intervention is to obtain a urine sample for culture and sensitivity. Older adults with recent falls may have atypical symptoms of urinary tract infection (UTI), which can present as new-onset confusion or falling. It is crucial to rule out UTI before initiating antibiotics. While administering antibiotics, encouraging protein intake, fluids, and consulting physical therapy are important interventions, they should follow the urine sample collection to ensure accurate diagnosis and appropriate treatment.